Ron Elledge is a seasoned Medicare consultant and author of “Medicare Made Easy.” As a Medicare expert, he regularly consults beneficiaries on Medicare rules, regulations, and strategies.
Caren Lampitoc is an educator and Medicare consultant for Medicare Risk Adjustments and has over 25 years of experience working in the field of Medicine as a surgical coder, educator and consultant.
Kelly Blackwell is a Certified Senior Advisor (CSA)®. She has been a healthcare professional for over 30 years, with experience working as a bedside nurse and as a Clinical Manager. She has a passion for educating, assisting and advising seniors throughout the healthcare process.
If you’re turning 65 or have a disability, you’re likely eligible for Medicare. Timing is critical when enrolling in Medicare, so you should understand when you’re eligible, when to enroll, and how to do it.
Find out if you’re eligible for Medicare and learn the steps you need to take to get enrolled.
Who Is Eligible for Medicare?
In general, you are eligible for Medicare if:
- You are age 65 or older and a U.S. citizen or permanent legal resident for at least five consecutive years.
- You are disabled and receiving disability benefits. Medicare is automatic after you have been on Social Security disability for 24 months.
- You are already receiving retirement benefits from Social Security or Railroad Retirement benefits.
- You were a state or local government employee after March 31, 1986, or a federal employee any time after December 31, 1982.
- You have end-stage renal disease (ESRD) or Lou Gehrig’s disease (ALS).
- You have been married to a qualified beneficiary for at least one year before applying.
- You are divorced from a qualified beneficiary whom you were married to for a minimum of 10 years, and you are single at the time of application.
- You are widowed by a qualified beneficiary to whom you were married for at least nine months before their death, and you are single at the time of application.
If you do not qualify under these requirements, you may be able to purchase Part A and enroll in Part B. Contact Social Security with any questions at ssa.gov or 1-800-772-1213.
When Should I Enroll?
Enrollment in Medicare is automatic if you’ve received Social Security or Railroad Retirement Board Benefits at least four months before you turn 65.
If you don’t qualify for automatic enrollment, you’ll need to fill out an application online or contact your local Social Security office.
You can enroll during an enrollment period:
- Initial enrollment: Your initial enrollment period is the seven months including and surrounding your 65th birthday.
- General enrollment: If you miss your initial enrollment period, you can use the general enrollment period, which runs January 1 to March 31. During this period, you can enroll in Original Medicare, Medicare Advantage, Medigap, or Part D.
- Open enrollment: From October 15 to December 7 annually, you can join, switch plans, or drop your coverage.
- Special enrollment periods: Stuck between enrollment periods? You may qualify for a special enrollment period. Special enrollment periods apply if you lose your coverage or have changes to your eligibility outside the regular enrollment periods.
When does Medicare coverage start?
Your Medicare coverage start date depends on when you enroll. Remember, during the IEP, you can enroll three months before you turn 65, the month you turn 65, and three months after you turn 65.
|When You Enroll||When Coverage Starts||Example: Turning 65 on May 10|
|The three months before you turn 65||The first day of the month you turn 65||May 1|
|The month you turn 65||The first day of the month after you turn 65||June 1|
|The month after you turn 65||Two months after you sign up||August 1|
|Two or three months after you turn 65||Three months after you sign up||October 1 (if you enroll in July)
November 1 (if you enroll in August)
How Do I Enroll In Medicare?
If you are not automatically enrolled in Part A and Part B, contact Social Security or the RRB during the three months before you turn 65. Although Medicare regulates the Medicare health insurance program, you must enroll through the Social Security Administration. According to Medicare, you can:
- Apply online (at Social Security) – This is the easiest and fastest way to sign up and get any financial help you may need. You’ll need to create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online.
- Call 1-800-772-1213. TTY users can call 1-800-325-0778.
- Contact your local Social Security office. You can speak with a local representative on the phone and may be able to schedule an in- person appointment if your situation is complicated.
- If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
If Social Security enrolls you over the phone, ask for the Medicare number assigned to you, the start dates for both A and B, and when you can expect your card in the mail. If you do not receive the card when promised, follow up on it. When you do receive your card, make sure your name is spelled correctly and verify that the Medicare number is the same. Also confirm the card shows the correct start dates for Parts A and B.
Keep track of your interactions with SSA representatives. Be sure to log the date, time, and the name of the person you talk with, and any pertinent information in the event a mistake is made in the processing of your enrollment.
Learn More From Our Sources
- CMS | Fact Sheet: Deciding Whether or Not to Enroll in Medicare Part A and B When You Turn 65 | Last accessed December 2021
- HHS | U.S. Department of Health and Human Services: Who is Eligible for Medicare? | Last accessed December 2021
- Medicare | How Original Medicare Works | Last accessed December 2021
- Medicare | Medicare Advantage Plans | Last accessed December 2021
- Medicare | What’s Medicare Supplement Insurance (Medigap)? | Last accessed December 2021
- Medicare | Ready to Sign up for Part A and Part B | Last accessed December 2021
- Medicare | Special Enrollment Periods (SEP) | Last accessed December 2021
- SSA | Medicare Benefits | Last accessed December 2021
- SSA | Find Your Local Social Security Office | Last accessed December 2021
Learn More About Medicare Enrollment
- Medicare Advantage Enrollment Periods | Last accessed January 2022
- Medicare Initial Enrollment Period | Last accessed January 2022
- Medicare Open Enrollment Guide | Last accessed January 2022
- Medicare Open Enrollment Survey | Last accessed January 2022
- Medicare Part D Enrollment | Last accessed January 2022
- The Medicare Annual Election Period (AEP) | Last accessed January 2022