Signing Up for Medicare

If you are approaching your 65^th birthday or have been receiving disability benefits from Social Security for almost 2 years, you’ll want to start thinking about enrolling in Medicare.  Medicare has been providing health care benefits for seniors and people with certain disabilities since 1965.  Today in this country, there are over 44 million people who depend on Medicare Part A for hospital insurance and Part B for medical insurance.

If you are close to 65 years old and are not sure whether you must enroll in Medicare yourself, or if you will be enrolled automatically, you could miss your enrollment period. It’s important to know when and how to sign up for your Medicare benefits.

Automatic Enrollment in Medicare

The Social Security Administration (SSA) and the Railroad Retirement Board (RRB) are responsible for enrolling beneficiaries in Medicare. If you are receiving Social Security or RRB benefits at the time you turn 65, the SSA or the RRB will automatically enroll you in Medicare Part A and Part B.

If you or your spouse has completed the requirements of working and paying Social Security taxes for at least 40 quarters (10 years), you are eligible for premium-free Part A when you turn 65 years of age. Medicare Part A is hospital insurance that covers inpatient hospital care, skilled nursing facility care, inpatient care in a skilled nursing facility (excluding custodial and long-term care), hospice care, and home health care. Part A has no premium for those who qualify, but you are responsible for an annual deductible and coinsurance.

Upon automatic enrollment in Part B, your Medicare options allow you to keep this Part B coverage or to opt-out if you prefer. If you keep your Part B coverage, you must pay your monthly premium. In 2020, the standard premium for Part B is $144.60.

Some people choose to opt-out of Part B because they already have medical insurance through an employer, a spouse’s benefit, or veterans’ benefits. CMS does require that this health insurance coverage meets the standard of Medicare coverage to be eligible for opting out without incurring a late enrollment penalty if you decide to sign up for Part B later.

You may opt-out of Part B medical coverage without affecting your Social Security status, but if you decide to enroll in Medicare Part B at a later time, you may be penalized by having to pay higher premiums on a permanent basis.

You may also be automatically enrolled in Medicare Parts A and B if you are younger than 65, but have a qualifying disability, end-stage renal disease, or ALS (Lou Gehrig’s disease). For most disabilities, if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, you will get Medicare in the 25^th month.

Medicare Automatic Enrollment

If you are receiving Social Security benefits when you turn 65, you will be automatically enrolled in Medicare by the SSA. It is not necessary to contact anyone unless you do not receive your Medicare packet in the mail by your birthday month. Three months prior to the commencement of your benefits, you will receive your Medicare card and “Welcome to Medicare” packet in the mail.

Who Needs to Enroll in Medicare?

For millions of Americans, the full retirement age is between 66 and 67 years old. They may not choose to receive retirement benefits from Social Security until they reach their full retirement age, but they are still eligible for Medicare benefits at age 65. People who are older than 65, or those who have not received Social Security or Railroad Retirement benefits, may need to enroll in Medicare Parts A and B on their own.

When is the Medicare Initial Enrollment Period?

If you are not receiving Social Security benefits when you turn 65, you will not be automatically enrolled in Medicare by the Social Security Administration. Therefore, you must enroll yourself during your initial enrollment period (IEP). This is a seven-month period that begins three months prior to your birth month. It includes your birth month and continues for the following three months after your birth month.

If you do not sign up for Medicare during your IEP, you will have the opportunity to enroll during Medicare’s General Enrollment Period which occurs every year beginning on January 1st and continues until March 31st.

Medicare Late Enrollment Penalties

You may avoid a late enrollment penalty if you, or your spouse, is employed and is receiving medical insurance coverage through a union or employer. In this case, you can enroll in Medicare Part B during a Special Enrollment Period (SEP). Keep in mind, COBRA and retiree benefits do not qualify as Medicare-standard benefits, so you should enroll in Medicare Part B during your IEP if you only have these benefits.

If you do not take advantage of your SEP and wait until the annual General Enrollment Period to sign up for Medicare Part B, you may incur the late enrollment penalty. This penalty is equivalent to 10 percent higher premiums for every month you were eligible and did not enroll in Medicare Part B.

You may be exempt from the late enrollment penalty if you are living or working as a volunteer outside the United States at the time your turn 65 (and are not receiving Social Security benefits). In this case, you will have a SEP when you return to the United States and be able to enroll in Medicare.

Signing Up for Medicare if Not Automatically Enrolled

You can enroll in Medicare Part A and Part B by doing one of the following:

• Visiting your local SSA office in person.

• Calling the official SSA phone number which is 800-772-1213.

• Mailing a letter that you have signed and dated to the SSA. The letter must include your full name, Social Security number, and the date you wish to be enrolled in Medicare Parts A and B.

• Applying online at the official site for the SSA at www.ssa.gov.

If you are eligible for Railroad Retirement benefits, you must contact the RRB or visit your local RRB office and get information on how to enroll in Medicare.

When you enroll in Medicare, be sure to ask for the names of people you speak to, use certified mail if you mail in your application, or ask for a written receipt from the SSA office if you go there in person to enroll.

Medicare Enrollment Options

When you qualify for Medicare, you can choose to get your benefits through Original Medicare, the federal program that administers your Part A and Part B coverage, or through a Medicare Advantage plan, also known as Part C.

Medicare Advantage plans are required to provide the same Part A and Part B benefits as Original Medicare, but most MA plans include additional benefits. These wide-ranging benefits vary between plans but can include vision and dental care, hearing exams, fitness programs, and prescription drug benefits.

When Can You Enroll in Medicare Advantage?

After you have enrolled in Original Medicare Parts A and B, you will be eligible to enroll in a Medicare Advantage (MA) plan from a private insurance provider. You can enroll in a Medicare Advantage plan during any of the following time periods:

• Your Initial Enrollment Period

• Special Enrollment Period

• General Enrollment Period runs from January 1 through March 31.

• Annual Enrollment Period (AEP) runs from October 15 through December 7 each year. During this period you can make changes to your Medicare coverage. You can switch from one Medicare Advantage plan to another Medicare Advantage plan, switch from Original Medicare to a Medicare Advantage plan, leave your Medicare Advantage plan and revert back to Original Medicare, and switch from one Part D Prescription Drug Plan to another Part D PDP.

If you have end-stage renal disease, you can enroll in a Medicare Advantage plan if it is a Special Needs Plan accepting people with ESRD. If you are already enrolled in a Medicare Advantage plan before being diagnosed with ESRD, you may keep our existing plan.

How Soon Do Medicare Benefits Begin After Signing Up?

If you are automatically enrolled in Medicare Parts A and B, your coverage begins on the first day of your birth month. If your birthday falls on the first of the month, your Medicare coverage begins on the first day of the month prior to your birth month.

If you are not automatically enrolled, your Medicare benefits starting date depends on the date you enroll. For example:

• By enrolling the month before your 65th birth month, coverage begins the 1st day of your birth month.

• By enrolling the month of your 65th birthday, coverage begins one month after, on the 1st of the month.

• By enrolling three months after your 65th birth month, coverage begins three months after you sign up.

If you enroll during the General Enrollment Period which runs between January 1 and March 31, your coverage begins on July 1 of the same year. If you enroll during a Special Enrollment Period, your coverage begins the first of the month after you enroll.

Signing up for Medicare healthcare benefits is not difficult, but it is important to enroll at the right time. If you are still unsure about when you should enroll, you can get more information from your local Social Security Administration office either by phoning or visiting in person or by checking online at the Social Security Administration’s official website.