Summary: Signing up for Medicare doesn’t have to be a daunting task. Below, we’ll walk you through considerations you should make prior to enrolling, as well as the steps you need to take to sign up for Medicare coverage. We’ll also cover signing up for additional coverage such as Medicare Supplement plans. Estimated Read Time: 6 min
If you’re not automatically enrolled in Medicare once you become eligible, you must sign up through Social Security. If you’re like most Americans, you’ve seen Social Security and Medicare taxes come out of your paychecks for years. Yet, more than likely, no one ever taught you how to apply for Medicare when your time comes.
Fortunately, we are here to help you through the Medicare enrollment process. Signing up for Original Medicare through Social Security doesn’t take much time and is designed to be an easy process. For those wanting to supplement their Medicare coverage, signing up can take a little more effort and prep work.
Step 1: Do I Qualify for Medicare? Determine if You’re Eligible
Before signing up for Medicare, you will first need to determine if you’re eligible for the program. To qualify for Medicare, you must be a United States citizen or permanent legal resident for at least five years in addition to any of the following criteria:
- 65 years of age or older
- Receiving Social Security Disability Income (SSDI) for a minimum of 24 months
- Diagnosed with amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD)
If you already receive Social Security benefits through retirement or disability, you will be automatically enrolled in Medicare when you turn 65. In that case, you will not need to apply for Original Medicare, but you must sign up for any supplemental coverage you wish to enroll in.
Step 2: When Will You Apply? Consider Enrollment Periods
Just like employer group insurance, Medicare has specific enrollment periods in which you can apply for coverage. If you do not sign up for Medicare during an enrollment period, you will have to wait until the next one to sign up. Knowing when to sign up for Medicare can help you avoid gaps in your healthcare coverage.
Your first opportunity to sign up for Medicare is during your Initial Enrollment Period. This period typically only occurs once and will be different for each person. The Initial Enrollment Period is a seven-month period that starts three months before your qualifying event, includes the month of your event, and lasts three months after. Your qualifying event is whatever event causes you to be eligible for Medicare, such as turning 65.
Signing up for Medicare when you first become eligible is the easiest way to ensure you don’t face late enrollment penalties. You can also sign up for additional coverage, such as a Medicare Part D Prescription Drug plan, Medicare Advantage plan, or Medicare Supplement Plan during your Initial Enrollment Period.
If you do not sign up for Original Medicare during your Initial Enrollment Period, you will have to wait for the General Enrollment Period to enroll. This period runs from January 1 to March 31 every year. Depending on your circumstances, this could mean going months without health coverage and facing late enrollment penalties.
Step 3: How to Sign Up for Original Medicare
When most people talk about Medicare, they are referring to Original Medicare. Original Medicare consists of Medicare Part A and Part B and is provided by the federal government.
Medicare Part A is inpatient (hospital) insurance with a $0 premium for people who paid Medicare taxes for at least 40 working quarters. Medicare Part B is outpatient insurance you use at the doctor’s office. You’ll pay a monthly premium for Part B, subject to adjustment depending on your income.
You’ll need to go through Social Security to apply for Original Medicare. There are three options for signing up: online, over the phone, and in person.
- Online: The Social Security Administration’s website, SSA.gov, offers an online option to sign up for Medicare. You’ll need a My SSA account, which you can use later to check on the status of your application.
- Over the Phone: Call the Social Security Administration toll-free at 1-800-772-1213 to sign up for Medicare via telephone.
- In-person: Some people prefer face-to-face interaction when signing up for Medicare. If this approach appeals most to you, you can enroll in person at your local Social Security office. Visit SSA.gov to locate an office near you.
Medicare Part A covers inpatient hospital care. It also covers skilled nursing facility services. Learn how to apply for Part A.
Medicare Part B covers outpatient services. Coverage includes doctor visits, medically necessary services, and preventive care.
When you sign up for Original Medicare, you will be given the choice of signing up for Medicare Part A, Medicare Part B, or both. If you don’t have other health coverage, you should sign up for both parts of Medicare when you first become eligible to prevent late enrollment penalties and ensure coverage.
If you’re still enrolled in coverage through your employer, you might consider only signing up for Medicare Part A and delaying your Part B until you retire. If your group coverage is considered creditable, you will receive a Special Enrollment Period for your Medicare Part B coverage and will not deal with a penalty.
Though not common, if you do not qualify for a $0 premium for Medicare Part A but would like to enroll in Medicare Part B, you may do so. You do not have to sign up for Medicare Part A to get Medicare Part B. However, since Medicare Part B does not provide inpatient coverage, you will need to pay those costs out-of-pocket.
Step 4: How to Sign Up for Additional Coverage for Medicare
Once you sign up for Medicare, you can sign up for additional coverage through a Medicare Advantage plan, a Medicare Part D Prescription Drug plan, or a Medicare Supplement plan. Since private insurance companies offer these plans, you will need to sign up through the provider. There are a few things you should keep in mind:
For Medicare Advantage plans, you must be enrolled in both parts of Original Medicare to sign up for a plan. It’s best to sign up for a Medicare Advantage plan during your Initial Enrollment Period; however, if you do not, you can sign up for one during the Annual Enrollment Period (October 15th – December 7th).
To sign up for a Medicare Part D plan, you are only required to have one part of Original Medicare. You’ll typically want to sign up for Medicare Part D as soon as you become eligible unless you have drug coverage through your job-based health plan. Delaying Medicare Part D without creditable drug coverage can result in a late enrollment penalty.
Medicare Part C plans, or Medicare Advantage (MA) plans, provide inpatient and outpatient coverage and may provide additional coverage.
Medicare Part D Prescription Drug plans help pay the costs of prescription drugs. These plans are available as stand-alone or as part of an MA plan.
If you wish to sign up for a Medicare Supplement (Medigap) plan, you must have both Medicare Part A and Part B. Once you enroll in both parts of Medicare, you will receive a Medicare Supplement Open Enrollment Period. This six-month period begins the first month you have Medicare Part B. At this time, you can enroll in any Medigap plan that is available in your area without medical underwriting. This means a plan carrier cannot deny you coverage due to a pre-existing condition.
Before enrolling in any additional coverage, it’s essential to shop and compare plans in your area. Since private insurers offer these plans, costs, coverage, and availability will vary.
Have Questions About How to Sign Up for Medicare? We Can Help
Signing up for Medicare doesn’t have to be a daunting task. Making sure you sign up when you become eligible is essential for avoiding penalties and gaps in coverage. If you have questions about the enrollment process, give us a call. Our licensed agents are ready to answer any questions you may have about signing up for Medicare.
Sources:
How Medicare Works, Medicare. Accessed August 2023
https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/how-does-medicare-work
Sign Up for Medicare, Social Security. Accessed August 2023
https://www.ssa.gov/medicare/sign-up
Get Medigap Basics, Medicare. Accessed August 2023
