Most people are automatically enrolled in Medicare when they reach age 65. This is when your Social Security benefits start. If you live in the continental United States the Social Security Administration (SSA) kicks off your Medicare Part A hospital insurance and/or Medicare Part B medical insurance when you turn 65. For those U.S. citizens living in one of the U.S. territories, such as Guam or Puerto Rico, you will be automatically enrolled in Medicare Part A only.
If you are still working and have health insurance through your employer, Medicare Part B is optional. However, your health insurance must be “creditable”. Be sure to compare rates before refusing Part B, as it may be a better deal.
If you are not automatically enrolled by the SSA, depending on your situation, there are several enrollment periods. It’s important to note that there Medicare can charge you penalties for not signing up when you should.
How to Enroll in Medicare Part A
The Social Security Administration (SSA) enrolls most people in Medicare Part A automatically when they turn 65. However, if you choose to delay receiving your Social Security retirement benefits or Railroad Retirement Benefits (RRB) beyond age 65, it is your responsibility to initiate Medicare Part A enrollment when you decide to retire.
Here’s what you need to do. Contact the SSA or RRB three months before you turn 65 or retire. You can stop by your local SSA office, log on to the SSA website (http://www.ssa.gov/), or call them at 1-800-772-1213. The RRB toll-free number is 1-877-772-5772.
How to Enroll in Medicare Part B
If you declined Medicare Part B automatic enrollment because you have credible coverage, or if you were not automatically enrolled, there are several enrollment periods where you can enroll later. Your Initial Enrollment Period (IEP) is a seven-month period that begins three calendar months before you first become eligible for Medicare and lasts for three calendar months after your month of eligibility. For most of us, that means three months before our 65th birthday. If you become eligible due to a disability, your IEP starts on the 25th month after you first start collecting disability benefits from the SSA. If you have Lou Gehrig’s Disease, your enrollment into Medicare will be automatic. If you are diagnosed with End-Stage Renal Disease (kidney failure), you must call Medicare to start your Part B enrollment.
If you miss your IEP you can enroll during Medicare’s General Enrollment Period. General enrollment run from 1 January through 31 March each year. You can stop by your local SSA or RRB office or call their toll-free number.
If you lose your employer group insurance, or if you decide you want to switch from your employer’s coverage to Medicare, you can ask Medicare for a Special Enrollment Period. Your eight-month Special Enrollment Period begins when you decide you no longer want coverage under your employer’s group insurance plan or if you lose your coverage due to employment termination. If you lose employment coverage during your normal IEP, a Special Enrollment Period does not apply.
How to Enroll in Medicare Advantage (Part C)
Medicare Advantage is the private insurance alternative to Medicare Part A and Part B. The enrollment process varies slightly by the insurer, but in all cases, you must have Medicare Parts A and B in order to enroll. You can enroll in Medicare Part C during your IEP or during the Medicare Advantage Annual Election Period (AEP), starting 15 October and ending 7 December. The open enrollment dates are not affected by Obamacare.
During the AEP you can add, drop, or change your Medicare Advantage plan. During this period you may change your enrollment in any Medicare Advantage plan without any penalties.
If you enroll in a Medicare Advantage plan during the AEP, and then later change your mind, you can drop the plan and go back to Original Medicare (Parts A and B) during the Medicare Annual Disenrollment Period (MADP). This period starts 1 January and ends on 14 February. If you don’t dis-enroll during this time period, you must keep your plan for the rest of the year. The only exception is if you qualify for a Special Enrollment.
How to Enroll in a Medicare Part D Plan
As soon as you are eligible for Medicare benefits you must have creditable prescription drug coverage. If you don’t have coverage as soon as you are Medicare eligible, and then later need it, Medicare can charge you a late penalty. For most people, it’s best to get prescription coverage, even if they don’t need it at age 65.
There are three ways to get credible prescription drug coverage. You can get it as part of a Medicare Part C plan (Medicare Advantage), or through a Medicare Part D plan, or if available, you can get it through an employer group plan.
You can enroll in a Medicare Part D Plan during your Initial Enrollment Period (IEP) or during the Annual Election Period (AEP). Also, if you drop a Medicare Advantage plan and return to Original Medicare during the Medicare Annual Disenrollment Period you can join a Part D Plan at that time.
How to Enroll in a Medigap Plan
Medigap plans are completely voluntary and there are no specific enrollment periods. However, you must enroll when first eligible in order to preserve your guaranteed issue rights (e.g., no insurance underwriting process). You only have a guaranteed right to buy a Medigap insurance policy in the six months beginning with the first month your turn 65 and are enrolled in Medicare Part B. After that an insurer can refuse to sell you insurance.
Medicare supplemental insurance is not compatible with Medicare Part C, but it is compatible with Part D. You can buy a Medigap plan through a qualified Medigap insurance agent in your state. They will handle all of the paperwork and explain the insurance benefits. Use the tool below to shop rates in your area:
