Once you’re eligible for Medicare, it’s important to know when and how to enroll. Below, I’ll explain when you need to manually enroll and when you’re automatically enrolled. Additionally, I’ll review the different ways you can sign up for Medicare.
Who Qualifies for Medicare?
There are two ways you qualify for Medicare:
Aging in at 65 years old
Collecting Social Security Disability Insurance (SSDI)
Once you’ve been collecting SSDI for 24 months, you’ll be automatically enrolled in Medicare.
How To Enroll In Medicare?
If you’re aging into Medicare at 65, you can sign up for Medicare up to three months before your birthday. Coverage will begin on the first day of your birth month. If you start collecting Social Security before you turn 65, you’ll automatically be enrolled in both Part A and Part B of Medicare, and the monthly premium for Part B will be deducted from your Social Security check.
If you’re disabled and collecting disability income, you’ll be automatically enrolled into both Part A and Part B on the 25th month of collecting. If you’ve been diagnosed with ALS or ESRD, you’ll be automatically enrolled as soon as you begin collecting SSDI. There is no 24-month waiting period.
Most beneficiaries opt to enroll in Part A since it’s premium-free. If you have another form of creditable coverage, like employer group insurance, you can opt to delay enrolling in Part B. Please note, if you do not have another form of creditable coverage and delay enrolling into Part B, you could face late-enrollment penalties in the future.
There are a few different enrollment periods for Medicare beneficiaries.
When Is Open Enrollment for Medicare?
The term “open enrollment” can be confusing for many new, as well as well-versed, Medicare beneficiaries. Different parts of Medicare have different enrollment periods. Let’s discuss the two enrollment periods specific to Part A and Part B.
Initial Enrollment Period
Your Initial Enrollment Period (IEP) for Medicare begins three months before your 65th birthday and ends three months after. This gives you a seven-month window to enroll in Part A and Part B. As stated above, if you’re collecting Social Security, you’ll automatically be enrolled in both parts. You’ll receive your Medicare card in the mail around the month of your birthday.
If you enroll before your birthday, your coverage will begin on the first of your birthday month. If your birthday falls on the first, your coverage will begin the first of the month before your birthday. If you enroll after your birthday, your coverage will begin the first of the month after your application has been processed.
General Enrollment Period
If you happen to miss your Initial Enrollment Period, the next time you can enroll in Part A and Part B is during the General Enrollment Period (GEP), which occurs annually between January 1 and March 31. The downside of enrolling during the GEP is your coverage will not become effective until July 1.
Medicare Special Enrollment Periods
Medicare also has Special Enrollment Periods (SEPs). There are a few scenarios, or changes in circumstance, where you can become eligible for a SEP. One is when you leave group employer coverage. Once you retire and leave your group plan, you’ll be eligible for an eight-month SEP to enroll in Part B.
Annual Enrollment Period
Most of the time when someone mentions the “Open Enrollment Period,” they are referring to the Annual Enrollment Period (AEP), which occurs annually between October 15 and December 7. This enrollment window is NOT to enroll in Part A and Part B. This window is ONLY for beneficiaries who are already enrolled in Part A and Part B. It gives them the opportunity to enroll, change, or disenroll from either Medicare Advantage and/or Part D.
How to Enroll in Medicare in 2023
There are three ways you can enroll in Part A and Part B:
Over the phone
At your local Social Security office
Technology has made enrolling in Medicare both quick and easy. All you have to do is create an account on the Social Security Administration website. The status of your application will be updated in your account dashboard.
Over the Phone
You can enroll over the phone by calling Social Security at 1-800-772-1213, Monday through Friday, between 7:00 a.m. and 7:00 p.m.
At Your Local Social Security Office
You can use the field office locator on SSA.gov to find your nearest Social Security office. Please keep in mind, due to the pandemic, many local Social Security offices are closed. It’s recommended to call ahead of time to confirm they are open.
Signing Up for Additional Parts of Medicare
Once you have Part A and Part B, you can then enroll in either a Medicare Advantage plan or Medigap plan to fill in the gaps in coverage.
Enrolling in Medicare Advantage
If you want to enroll in a Medicare Advantage plan, you can do so during your Initial Coverage Election Period (ICEP), which is the same as your Initial Enrollment Period for Part A and Part B. If you miss your ICEP, the next time to enroll in Medicare Advantage is during the AEP in October.
Enrolling in Part D Prescription Drug Coverage
You can also enroll in a Part D prescription drug plan during your IEP. If you miss this window, the next time you can enroll is during the AEP. The exception is if you qualify for a SEP due to a change in circumstance.
Enrolling in Medigap
If you want to enroll in Medigap, you can do so as soon as you know your Part B effective date. Your Part B effective date will trigger your one-time six-month enrollment period. During this enrollment window, you can enroll in a Medigap plan with guaranteed-issue rights. This means a carrier cannot deny you coverage due to any preexisting conditions.
If you miss your Medigap OEP, you can still enroll in a Medigap plan at any time of the year. You will just have to go through medical underwriting. There is no annual enrollment period for Medigap.
The exception to this one-time OEP is if you’re collecting SSDI. Those collecting SSDI will get two Medigap OEPs. The first one will begin when your Part B becomes effective on the 25th month of collecting SSDI. The second one will occur when you age into Medicare at 65.
To apply for Medicare, you will need the following documentation:
A copy of your birth certificate
A driver’s license or state ID
Proof of citizenship
Current health insurance information (if applicable)
If you enrolled in Part A only and are ready to enroll in Part B, you will need to complete form 40B. If you delayed enrolling due to having employer group coverage, you will need your employer to complete form L564 and submit it along with form 40B.
Once you submit your application, it can take up to 60 days to process.
Do You Have to Enroll in Medicare Every Year?
No, you do not need to enroll in Medicare every year.
When Does Medicare Start?
Your Medicare coverage will start the first of the month after your application is processed. If you’re automatically enrolled, it will begin the first of the month of your 65th birthday or first of the month on your 25th month of collecting SSDI.
How to Get a Replacement Medicare Card
You can get a replacement card by contacting your local Social Security office. You can also request a new one or print one from your SSA account dashboard at any time.
The most important takeaway is to make sure you apply during your IEP. If you miss this window of opportunity, you will have to wait until the GEP to enroll. If you enroll during the GEP, you’ll have to wait until July 1 for your coverage to become effective.
Additionally, be sure to read my helpful Medicare guides to learn more about your coverage and options:
Your Social Security is no longer taxed once you’ve reached full retirement age, which is between the ages of 65 and 67, depending on the year you were born. The exception is if you’re still working, in which case you may be subject to taxes.
No, it’s not mandatory to go on Medicare when you turn 65. Medicare is not mandatory at all. However, there are late-enrollment penalties if you delay enrolling without having another form of creditable coverage.
Those collecting Social Security will have their Part B premiums automatically deducted from their monthly check. The Part B premium does increase annually. The current Part B premium for 2023 is $164.90. The Part B premium amount for 2024 will be announced at the beginning of November.
As the Medicare expert for Medigap.com, Lindsay Malzone has ample experience helping seniors understand the ins and outs of their Medicare coverage and navigating the complex world of supplemental insurance. She has written for a variety of web publications based on her Medicare expertise. Ultimately, her passion lies in helping people find the right healthcare for their needs.