If you’re approaching retirement, you may ask yourself, “When does Medicare start?” This article will help you understand when your Medicare benefits will begin.
Initial Enrollment Period (IEP)
Everyone turning age 65, or getting Medicare benefits due to their Social Security disability status, gets an Initial Enrollment Period (IEP). How long it takes for Medicare to start depends on when you enroll in the program during your IEP.
If you sign up for Medicare Part A and Medicare Part B during the first three months of your IEP, Medicare coverage starts on the first day of your birthday month.
This means if you turn 65 years old on November 30, your start date is November 1.
If your birthday is on the first day of the month, benefits begin the first day of the prior month. For instance, if your birthday is on September 1, your coverage begins on August 1.
When is the initial Medicare enrollment period?
When you first become eligible for Medicare, you have a 7-month window, called the Initial Enrollment Period, to sign up for Medicare Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that: Begins 3 months before the month you turn 65.
General Enrollment Period
You can sign up for Part A any time during the initial enrollment period or afterward.
If you sign up within 6 months of your 65th birthday, Medicare starts the same time as if you signed up during the initial enrollment period (first day of your birthday month or the first day of the previous month if your birthday falls on the 1st.
When is the general enrollment period for Medicare?
The general enrollment period for Medicare is January 1 to March 31.
Enrolling in Medicare After Turning 65
Retirees who sign up for Medicare after turning 65 will have to wait a month or more for coverage to begin.
If you sign up for free Part A and/or Part B:
- The month you turn 65, you will receive Medicare a month after signing up.
- One month after turning 65, you will receive Medicare two months after signing up.
- Two months after turning 65, you will receive Medicare three months after signing up.
- Three months after turning 65, you will receive Medicare three months after signing up.
When to Choose a Medicare Advantage Plan (Part C)
You can enroll, switch, or cancel a Medicare health plan (Medicare Advantage Plan (Part C) during the following times:
- Initial Enrollment Period: March, April, or May
- Open Enrollment Period: October 15 – December 7
- Medicare Advantage Open Enrollment Period: January 1 – March 31
During the Medicare Advantage Open Enrollment Period, you can switch to another health insurance plan or go back to your Original Medicare health insurance. If you switch Medicare Advantage plans or go back to Original Medicare (with or without a Medicare drug plan), your new coverage will begin on the first day of the month after your new plan gets your request for coverage.
Keep in mind, if you go back to Original Medicare you may not be able to buy a Medicare Supplement policy. Once you cancel a Medigap plan, the insurer has the right to deny coverage based on preexisting conditions. You only have a guaranteed-issue right when you first qualify for Medicare.
When to Enroll in Medicare Part D
Medicare Part D (drug coverage) can be enrolled in three months before you turn 65 during the enrollment period. You can also enroll up to three months after you turn 65 years old.
Prescription Drug Coverage for the Disabled
If you are under 65 years old and receive Medicare due to a disability, you can enroll in Medicare Part D three months before the 25th month you receive Social Security or Railroad Retirement Board benefits. You can also enroll up to three months afterward.
Medicare Part D coverage will begin the first day of the 25th month you receive social security benefits.
In other words, you must receive 25 months of disability benefits from the social security administration or Railroad Retirement Board before you can receive Medicare Part D.
Annual Enrollment Period for Medicare Part D
Annual Enrollment Period (AEP) starts October 15 and ends December 7. Changes go into effect on January 1.
Changes you may want to make during the AEP are:
- Going from a Medicare Advantage Plan that offers drug coverage to one that does not offer it.
- Enroll in a Medicare Prescription Drug Plan.
- Switch to another Medicare Prescription Drug Plan.
- Disenroll from a Medicare prescription drug coverage plan.
Special Enrollment Period for Medicare Part D
A Special Enrollment Period (SEP) is available depending on eligibility:
- If you lived outside of the United States and recently moved back into the country.
- You have Medicare and Medicaid or Extra Help for your Medicare prescription coverage.
- The Extra Help assistance has been changed, so you need help with covering the costs of your prescription drugs.
- You’ve lost your prescription drug coverage.
- There’s been a change to your Medicaid benefits.
- There’s been a change to your employment situation or union.
- You joined a Pharmacy Assistance Program.
- You’ve moved outside of your service area.
- Your Medicare contract is ending or has ended.
- You’ve left the PACE program (Program of All-Inclusive Care for the Elderly).
- You are either moving into or moving out of a nursing facility or long-term care facility.
- You enrolled in the Medicare Advantage Plan.
- You want to choose a different Medicare plan.
- You’ve been affected by a weather-related emergency or major disaster.
- You have recently been released from prison.
- You received lawful presence status in the U.S.
Late Enrollment Penalty for Medicare Part D
The late enrollment penalty is an amount that is added to your Medicare drug coverage (Part D) monthly premium when you:
- Enroll in Medicare Part D after the Initial Enrollment Period.
- You don’t have Medicare drug coverage for 63 days or more.
- You do not have creditable prescription drug coverage for 63 or more days.
The late enrollment penalty is permanent and will have to be paid for as long as you receive Medicare drug coverage.
When Does Medicare Part D Start?
Medicare Part D plans begin the first month after you enroll on the first day of the month. If you sign up for Medicare Part D coverage on January 20, your coverage will begin on February 1.
Medicare Supplement Insurance (Medigap)
Medigap fills the gaps in Original Medicare to provide full coverage for those who need it. Original Medicare pays for a lot of health care services, but not all of them. The medical insurance provided by Medigap can help with the costs of:
- Health care services when traveling outside of the United States
When to Buy a Medigap Policy
You can purchase a Medigap policy during your six-month Medigap Open Enrollment Period. This period starts the month you turn 65 years old and have Medicare Part B. It’s possible to buy a Medigap policy after this time, but they are usually more expensive.
An Overview of When Medicare Starts
Medicare starts the first day of your birthday month unless your birth date falls on the 1st, it will then start the month before on the 1st. If you enroll in Medicare after your 65th birthday, you may need to wait up to three months for coverage to start depending on how long after your birthday you enroll in the program.
If you’re disabled, you may be eligible for Medicare when you receive your 25th payment from social security.
For additional information, visit the Medicare.gov website. TTY assistance is available.