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How to Enroll in Medicare in 5 Easy Steps

This step-by-step guide explains how to enroll in Medicare. If you’re turning 65 (or if you’re under 65 and qualify for Medicare benefits), you can apply for Medicare online, over the phone, or by visiting your local Social Security office.

September 29, 2017 - By Erica Block - read

Congrats! You’re eligible for Medicare and are ready to apply for coverage. Not sure what happens next? Below we explain how to enroll in Medicare and outline steps you will need to follow in order to begin receiving benefits.

Step 1: Learn About the Individual Parts of Medicare

Medicare is made up for four parts: Part A, Part B, Part C, and Part D. Before you actually apply for Medicare, it’s helpful to know about each part in order to determine what kind of health coverage you’ll need. For most Americans nearing the age of 65, signing up for Medicare Parts A and B (together known as “Original Medicare”) is an important first step in laying out their healthcare options.

Medicare Part A: Part A is provided by the federal government and covers most of the costs associated with hospitalization. This includes inpatient hospital care, stays in hospitals and skilled nursing facilities, and hospice care.

Medicare Part B: Part B is provided by the federal government and covers most of the costs associated with medical care. This includes doctors’ visits, preventive care and services, and any outpatient medical services.

Medicare Part C: Part C is also known as “Medicare Advantage,” and serves as a substitute for Medicare Parts A and B. Unlike Parts A and B, Part C is not provided by the federal government. Part C is an option for people who are interested in getting their Medicare coverage through a private insurer.

Medicare Part D: Part D provides prescription drug coverage for people who are already enrolled in Medicare Parts A and/or B. Unlike Parts A and B, Part D is not administered by the federal government; instead, you can get prescription drug coverage through federally-approved private insurers.

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Step 2: Determine If Your Original Medicare Coverage Will Start Automatically

Some people are enrolled automatically in Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) and other people have to sign up for it. In most cases, whether or not you’re enrolled automatically depends on whether you’re receiving Social Security benefits.

Depending on your situation, you may not even have to apply for Medicare – your coverage simply ‘kicks in’ once you reach the age of 65. Check to see which of these situations best describes your own:

  • You are currently collecting Social Security or Railroad Retirement Board (RRB) benefits. If you already receive Social Security benefits or benefits from the Railroad Retirement system, then you are automatically enrolled in Medicare Parts A and B on the first day of your birthday month when you turn 65 years old. Your Medicare ID card will be mailed to you three months before your 65th birthday.
  • You are not receiving Social Security or Railroad Retirement Board (RRB) benefits at the present time. If you aren’t receiving retirement benefits, you will need to sign up for Medicare Part A and/or Part B through Social Security or the Railroad Retirement Board.
  • You’re younger than 65 and have a disability. If you qualify for Medicare because you have a disability, you’ll be automatically enrolled in Medicare on the 25th month of receiving disability benefits.
  • You’ve been diagnosed with ALS (Amyotrophic Lateral Sclerosis, also known as Lou Gehrig’s disease) or End-Stage Renal Disease (ESRD). If you get Medicare because you have amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), you’ll be enrolled automatically in Medicare once you begin to receive disability benefits.

Step 3: Know When to Sign Up for Medicare Part A and/or B Coverage

If your Original Medicare coverage won’t start automatically, then it’s important to know precisely when and how to enroll in Medicare Parts A and B. At minimum, most seniors aged 65 and older can sign up for Medicare Part A. Enrollment in Medicare Part B is optional, but if you don’t sign up for Part B when you are first eligible, Part B coverage may cost more if you decide to sign up at a later date.

How to Enroll in Medicare during your Initial Enrollment Period (signing up ASAP): Your Initial Enrollment Period will last for seven months. This Initial Enrollment Period begins three months before the month of your 65th birthday, and ends three months after your birthday month. If you fail to enroll before your birthday month, your coverage will be delayed.

How to Enroll in Medicare during your General Enrollment Period (waiting to enroll, with a penalty): You’ll have to sign up during the General Enrollment Period – which falls between January 1 and March 30 every year – if you didn’t sign up during your Initial Enrollment Period. At this point, you’ll be charged a late enrollment penalty. Your premiums for Part B will be permanently increased by 10% for each year that you neglected to sign up for Part B and your monthly premiums for Part A will temporarily increase by 10 percent. Your coverage will start three months after the General Enrollment Period ends.

How to Enroll in Medicare during a Special Enrollment Period (waiting to enroll, without a penalty): If you have health insurance through your job, you can sign up for Medicare without incurring penalty during a Special Enrollment Period. This Special Enrollment Period will last for eight months after you leave your employer. It’s a good idea to sign up two months before leaving work, so that your Medicare coverage will be ready once your employer-sponsored healthcare ends.

Step 4: Apply for Medicare

You can apply for Medicare online or you can sign up by calling Social Security at 1-800-772-1213. Alternatively, you can enroll by visiting your local Social Security Office. If you don’t know where Social Security Offices are located, use the SSA office locator to find one nearby.

What Information/Documentation Do I Need to Complete My Medicare Application?

It’s helpful to have the following information on hand before you begin filling out your Medicare application forms:

  • Your Social Security claim number
  • Your current address and phone number

If you’re signing up during a Special Enrollment Period you will also need:

  • Request for Employment Information Form CMS-L564 (your employer fills this out)

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Step 5: Consider Your Additional Coverage Options

Once you’re enrolled in Medicare Parts A & B, you have three additional options to consider:

  • Medicare Part D: Add prescription drug coverage to your benefits by signing up for a Medicare Part D prescription drug plan.
  • Medicare Supplement: Enhance your Original Medicare coverage and patch gaps in coverage by enrolling in a Medicare Supplement (Medigap) plan.
  • Medicare Part C (“Medicare Advantage”): Alternatively, you can choose to get all your coverage in the form of a Medicare Advantage plan (also known as Medicare Part C), with or without prescription drug benefits.

How to Enroll in Medicare Part C (Medicare Advantage)

Medicare Advantage, also called Medicare Part C, is an alternative way to receive benefits provided by Medicare Parts A and B and is offered through private insurance companies. All Medicare Advantage plans are required to offer the same benefits as Medicare Part A and Part B do. Some Medicare Advantage plans also include additional benefits, such as prescription drug and dental or hearing coverage. You must be enrolled in Medicare Parts A and B to sign up for a Medicare Advantage plan through a private insurer.

When Can You Enroll in Medicare Part C / Medicare Advantage?

1. During Your Initial Enrollment Period (IEP)

You may enroll in a Medicare Advantage plan when you first become eligible for Medicare, during your seven-month Initial Enrollment Period.

2. During Medicare’s Annual Election Period

You can also add, drop, or switch to a different Medicare Advantage (Part C) plan during Medicare’s Annual Election Period, which runs from October 15 through December 7 of each year. During this period, you may:

  • Switch from Original Medicare (Parts A and B) to a Medicare Advantage plan, and vice versa;
  • Switch from one Medicare Advantage plan to a different one;
  • Switch from a Medicare Advantage plan without prescription drug coverage to a Medicare Advantage plan that includes prescription drug coverage, and vice versa.

How to Enroll in Medicare Part D

Medicare prescription drug coverage is optional and beneficiaries do not automatically receive it. You can receive coverage for prescription drugs by either signing up for a stand-alone Medicare Part D prescription drug plan (PDP), or by enrolling in a Medicare Advantage plan that includes prescription drug coverage.

Medicare prescription drug plans and Medicare Advantage plans are available through private insurers. Note: a person cannot be enrolled in both a stand-alone Medicare prescription drug plan and a Medicare Advantage plan that includes drug coverage.

Types of Medicare Part D Plans

There are two types of Part D prescription drug plans. Whether you’re enrolled in Medicare Advantage or enrolled in Original Medicare (Parts A and B) dictates the type of plan you may choose. If you have:

  • Original Medicare (Part A and Part B): Choose a stand-alone prescription drug plan (PDP) if you want to continue receiving your healthcare benefits through Original Medicare.
  • Medicare Advantage (such as an HMO or PPO): If you enroll in a Medicare Advantage Plan, you will choose a plan that includes Part D prescription drug coverage as part of your Medicare Advantage benefits package.

When You Can Enroll in Medicare Part D

1. During Your Initial Enrollment Period (IEP)

Medicare beneficiaries are first eligible to sign up for Medicare Part D coverage during their Initial Enrollment Period (IEP) for Part D, which occurs during the same seven-month period as their Initial Enrollment Period for Medicare Parts A and B.

2. During Medicare’s Annual Election Period

If you did not enroll in a Part D plan during your IEP, you have another chance to sign up for prescription drug coverage during the Part D Annual Election Period, which runs from October 15 through December 7. During AEP, you may:

  • Sign up for a Medicare Part D prescription drug plan (PDP);
  • Join a Medicare Advantage plan that includes prescription drug coverage;
  • Switch from a Medicare Advantage plan that doesn’t include drug coverage to a Medicare Advantage plan that does (and vice versa).

Are There Other Times When I Can Sign Up for Medicare Part D?

Outside of the Part D Initial Enrollment Period and the Annual Election Period, the only time you can make changes to your prescription drug coverage without qualifying for a Special Election Period is during the Medicare Advantage Disenrollment Period (MADP). However, you can only do this if you are dropping your Medicare Advantage coverage in favor of switching back to Original Medicare. The Medicare Advantage Disenrollment Period runs from January 1 to February 14.

Medicare Part A and Part B do not include prescription drug coverage, and if you switch back to Original Medicare during the Medicare Advantage Disenrollment Period, you will have until February 14 to enroll in a stand-alone Medicare Part D prescription drug plan.

Delaying Medicare Part D Enrollment

Some people choose to delay their Medicare Part D enrollment if they don’t need prescription drug coverage just yet, or if they are still working and already have drug coverage through their employer-sponsored group plan.

How to Enroll in Medicare Supplement Plans

Medigap plans – also known as Medicare Supplement insurance plans – provide additional coverage for costs not covered by Medicare Parts A and B, such as copayments, deductibles, and medical care administered while traveling outside the United States. Unlike Original Medicare, which comes from the federal government, Medigap plans are sold by private insurers.

When Are You Eligible for Medicare Supplement Coverage?

Most people are eligible for Medigap coverage once they’ve turned 65 and are enrolled in Medicare Part A and Part B.

Can You Get Medigap If You’re Younger Than 65?

If you are younger than 65 and have Medicare, you may or may not be able to enroll in a Medicare Supplement plan; federal law doesn’t require states to offer Medigap coverage to beneficiaries under 65.

Some U.S. states do sell Medigap plans to beneficiaries who are younger than 65, provided that they have a disability or have been diagnosed with end-stage renal disease or amyotrophic lateral sclerosis (Lou Gehrig’s disease). If you’re under 65 and have Medicare, your ability to enroll in a Medigap policy will depend on where you live and whether your state offers Medigap coverage to beneficiaries younger than 65. This chart lists the states which offer Medigap coverage to people under age 65.

Can You Enroll in a Medigap Plan If You’re Enrolled in Medicare Advantage (Part C)?

Medigap and Medicare Advantage plans cannot work together. If you have a Medigap plan and enroll in a Medicare Advantage plan, you should cancel your Medigap policy, as the coverage it provides is superfluous and it will not provide you with additional benefits which aren’t already included in your Medicare Advantage plan coverage.

Conversely, if you’re enrolled in a Medicare Advantage plan, it is illegal for a private insurance company to sell you a Medigap plan.

When Can You Enroll in a Medicare Supplement Plan?

1. At Any Point Following Enrollment in Medicare Part B

Though eligible individuals can enroll in a Medicare Supplement plan at any time, the best time to enroll in a Medigap policy is when you first sign up for Medicare Part B. This is when you’ll have the greatest number of Medigap plan options available to you.

2. During your Medigap Open Enrollment Period

If you’re 65 or older, your Medigap Open Enrollment Period is a six-month span that begins on the first of the month following your enrollment in Medicare Part B. For example, if you turn 65 on April 15 and enroll in Medicare Part B on May 3, your Medigap Open Enrollment Period starts on June 1 – the 1st of the month when you’re both 65 (or older) and enrolled in Medicare Part B – and concludes on December 1.

During your 6-month Medigap OEP, insurance companies cannot deny or charge more to sell you coverage because of your medical history, or any pre-existing conditions you may have. If you have medical issues or disabilities, it’s especially important to enroll in Medigap during your OEP, when you are first eligible.

If you sign up for Medigap after your OEP has passed: After your 6-month Medigap Open Enrollment window has passed, you will be required to provide a detailed medical history and answers to a long list of health questions when you apply to buy a Medigap policy. In other words, you risk being denied coverage by waiting to sign up.

How to Enroll in a Medicare Supplement Plan: You can purchase a Medigap policy online, by mail, by phone, or in person from a licensed insurance agent. The prices will vary among different insurance companies.

Checklist: How to Enroll in Medicare Coverage

  1. Learn about the individual parts of Medicare in order to help you determine what kind of health coverage you’ll need.
  2. Determine if your Original Medicare coverage will start automatically; if not, you will need to sign up for it.
  3. Know when and how to enroll in Medicare Part A and/or B, especially if Original Medicare coverage won’t start automatically for you. It’s important to know precisely when you’re allowed to sign up for Medicare Parts A and B.
  4. Apply for Medicare, either by enrolling online, calling Social Security at 1-800-772-1213, or by visiting your local Social Security Office. Don’t forget to gather any information and/or documentation needed to complete your enrollment application.
  5. Consider your additional coverage options and decide if you would like to enroll in a Medicare Part D or Medicare Supplement plan. Also consider whether you want to enroll in Medicare Advantage to receive all of your benefits in one package, or if you’d prefer to retain your Original Medicare coverage.

Taking the Next Steps

If you’re nearing the age of 65, then it’s important you start considering your Medicare coverage.

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