You can apply for Medicare as soon as you’re eligible for Medicare, which is usually when you turn 65, but could be earlier if you have a qualifying disability. Enrolling in Part B on time will help you avoid the pitfalls of late enrollment penalties and delayed coverage. Read on for all the details of enrolling in Original Medicare Part B and your Medicare application.
When Are You Eligible for Medicare Part B?
Anyone who qualifies for premium-free Medicare Part A is eligible for Medicare Part B by enrolling and paying a monthly premium. In general, you are eligible for Medicare Part B if:
- You are age 65 or older and a U.S. citizen or permanent legal resident for at least five years in a row.
- You are already receiving retirement benefits or are eligible for benefits based on work credits.
- You are disabled and receiving disability benefits. Everyone who is eligible for Social Security Disability Insurance (SSDI) benefits is also eligible for Medicare after a 24-month qualifying period.
- You have end-stage renal disease (ESRD) or Lou Gehrig’s disease (ALS). For eligibility based on ESRD, you must meet two conditions:
- Medical—If you have severe kidney disease, you must be diagnosed with ESRD by your treating physician. Medicare defines ESRD as kidneys having permanently stopped functioning, and when your life is dependent on either long-term dialysis or a kidney transplant.
- Earned Work Credits—You, your spouse, or your parents (if you are a minor) must have earned a certain number of SSA work credits. Contact the SSA at (800) 772-1213 to learn if you have enough work history to qualify for ESRD Medicare.
For more information on eligibility, read Medicare Enrollment: Who, When, and How To Enroll.
Is Medicare Part B Enrollment Automatic?
You should be automatically enrolled in Original Medicare (Parts A and B) when you turn 65 if:
- You are receiving benefits from the SSA or Railroad Retirement Board (RRB) for at least four months before your 65th birthday.
- You are paying taxes and have a residential address within the U.S.
If you are not enrolled automatically in Part A and Part B, contact SSA or the RRB three months before you turn 65 to file a Medicare application — the earlier the better to confirm everything is in order.
Never assume you have enrolled automatically in Original Medicare. Under the following circumstances, you will not be enrolled automatically:
- You are living outside of the U.S. or its territories
- You are not yet receiving SSA or RRB benefits
- You have a post office box and not a residential address
- You are not paying U.S. taxes
When Can You Sign Up for Medicare Part B?
You can sign up for Medicare Part B as early as three months before you turn 65 or during a Part B Special Enrollment Period (SEP), or earlier if you qualify based on ESRD or ALS. You are automatically enrolled in Parts A and B 24 months after you qualify for Social Security Disability.
Medicare enrollment at age 65
If you qualify for Medicare, your seven-month Initial Enrollment Period (IEP) will run three months before turning 65, the month you turn 65, and three months after the month you turn 65.
The later you sign up during the IEP, the longer it takes to get coverage. If you fail to sign up during the three months before the month you turn 65, your Part B coverage may be delayed, as well as your Supplement, Part C Medicare Advantage (MA), or Part D Prescription Plans.
You may enroll anytime during your IEP with no penalties. See the IEP enrollment schedule and the coordination between the month you sign up and the time you begin receiving coverage:
|If you sign up:||Coverage starts:|
|Before the month you turn 65||The month you turn 65|
|The month you turn 65||The next month|
|1 month after you turn 65||2 months after you sign up|
|2 or 3 months after you turn 65||3 months after you sign up|
You can coordinate your Medicare Supplement, MA, or Part D Drug Plan to start on the same date as your Medicare A and B coverage. You must have both Parts A and B to enroll in Medicare Supplement or MA Plans.
If you don’t sign up for Part B during your IEP at 65, you can use one of these enrollment periods:
- SSDI at any age: Once you begin receiving benefits, there is a 24-month waiting period and Original Medicare automatically begins on the first of the 25th month.
- Special Enrollment Period (SEP): There are two SEPs for Part B enrollment. One is for those continuing to work who maintain creditable coverage, and the other is for people volunteering overseas for at least 12 months. For detailed information, read this Medicare article.
- General Enrollment Period (GEP): If you have delayed Part B coverage beyond your IEP and have no SEP, you can sign up yearly from Jan. 1 through March 31 with coverage beginning July 1.
How can you delay Medicare Part B?
You might want to delay Part B enrollment if you’ll be eligible for an SEP in the future or you will fall under the Income Related Monthly Adjustment Amounts (IRMAA). Calculate the benefits and weigh the options before delaying or dropping Part B coverage.
If you have a legitimate reason, there are four ways to conduct a delayed enrollment:
- Call SSA at 1(800) 722-1213. Medicare is managed by CMS, but enrollment is overseen by SSA.
- Go to SSA online to log on to an existing account or register a new one. You do not have to receive SSA benefits to enroll in Medicare.
- Visit your local SSA office, which can be found on the Field Office Locator page. Be sure to call in advance to schedule an appointment.
- If you are living outside of the U.S., call or visit your nearest U.S. Embassy or Consulate for enrollment forms. Read on for Foreign Country Service Information.
Can you sign up for Medicare Part B later if you don’t sign up for it initially?
Yes, you can sign up during the GEP between Jan. 1 and March 31 with coverage beginning July 1, or during the timeline specified by a qualifying SEP.
What Does Medicare Part B Cover?
Part B, often referred to as “medical insurance,” is part of Original Medicare. It covers medical services received from a doctor and supplies that are medically necessary to treat your health condition. This can include outpatient care, diagnostic and ambulance services, and durable medical equipment. Part B also covers preventive services, including certain vaccines, cancer screenings, rehabilitative services ordered by a doctor, and wellness visits.
Medicare Part B preventive services include a one-time “Welcome to Medicare” preventive visit; flu, pneumonia, and hepatitis B shots; cancer, cardiovascular, diabetes screenings, and more.
Learn More From Our Sources
- Medicare.gov | Special Circumstances (Special Enrollment Periods) | Last accessed August 2022
- SSA.gov | Sign IN /UP | Last accessed August 2022
- SSA.gov | Field Office Locator | Last accessed August 2022
- SSA.gov | Foreign Country Service Information | Last accessed August 2022
- Medicare.gov | Medicare & You | Last accessed August 2022