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Applying for Medicare is relatively simple. In fact, in certain instances — and for certain parts — you get automatically enrolled. Here’s how to apply for Medicare.
Medicare is the federal health insurance program for Americans 65 and over. It also covers younger Americans with certain disabilities. Applying for Medicare is relatively simple. In fact, in certain instances — and for certain parts — you get automatically enrolled. Here’s how to apply for Medicare.
You are eligible for Medicare when you turn 65, so long as you’re a U.S. citizen or permanent resident. You will get enrolled automatically in Original Medicare if:
Original Medicare is comprised of Medicare Part A (hospital insurance) and Medicare Part B (outpatient insurance). If you’re 65 and not yet receiving federal retirement benefits, you’ll need to enroll yourself. Once you have Original Medicare, you can opt to buy Medicare Part C, a private alternative to Medicare Part A and Medicare Part B, and/or Medicare Part D, which is prescription drug coverage.
If you aren’t eligible for automatic enrollment, you must sign up for Medicare through the Social Security Administration. You can do this in a few ways:
However, it’s probably easiest to enroll via the online application.
Medicare is run by the Centers for Medicare and Medicaid Services (CMS), but you apply online through the Social Security Administration’s website. Here’s how:
The online application is available:
The online Medicare application isn’t a particularly heavy lift. You’ll need to provide personal information, including your Social Security number, date and place of birth and information about your current employment and health insurance plan.
Once you submit your application, SSA will review it, contact you if it needs more information or documents, process your paperwork and mail your a decision letter.
You don’t need to re-apply for Medicare each year. You can review and change coverage each open enrollment period, which runs October 15 to December 7. Plan changeover is on January 1.
Newly eligible Medicare beneficiaries get an initial seven months to enroll for Medicare. It kicks off three months before you turn 65 and ends three months after your 65th birthday. Coverage begins July 1 of the year you sign up.
Beyond that, the application process varies, depending on what part of Medicare you are trying to apply for. Medicare has several enrollment periods. Each one takes place during the same time of year with plans going into effect on set days after the enrollment window closes. Here's an overview of the Medicare enrollment periods.
|Who can enroll?||When is it?||What can you do?||Coverage begins?|
|Initial enrollment||Newly eligible beneficiaries||3 months before 65th birthday to 3 months after||Enroll in Medicare||July 1 of that year|
|Annual election period||Current beneficiaries||Oct. 15 to Dec. 7||Change plans & drug coverage||Jan. 1|
|Medicare general enrollment||People who missed initial enrollment||Jan. 1 to March 31||Enroll in Medicare||July 1 of that year|
|Medicare Advantage disenrollment||Medicare Part C enrollees||Jan. 1 to Feb. 14||Drop Part C; enroll in A, B & D||Day 1 of the next month|
If you're shopping for a new plan during the 2019 annual election period, our partner Via Benefits can help you compare and buy Medicare plans in your area.
You can also apply for Medicare during a special enrollment period. You usually only qualify for one after a big life event, most notably the loss of health insurance from another source, like an employer.
Learn more about Medicare open enrollment.
If you qualify for premium-free Medicare Part A, you can apply any time after your initial enrollment period starts. You are eligible for premium-free Medicare Part A if you’re getting or are eligible for federal retirement benefits.
If you must pay for Medicare Part A, you can only apply during:
If you must pay for Part A and don't apply when you're first eligible, you’ll face a late enrollment penalty. Unless you meet the conditions for a special enrollment period, your monthly premium may go up 10%. You pay the that higher premium for twice the number of years you were eligible for Part A, but didn't enroll.
Learn more about Medicare Part A.
When you apply for Medicare, you’ll be asked if you want to enroll in Medicare Part B. You don’t have to because Medicare Part B requires all beneficiaries to pay a premium. Most people pay a $134 monthly Medicare Part B premium, but you can learn more about how Medicare costs work here).
Americans ages 65 or over who are still on a group health plan through a current employer or spouse’s employer might to forego that premium and put off applying for Medicare Part B. These people usually qualify for a special enrollment period once that coverage ends.
If you don’t enroll for Medicare Part B when you’re first eligible and won’t qualify for a special enrollment period down the line, you’ll face a late enrollment penalty.
Your monthly Part B premium will go up 10% for each full 12-months you were eligible, but didn’t apply. Plus, you may have to wait until Medicare’s general enrollment period to sign up.
Learn more about Medicare B.
Medicare Part C plans, more commonly known as Medicare Advantage plans, are offered by federally approved private insurers as alternatives to Original Medicare. Some beneficiaries opt for a Medicare Part C plan because they tend to cover more services, like vision, dental and even prescription drug coverage.
You don’t apply for Medicare Part C so much as you purchase a plan. You do have to enroll — and stayed enrolled — in Original Medicare in order to buy a Medicare Advantage Plan.
You can compare Medicare Advantage plans in your state on the Medicare website and purchase the one you want directly from the insurer during initial, open or special enrollment.
Learn more about Medicare Part C.
Medicare Part D plans, or PDPs, are also sold through government-approved private health insurance companies, but they only cover prescription drugs. Similar to Medicare Part C, you must enroll in Original Medicare to then buy Medicare Part D. Unlike Medicare Part C, you face a late enrollment penalty if you go 63 days or more without prescription drug coverage after your initial enrollment period ends. That’s largely related to the fact that Original Medicare doesn’t cover medication. You can bypass this penalty, though, if you have other creditable prescription drug coverage, including through a Medicare Part C plan.
The Medicare Part D late enrollment penalty is 1% of the national base beneficiary premium ($35.02 in 2018) times the number of months you could sign up, but didn’t.
You can also compare Medicare Part D plans in your state on the Medicare website and purchase the one you want directly from the insurer during initial, open or special enrollment.
Learn more about Medicare Part D.
Original Medicare beneficiaries can purchase Medicare supplement coverage, also known as a Medigap plan, to help pay for Medicare Part A and Medicare Part B out-of-pocket costs, like copays and deductibles. You can shop for a Medigap plan on the Medicare website and purchase one from the private insurer at any time. However, if you are shopping outside of your Medigap open enrollment period and don't have a guaranteed issue right, the insurer can turn you down or charge you a higher premium for pre-existing health conditions. Medigap open enrollment last six months, starting the month you turn 65 and enroll in Medicare Part B. Guaranteed issue rights are associated with losing old coverage, like health insurance through an employer.
Learn more about Medicare supplement insurance (Medigap).
Low-income Medicare beneficiaries are eligible for programs that help cover out-of-pocket costs. The Medicare Savings Programs provides premiums assistance for Medicare Part A and Medicare Part B. The programs are subsidized by the federal government, but administered through the state governments, so you have to apply for a Medicare Savings Program through your state's Medicaid office.
The Extra Help program provides financial assistance for prescription drug coverage. You can apply for Extra Help on the Social Security Administration’s Medicare benefits page.
Learn more about Medicare Extra Help.
Remember, Medicare is one of two government-sponsored health insurance programs for Americans. Medicare is primarily for Americans 65 and over, while Medicaid provides coverage for low-income, needy Americans. Low-income, elderly individuals might be eligible for both programs.
Medicaid eligibility varies by state, given each one jointly funds its program alongside the federal government. If you are eligible for Medicaid, you can apply all-year-round through Healthcare.gov or your state's Medicaid website.
Learn more about the differences between Medicare and Medicaid here.
Policygenius’ editorial content is not written by an insurance agent. It’s intended for informational purposes and should not be considered legal or financial advice. Consult a professional to learn what financial products are right for you.
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