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Medicare Basics

When to Enroll in Medicare

Medicare Enrollment Is not Automatic

Many people are surprised to learn that they are not automatically enrolled in Medicare Parts A and B. This is particularly true now that the retirement age (as per Social Security) is either 66 or 67. Previously, if you received Social Security benefits at age 65, you received your Medicare card around three months before your 65th birthday.

You need to sign up for Medicare if you:

  • Have end stage renal disease
  • Are within three months of your 65th birthday but do not receive Railroad Retirement Board or Social Security benefits
  • Are a resident of Puerto Rico and receive Railroad Retirement or Social Security benefits, in which case you receive Part A on your 65th birthday but must sign up for Part B

You can apply for Medicare online here. Assuming the information you enter matches Medicare’s records, you do not need to submit documentation, such as a birth certificate. However, if there are any discrepancies in your records or you were not born in the United States, you may need to apply in person or over the phone via the Social Security office.

Please note that, if you do need to apply for Medicare through Social Security, you typically need to schedule an appointment, which may take months. If you expect there are any discrepancies in your records, call your local Social Security office to make an appointment as soon as possible.

Medicare Enrollment Periods

Please make note of Medicare’s different enrollment periods. These allow you to complete your initial enrollment or make changes to your existing coverage.

Initial Enrollment Period (IEP)

Your Initial Enrollment Period begins three months before your birthday month and ends three months after your birth month, for a total of 7 months.

Medicare Advantage Enrollment Period

This is for beneficiaries who miss their IEP. It runs from January 1 through March 31 with coverage beginning July 1 of the year you enroll.

Special Enrollment Period (SEP)

You are eligible for a Special Enrollment Period if you wait to enroll in Medicare Part B because you currently have coverage through either their or their spouse’s employer. If you lose coverage, you have eight months to enroll in Part B without receiving a penalty.

Medicare Advantage (MA) and Prescription Drug Plan Enrollment Period

Also known as Open Enrollment, this runs from October 15 to December 7 and allows you to either switch to an MA plan or switch back to Original Medicare.