When and how to apply for Medicare
Learn about Medicare enrollment periods and how to sign up for Medicare Parts A, B, C and D
You’re about to get Medicare! That’s great news because the program helps pay for your health care costs and brings peace of mind. But learning how Medicare works and how to apply can be overwhelming. You might have questions, like:
What does Medicare cover?
When can I sign up for Parts A and B?
What about signing up for the optional Parts C and D?
Or is a Medigap plan right for me?
Exactly how do I sign up for Medicare?
Do I have to sign up every year?
How will I know when I’m enrolled?
We’ll help you get answers to all your questions. Let’s take a look at all the steps to get you to the finish line.
Learn how Medicare works
Before you apply for Medicare, spend time learning about what Medicare covers and when you can sign up or change plans.
Get helpful information at these official sites:
- The Centers for Medicare & Medicaid Services (CMS) manages the Medicare program. You can get information at medicare.gov.
- The Social Security Administration works with CMS to enroll people in the Medicare program and administers Social Security benefits.
Medicare has two “parts”:
- Part A is hospital insurance. It covers inpatient hospital stays, home health care and skilled nursing facility care. Most people don’t have to pay a premium for Part A.
- Part B is medical insurance. It covers doctor visits, outpatient services, lab tests and screenings, and durable medical equipment. Part B has a monthly premium, based on income.
Medicare from the federal government, also called Original Medicare, covers Part A and Part B. It doesn’t cover all your health care costs, and it doesn’t include coverage for most outpatient prescription drugs (Part D). That’s where a private Medicare plan can help. For more on what these different parts of Medicare cover, check out this article.
When to apply for Medicare
People often ask, “Is it mandatory to sign up for Medicare at age 65?” Enrolling in Medicare is tricky if you don’t know when you’re eligible. There are certain times when you can sign up for Medicare or switch plans. If you don’t apply for Medicare at the right time, you may end up paying a late enrollment penalty when you sign up later.
Here are the general guidelines to sign up for Medicare.
- Most people apply for Medicare when they are going to turn age 65
- Or you may qualify at any age if you have a disability, Amyotrophic Lateral Sclerosis (ALS), or End Stage Renal Disease (ESRD)
It’s smart to sign up for Medicare Part A when you’re eligible. You can enroll in Medicare Part B at the same time as Part A. Or you can delay enrolling in Part B for a variety of reasons.
Usually people delay Part B if they have primary health insurance from their job or a spouse’s. Check with your human resources department to make sure the group or union plan meets the requirements to delay Part B enrollment. If so, once your coverage from an employer or union stops, you have eight months to sign up for Part B without any penalty.
Remember, if you don’t sign up for Medicare when you should, you could pay a late enrollment penalty. That penalty would be added to your monthly premium permanently. So it’s best to know the right time to sign up.
The key periods to apply for Medicare are: Initial Enrollment Period, General Enrollment Period, Annual Enrollment Period and Special Enrollment Period. Here’s how they work:
Medicare Initial Enrollment Period
Your first chance to enroll in Medicare is around age 65 when you have a seven-month window to apply. During the Medicare Initial Enrollment Period, you can enroll in Original Medicare Parts A and B. You can look at plans or sign up at any time during the three months before, the month of, and the three months after your 65th birthday. Need coverage the month you turn 65? Sign up in the three-month window before your birthday.
After you enroll in Parts A and/or B, you may be able to enroll in a Medicare Part C or Part D plan to get extra medical and prescription drug coverage. We’ll talk more about that below.
Medicare General Enrollment Period
If you don’t sign up for Medicare Part A and/or Part B when you’re eligible, you can apply for Medicare for the first time using the General Enrollment Period from Jan. 1 through March 31 every year. This enrollment period is only available to people who didn’t sign up during their Initial Enrollment Period and who aren’t eligible for a Special Enrollment Period (see below). Coverage would begin July 1. You may have to pay a higher premium for Part A and/or Part B due to late enrollment.
Medicare Annual Enrollment Period
Once you sign up for Original Medicare Part A and Part B, you have the coverage and don’t need to renew it. But every year you have an opportunity to sign up for Part C (Medicare Advantage plan) or add Part D (Medicare Prescription Drug Plan) to Original Medicare if you want more coverage. Private insurance companies offer Part C and Part D plans through contracts with the Medicare program. You can apply for these plans during the Medicare Annual Enrollment Period (also known as Medicare Annual Election Period or open enrollment). This happens every year from Oct. 15 through Dec. 7. Your new plan would be effective Jan. 1 of the following year.
Medicare Special Enrollment Periods
Situations come up throughout the year that give you the chance to sign up for or change your Medicare plan. These special times are outside of your Initial Enrollment Period or the Annual Enrollment Period.
There are several special cases that trigger a Special Enrollment Period. Visit medicare.gov to find out more. Here are some common situations:
- You move: Whether you move to a new address, a new county or state, or into a nursing home, you’ll be able to apply for a new Medicare plan.
- You want to switch to a 5-star Medicare plan: Every year, Medicare evaluates plans based on a 5-star rating system. Medicare considers these plans “excellent.” You can make the switch once to a 5-star plan anytime from Dec. 8 through Nov. 30 if one is available in your area.
- You lose your current coverage: This applies if you or your spouse will retire or change to a job that doesn’t offer coverage. It doesn’t apply if your insurance company cancels your coverage because you didn’t pay your monthly premiums.
- Your plan changes its contract with Medicare: Enrollment in a plan depends on the plan’s contract with Medicare, and for various reasons these contracts could change.
How to sign up for Medicare
- If you aren’t yet getting Social Security or Railroad Retirement benefits, you need to apply for Medicare.
- If you already get Social Security or Railroad Retirement benefits, the SSA or RRB will automatically sign you up for Medicare Part A and B so it’s effective the month of your 65th birthday.
How to apply for Medicare through Social Security
Apply online: The easiest way to complete the Medicare enrollment application is online at ssa.gov. It’s convenient to sign up from home. You can start and stop the application and save your information. After you submit your application, you’ll get a receipt to print and keep. You can also check the status of your application.
Apply in person: Visit your local Social Security office. You can find the nearest office with the Social Security office locator. They recommend that you make an appointment.
Apply by phone: Call Social Security at 800-772-1213 (TTY 800-325-0778).
How to apply for Medicare through the RRB
If you worked for the railroad, contact the RRB at 877-772-5772 (TTY 711) to apply for Medicare.
Can my spouse and I sign up for Medicare together?
As a married couple, you’ve probably done everything together for quite some time. So it makes sense that you’d like to find out if you and your spouse can sign up for Medicare together. Unfortunately, it’s not possible.
Medicare only offers plans for individuals. You can’t have a dependent or be one on a Medicare plan. You and your spouse are eligible based on your birthdates. Your seven-month Initial Enrollment Period may overlap with your spouse’s sign-up window. But you each need to sign up for Medicare individually and select your own plan.
Want more coverage than Original Medicare?
Parts A and B cover a portion of your health care costs. Many people choose to enroll in a private Medicare plan that offers more coverage. You’ll need to be eligible for and/or enrolled in Part A and Part B for these types of plans. So it’s best to have your Part A and Part B effective dates and your Medicare ID number when you’re ready to enroll.
You can apply for private Medicare plans that have medical only or Part D only coverage. There are also convenient plans that combine medical and Part D coverage. You’ll want to check which plans are available in the county where you live. Learn more about the different types of private Medicare plans in these articles:
Medicare Supplement (Medigap) is medical-only coverage.
Medicare Cost can be a medical-only plan or combined medical and Part D coverage.
Medicare Prescription Drug Plan (Part D) is a Part D drug plan only
You can sign up for Medicare Advantage, Medicare Cost or Medicare Prescription Drug plans during your Initial Enrollment Period, the Medicare Annual Enrollment Period or if you qualify for a Special Enrollment Period. You can apply for a Medigap plan during the six-month period that starts the month of your 65th birthday. During this period you have a guaranteed issue right, which means you don’t have to provide your health information.
You do not apply for a private Medicare plan through SSA or RRB. Here are some ways to apply for a private Medicare plan:
- Use the online Medicare Plan Finder
- Call 1-800-MEDICARE (1-800-633-4227 or TTY 1-877-486-2048). Talk to a counselor about the options and how to enroll, available 24 hours a day, seven days a week.
- Work directly with the Medicare plan you want, either at their website or by calling or meeting with a sales representative.
- Work with a licensed independent broker who represents different Medicare plans.
- Call the Minnesota Senior LinkAge Line. This is a free information and assistance service. Call 800-333-2433 (TTY 711).
What happens after you apply for Medicare?
CMS will review and process your application. They’ll contact you if they need more information.
When you’re approved for Medicare Part A and/or Part B, CMS will send you a welcome packet that includes the following:
- your confirmation letter
- your red, white and blue Medicare ID card
- a “Welcome to Medicare” booklet that walks you through decisions you may have to make with your Medicare coverage
- the Medicare & You handbook
If you’ve applied for a private Medicare plan such as a Medicare Advantage, Medicare Cost, Medigap or Medicare Prescription Drug Plan, when your enrollment is accepted you’ll get a separate confirmation letter and ID card.
Medicare helps pay for your health care costs, and that brings peace of mind. The program also wants you to stay healthy and covers a preventive visit with your doctor each year. So once you get Medicare Part B, schedule your initial “Welcome to Medicare” visit with your doctor. And each year you get an “Annual Wellness Visit” with your doctor. For more helpful tips about how to use Medicare the first year you have it, refer to this handy Medicare checklist.