How and When Are You Supposed to Enroll in Medicare?

Most people are enrolled in Medicare automatically when they reach age 65, but depending on how and when you become eligible, your process may be different.

Automatic enrollment

You’ll be automatically enrolled in Part A and Part B when you turn 65 if you signed up for Medicare when you signed up for your retirement benefits. You don’t need to do anything else to activate your coverage.

If you are receiving Social Security disability benefits, you’ll be automatically enrolled in Part A and Part B after your 24th month of benefits. There are exceptions for end-stage renal disease and amyotrophic lateral sclerosis (ALS): You’ll be enrolled in Part A and Part B the same month your disability benefits start.

Most people get premium-free Part A and keep the coverage regardless of other health insurance benefits. If you decide you don’t want Medicare Part B because you have coverage through an employer plan, for example, you can follow the instructions on your Part B card to delay coverage.

Manual Enrollment

If you aren’t receiving retirement benefits when you turn 65, you may need to manually enroll in Medicare. The initial enrollment period for Medicare benefits begins three months before the month you turn 65, includes your birthday month, and extends for three additional months.

At any point during this period, you can enroll in Medicare in one of three ways:

• Apply online at the Social Security website
• Apply by phone by calling 1-800-772-1213 (TTY users 1-800-325-0778) Monday through Friday from 7 am to 7 pm
• Apply in person at your local Social Security office

If you will get your retirement benefits through the Railroad Retirement Board, you need to contact the RRB to apply (1-877-772-5772, TTY users 1-312-751-4701).

Medicare Advantage Enrollment

You can enroll in a Medicare Advantage plan instead of Original Medicare during your initial enrollment period, or during the new Medicare Advantage Open Enrollment Period which runs from January 1 through March 31. Contact the plan directly for enrollment instructions.

Medicare Part D Enrollment

Part D is technically considered optional coverage, but you will pay a penalty if you don’t have creditable prescription drug coverage for more than 63 consecutive days. Your initial enrollment period for Part D coincides with the Medicare initial enrollment period.

You can get Part D coverage in one of two ways, by either enrolling in a stand-alone plan to complement Original Medicare, or as part of a Medicare Advantage plan with prescription drug coverage (MAPD).

Medicare Supplement Plans

There is generally only one period during which you have guaranteed issue rights to purchase any Medicare Supplement Plan available in your state regardless of your health status or pre-existing conditions. This is during your Medigap Open Enrollment Period, which begins on the first day of the month of your 65th birthday and lasts for six months.

If you apply for coverage outside your Open Enrollment period, you may have to pass medical underwriting; you may be turned down for a plan, or charged a much higher premium. There are only a few very limited instances outside the Open Enrollment period where guaranteed issue rights apply, so if you want a Medigap plan, you should buy one as soon as you are first eligible.

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