How to Apply for Medicare

There are a few options when it’s time to apply for Medicare. Enrollment in Medicare may be automatic for some people. For others, it depends on when the individual becomes eligible to enroll in Medicare.

How to Apply for Medicare

If you’re Medicare-eligible, you may enroll in Medicare Parts A and B in these ways:

• Visit www.SocialSecurity.gov
• Call Social Security at 1-800-772-1213 Monday – Friday from 7:00AM to 7:00PM. TTY users should call 1-800-325-0778.
• Go to a local Social Security field office. Request an application or, if you need help, ask for assistance.
• If you were employed by a railroad, contact the Railroad Retirement Board to enroll in Medicare at 1-877-772-5772. TTY users should call 1-312-751-4701 Monday – Friday from 9:00 AM to 3:30 PM Central Standard Time.

When to Apply for Medicare

In some situations, enrollment in Medicare may automatically occur.

If you already receive retirement benefits, including Social Security or Railroad Retirement benefits at age 65,

your Medicare application is “automatic.” You’re enrolled in Medicare Parts A and B (hospital insurance plus medical insurance) when you sign up for Social Security or Railroad Retirement Board benefits.
If you don’t live in the 50 states or in the District of Columbia, e.g. if you’re a Puerto Rico resident, you’re automatically signed up for Medicare Part A. You must apply for Medicare Part B, however.

If you receive Social Security Disability benefits or Railroad Retirement Board disability,

there’s no need to apply for Medicare. In this scenario, you’re automatically signed up for Original Medicare (Part A and Part B) when you’ve received 24 months of disability benefits in most cases.:

• In some instances, qualifying for Social Security Disability means you ’re automatically enrolled in Medicare right away, e.g. when end-stage renal disease (ESRD) is present.
• If the recipient has ESRD, ALS (Lou Gehrig’s disease), needs kidney dialysis or receives a kidney transplant, he or she is Medicare-eligible when the disability benefits begin.

Although you will automatically get Medicare Part B, you don’t have to keep it. You may drop this coverage:

• If Medicare benefits haven’t started yet and you receive the Medicare card, follow the instructions in the envelope and return the card to CMS.
• If you don’t return the card to Medicare, you must pay premiums for Medicare Part B.
• Contact Social Security to drop the Part B coverage.
• If Medicare benefits have started, call Social Security to learn how to send your written request. Your coverage for Part B will end on the first day of the month after which Social Security receives the request.

You may elect to delay applying for Medicare Part B if you already have health insurance from an employer or from a spouse’s health plan.
If you don’t enroll in Medicare Part B at this time, you may be charged a late enrollment penalty:

• Your monthly premiums for Part B Medicare could be +10 percent/12-month period that you were Part B-eligible.
• This premium increase remains in effect as long as you have Medicare.

There’s an exception to the Part B late penalty. If you’re employed and receive health and medical insurance from the employer or from a spouse’s health and medical insurance, you won’t pay a penalty to delay your Part B enrollment. Note that the private health insurance must be received from yours or a spouse’s employment—not retiree or COBRA benefits.

Initial Enrollment Period for Medicare

For most people living in the United States, Medicare Part A enrollment occurs automatically. There are a few scenarios in which you might need to enroll in Parts A and/or B during the Initial Enrollment Period (IEP). The IEP is a seven-month period that starts three months before the beneficiary’s 65th birthday (including the month on which the birth occurs and ends three months later).
Scenarios in which you’d enroll in Medicare Parts A and/or B during IEP include:

• You haven’t received retirement benefits yet. If you’re close to your 65th birthday, it’s possible to apply for Medicare Parts A and/or B in the IEP.
• It’s possible to delay Railroad Retirement or Social Security retirement benefits past your 65th birthday (your Social Security Full Retirement Age may be older than age 65 and you have the option to delay taking Social Security benefits up to age 70). In this scenario, apply for Medicare and delay your request for retirement benefits.

You might not qualify for Railroad Retirement or Social Security retirement benefits. In that scenario, you aren’t automatically signed up for Medicare. It’s still possible to sign up for Parts A and/or B in the IEP:

• Medicare Part A might not be ‘premium-free’
• The cost of Part A premiums per month depends on how long you were employed and paid taxes into the Social Security/Medicare system.
• You must still pay Part B premiums.

General Enrollment Period for Medicare

If you don’t apply for Medicare during the IEP period (when first eligible), it’s possible to enroll in the Medicare General Enrollment Period:

• The General Enrollment Period occurs between January 1 – March 31.
• You may need to pay late enrollment penalties if you didn’t sign up when first eligible for Medicare.

Medicare Special Enrollment Period

If you receive group medical insurance from a union or employer when you’re first Medicare-eligible, you may decide against enrolling at that time.
However, if it makes sense to switch from group health and medical benefits from the group plan or you lose this coverage, it’s possible to sign up when you’re still enrolled in the group plan—or during a Medicare Special Enrollment Period (SEP):

• The eight-month SEP begins in the month employment ends (or when the group health and medical coverage ends)—whichever happens first.
• If you enroll in a SEP, you may not need to pay late enrollment penalties.
• The SEP doesn’t apply if you become Medicare-eligible because of ESRD.