Medicare has various parts, some of which you might receive automatically, and others you may manually sign up for. Find out when you can enroll in each one.
Enrolling in Original Medicare, Part A and Part B
U.S. citizens and legal permanent residents (residing in the U.S. for five continuous years) may be eligible to enroll in Original Medicare, Part A and Part B. Most people qualify for Medicare when they’re 65 or older, but you can also qualify at any age through disability, or by having either end-stage renal disease or amyotrophic lateral disease (also known as Lou Gehrig’s disease).
If you already receive Social Security Administration (SSA) benefits or Railroad Retirement Board (RRB) benefits, then you will be automatically enrolled in Part A and Part B the first day of the month that you turn 65 years old. Your Medicare card will be mailed to you about three months before your 65th birthday.
Keep in mind that many beneficiaries get Part A for free if they’ve worked the required time under Medicare-covered employment (10 years, or 40 quarters). However, if you’re already receiving retirement benefits, you’ll be automatically enrolled in Part B, which comes with a monthly premium. If you decide you don’t want Part B because you have to pay a premium for it, you have the option to opt out of it when you receive your “Welcome to Medicare” packet (which arrives with your Medicare card). Just follow the instructions in the packet and mail back your Medicare card. If you keep your Medicare card, you agree to keep Part B and pay monthly premiums for it.
If you’ve been receiving SSA or RRB disability benefits for at least two years, you’re automatically enrolled in Original Medicare, Part A and Part B, in the 25th month of disability benefits. You’re also automatically enrolled in Medicare if you have amyotrophic lateral sclerosis; in this case, your Medicare coverage would start the first month that your disability benefits start.
If you don’t receive Social Security or Railroad Retirement Board retirement or disability benefits, then you may need to manually enroll in Original Medicare, Part A and Part B. You’re first eligible to do so three months before your 65th birthday, during your Initial Enrollment Period (IEP). This period lasts for a total of seven months, including the three months before your birth month, month you turn 65, and the three months following it.
If you qualify for Medicare because you have end-stage renal disease, you don’t get Medicare coverage automatically and will need to sign up for it. Contact the SSA or RRB for more information (contact information below).
If you did not sign up for Medicare Part A and Part B during your Initial Enrollment Period, your next opportunity to do so will be during the General Enrollment Period, which runs from January 1 through March 31 each year. Your coverage begins on July 1, and you may have to pay a late-enrollment penalty for Part A and/or Part B, which comes in the form of a higher premium. If you don’t qualify for premium-free Part A and need to pay a monthly premium for this coverage, then you may owe a late-enrollment penalty later when you do enroll. The Part A late-enrollment penalty is a 10% higher premium for twice the number of years you could have had Part A and did not sign up for it.
Like the Part A premium, you may also have to pay a late-enrollment penalty for your Part B premium, which may also increase by 10% for each full 12-month period that you could have had Part B, but did not take it. Unlike Part A, you must continue paying this late-enrollment penalty for as long as you remain enrolled in Part B.
In some situations, you may delay Medicare enrollment and sign up later with a Special Enrollment Period (SEP). Some examples of qualifying situations include, but aren’t limited to, if you are currently working and covered by an employer-sponsored group plan. In this case, you’ll get an eight-month SEP to sign up for Medicare Part A and/or Part B once you stop working or that health coverage ends (whichever happens first). Keep in mind that certain types of coverage, such as COBRA or retiree coverage, don’t count as health coverage based on current employment and wouldn’t qualify you for an SEP. If you’re not sure if you’re eligible for an SEP, contact the SSA (or RRB) at the contact information below to clarify.
How to enroll in Medicare Part A and Part B
To sign up for Original Medicare, Part A and Part B, you can:
- Apply online via the Social Security Administration(SSA). If you’re not yet ready to retire, you have the option to apply for Medicare only.
- Visit your local SSA office.
- Contact the SSA by phone at 1-800-772-1213 (TTY users can call 1-800-325-0778). Social Security representatives are available Monday through Friday, from 7AM to 7PM.
If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772 (TTY users call 1-312-751-4701), Monday through Friday, from 9AM to 3:30 PM.
Enrolling in Medicare Supplement (Medigap) coverage
Medicare Supplement (Medigap) plans are offered through private insurance companies and may help pay for certain “gaps” in Original Medicare coverage, such as cost sharing (copayments, coinsurance, or deductibles), the first three pints of blood, and emergency health coverage when you’re traveling out of the country. If you’re enrolled in Original Medicare, you may enroll in a Medigap plan at any time during the year; unlike Original Medicare, there aren’t set enrollment periods to sign up or switch plans. Keep in mind that not every state offers Medicare Supplement insurance to beneficiaries under 65; check the rules in your state to see if these plans are available.
Although there aren’t annual enrollment periods for Medicare Supplement coverage, the optimal time to enroll in a Medigap plan is during your Medigap Open Enrollment Period (OEP). Your individual Medigap Open Enrollment Period is six months long and begins on the first day of the month that you are at least 65 years old and enrolled in Medicare Part B. Once this period is over, you can’t get it again.
During this period, you have a guaranteed-issue right to buy a Medigap policy. This means the insurance company may not subject you to medical underwriting (a review of your medical history and the potential risk level it represents to the insurance company). You also can’t be turned down for coverage because of pre-existing conditions or charged higher premiums because of your health status. Outside of your Medigap Open Enrollment Period, your enrollment application to a Medigap plan may be subject to medical underwriting. In this scenario, you may be denied coverage or charged more if you have health problems. You may have more difficulty finding a Medicare Supplement plan that will accept you.
Enrolling in Medicare Advantage (Medicare Part C) coverage
A Medicare Advantage plan provides your Original Medicare (Part A and Part B) coverage through a Medicare-contracted private insurance company, sometimes along with other benefits that the government program doesn’t cover (such as prescription drugs or routine vision or dental). You can sign up for a Medicare Advantage plan right after you’re enrolled in both Part A and Part B, during your Initial Coverage Election Period, which usually coincides with the same seven-month period as your Initial Enrollment Period (starting three months before you turn 65, including your birthday month, and ending three months later). Or, you can enroll in a plan during the Annual Election Period (AEP), which lasts from October 15 through December 7 each year. You can also use the AEP to switch plans if you’re already enrolled in a Medicare Advantage plan – or wish to disenroll from your current plan and return to Original Medicare.
If you enroll in a Medicare Advantage plan and then find that you prefer Original Medicare, Part A and Part B, to this coverage, you’ll have from January 1 through March 31 of each year to disenroll from your Medicare Advantage plan and return to Original Medicare. This is called the Medicare Advantage Open Enrollment Period. You can also use this period to enroll in a stand-alone Medicare Prescription Drug Plan for your prescription coverage, since Original Medicare prescription drug coverage is limited. You also can switch from one Medicare Advantage plan to another during this period.
Medicare Advantage plans allow for Special Election Periods (SEP) in certain qualifying situations. Some of the conditions that can qualify you for a Special Enrollment Period are (this is not an all-inclusive list):
- If you move to a new address that’s outside of your plan’s service area.
- If you suffer from certain chronic or disabling medical conditions and there’s a Medicare Advantage Special Needs Plan for people with your condition.
- If you are enrolled in the Extra Help program (which helps with prescription drug costs), or you qualify for this program.
- If you are enrolled in Medicaid – or if you lose your Medicaid eligibility.
During a Special Election Period, you may enroll in or disenroll from a Medicare Advantage plan. You can also use this period to switch plans or return back to Original Medicare.
Enrolling in Medicare Part D (prescription drug coverage)
Part D is the Medicare prescription drug benefit, which is available through a stand-alone Medicare Prescription Drug Plan that works alongside Original Medicare or as part of a Medicare Advantage Prescription Drug plan.
You’re first eligible for Part D once you’re enrolled in Part A and/or Part B and live in the service area of a Medicare plan that includes prescription drug coverage. You can sign up for Medicare prescription drug coverage during your Initial Enrollment Period for Part D, which typically takes place at the same time as your IEP for Part B (starting three months before your 65th birthday, including your birthday month, and ending three months later).
Like Medicare Advantage plans, beneficiaries can also enroll in Medicare prescription drug coverage during the Annual Election Period that runs from October 15 through December 7. During this period, Original Medicare beneficiaries can enroll in a stand-alone Medicare Prescription Drug plan for the first time, switch plans, or disenroll from their current plan. If you’d rather get your prescription drug benefits through Medicare Part C, you can use this period to enroll in a Medicare Advantage plan that includes prescription drug benefits (not all do), switch plans, or disenroll from your current plan and return to Original Medicare.
Similar to Medicare Advantage plans, you may be eligible to make changes to your Medicare prescription drug coverage outside of the regular periods if you qualify for a Special Election Period (SEP). Many of the same situations that may qualify you for a Special Election Period under Medicare Advantage also apply to Part D coverage (see the above section). Other situations that may qualify you for an SEP include if you weren’t correctly notified that you’d be losing creditable prescription drug coverage or if you’re either enrolled in or lose eligibility for a State Pharmaceutical Assistance Program.
Enrolling in Medicare plans
Unlike Original Medicare, Medicare plans (such as Medicare Advantage and Medicare Prescription Drug Plans) are available through Medicare-contracted private insurance companies. So, instead of enrolling in a plan through Social Security or the Railroad Retirement Board, you can get this coverage directly through the insurance company, by visiting Medicare.gov, or through a licensed insurance broker like eHealth.