There are several ways to enroll into Original Medicare
- Calling Social Security at 1-800-772-1213 (TTY users 1-800-325-0778)
- Enroll online www.SocialSecurity.gov
- Visit the Social Security office nearest you.
When you enroll into Medicare
Here are a few scenarios when a person qualifies for Medicare
Automatic Enrollment
- Receiving retirement benefits – When you sign up for retirement benefits and Medicare Part B at the same time, when you turn age 65 and you are collecting Social Security or Railroad Retirement Board retirement benefits, you will automatically be enrolled into Original Medicare.
- Receiving disability benefits – If you are collecting a certain type of disability benefit from Railroad Retirement Board or Social Security, you may be younger than 65 and automatically be enrolled into Medicare Part A and B after 24 months of collecting disability.Please Note:If you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), you may automatically be enrolled in Medicare Part A and Medicare Part B within the same month as the same month as your disability benefits start.
Opting Out of Medicare Part B
You may want to delay Medicare Part B if you are receiving health care coverage from your employer, or your spouse’s employer. Before you delay your Medicare Part B benefits, speak with your employer’s health care administrator and ensure you understand what the consequences are if you drop Medicare Part B and how your health care works with Medicare.
If your Medicare has started, contact Social Security for instructions on how to submit a request to cancel Medicare Part B. Typically, you will need to submit a signed document and your coverage will stop on the first day of the month when Social Security receives your document.
If your Medicare Part B has not yet started and you have your Medicare card, there are instructions that came with the card you may follow to send it back. If you choose to keep your Medicare card and Medicare Part B, then you will need to pay premiums.
Late-enrollment penalty for Medicare Part B
Note that if you want to avoid paying a late enrollment penalty for Medicare Part B, then sign up when you are first eligible. This penalty will last for as long as you have Medicare. If you wait to enroll, you could pay a 10% higher premium for every year that you were eligible for Part B, but didn’t enroll. This penalty may last for as long as your Medicare enrollment stands. You can apply for Medicare during several enrollment periods if you are not automatically enrolled.
There is one exception if you want to postpone your Medicare Part B enrollment without paying a late-enrollment penalty. This exception occurs if you receive health coverage by way of an employer health plan or your spouse’s employer plan. COBRA or retiree benefits are not considered as present employer health coverage.
Medicare Initial Enrollment Period
Medicare Part A enrollment is automatic for most people. Yet, there are various times where you will have to enroll manually in Medicare Part A and/or Part B during your Initial Enrollment Period (IEP). This time frame is a total of 7 months which begins 3 months before you turn 65, the month you turn 65, and ends 3 months after the month you turn 65.
Here are the some of the conditions where you would enroll during your IEP:
Are you not receiving retirement benefits currently?
If you’re almost going to turn 65 and not yet getting retirement benefits, then you can enroll for Medicare Part A and/or Part B during your IEP. There is an alternative to apply for retirement benefits at a later time and to sign up for only Medicare. This is if you want to postpone your Railroad Retirement Board or Social Security benefits after age 65.
What happens if you do not qualify for retirement benefits?
Then you will not automatically enroll into Original Medicare if you do not qualify for certain retirement benefits. These benefits are from the RRB or Social Security. But, you can use your Initial Enrollment Period to sign up for Part A and/or Part B coverage. How long you worked and paid Medicare taxes will determine the cost of your Part A premium (It could be premium-free). Yet, paying a Medicare Part B premium is mandatory.
Medicare General Enrollment Period
You can sign up for Original Medicare during the General Enrollment period if you did not sign up during your IEP. For Original Medicare, the general period is from January 1 - March 31 of every year. Late enrollment penalties for Medicare Part A and/or Part B are mandatory if you did not enroll when you were first eligible.
Medicare Special Enrollment Period
You can still enroll in a Medicare Special Enrollment Period (SEP) if you don’t want to enroll during your IEP under certain conditions. This happens if your employer or union covers your group medical insurance. If you happen to decide to switch from your group coverage to Medicare or if you lose your group insurance. Then you can enroll at any time your group plan still covers you or during a Special Enrollment Period.
When your group health coverage ends or your employment ends, then you will have an eight month special enrollment period right after. You normally will not have to pay a late enrollment penalty if you enroll during an SEP.
If you’re eligible for Medicare because you have ESRD, then the Special Enrollment Period will not apply. Retiree health coverage and COBRA do not count as present employer coverage so you will not qualify for a SEP with those coverages alone.
Medicare Advantage plan enrollment
Private insurance companies contracted by Medicare offer another way to receive Original Medicare benefits. Medicare Advantage, also called Medicare Part C plans is what these private insurance companies offer. These plans have to offer at least the same benefits as Original Medicare (Part A and Part B). They also may include extra benefits, like prescription drug coverage. If you want to sign up for a Medicare Advantage plan, you must have Original Medicare, Part A and B.
There are two periods in which you can enroll in a Medicare Advantage plan:
- The Initial Coverage Election Period
- The Annual Election Period
The Initial Coverage Election Period For the Medicare Advantage Plan:
The Initial Coverage Election Period will allow most people to enroll in a Medicare Advantage plan. This enrollment will take place at the same time as your Initial enrollment period, unless you postpone your Part B enrollment. This time frame will start 3 months before you get both Medicare Part A and Medicare Part B and ends under the following:
- The last day of your Medicare Part B IEP (Initial Enrollment Period).
- The last of the month before you have both Medicare Part And Part B.
If you’re eligible for Medicare because of your disability and you’re under 65. Then your Initial Enrollment Period will depend on when your disability benefits began.
The Annual Election Period for The Medicare Advantage Plan:
During the Annual Election Period, you can drop, change, or add to your Medicare Advantage plan. This time frame happens from October 15 — December 7 each year. Here’s what you can do during this period:
- Change from one Medicare Advantage plan to a different one.
- Change from a Medicare Advantage plan that does not have prescription drug coverage to A Medicare Advantage plan that does — vice versa.
- Change from Original Medicare to a Medicare Advantage plan — vice versa.
Open Enrollment Period For The Medicare Advantage Plan
This is a limited annual enrollment period which goes from January through March 31 of each year. Here’s what you can do during this time:
- If you have a Medicare Advantage plan you can change it to another Medicare Advantage plan.
- Go back to Original Medicare and disenroll from your Medicare Advantage plan.
The Open Enrollment Period cannot make most other coverage changes. But, if you want to drop your Medicare Advantage plan, you can use a stand-alone Medicare prescription drug plan during this period. That’s because Original Medicare does not include prescription drug coverage.
You will not be able to make changes to your Medicare Advantage plan outside the Annual Election Period and Open Enrollment Period. This stands true unless you are eligible for a Special Election Period.
Medicare prescription drug coverage
If you want Medicare prescription drug coverage, then you can enroll in a Medicare Advantage plan that includes drug coverage or a stand-alone Medicare prescription drug plan. Signing up is optional and there is no automatic enrollment. Private insurers offer Medicare Advantage plans and Medicare prescription drug plans. Please be aware that you can’t have both: A Medicare Advantage plan that includes drug coverage and a stand-alone Medicare prescription drug plan.
Medicare Part D Initial Enrollment Period:
If you want Part D, you can sign up for a stand-alone prescription drug plan during your Part D IEP. Here’s how you know if you qualify for prescription drug coverage:
- You have Medicare Part A coverage and/or Medicare Part B coverage.
- The health plan covers the service area you live in.
When will my Initial Enrollment Period for Part D happen? It will happen at the same time as your Medicare Part B IEP. (Three months before you qualify for Part B, includes the month you qualify, and ends three months later).
Here’s what you must do once you qualify for Medicare Part D:
- Enroll in a Medicare Advantage Prescription Drug plan.
- Enroll in a Medicare prescription drug plan.
- Or have a creditable prescription drug coverage (This coverage must pay at least as much as normal Medicare prescription drug coverage).
If a beneficiary already has creditable prescription drug coverage through an employer group plan, then they can choose to postpone enrollment for Medicare Part D.
Yet, you might have to pay a late-enrollment penalty if you do not sign up for Part D prescription drug coverage when you’re first eligible. This is if you sign up later without creditable prescription drug coverage for 63 plus straight days.
Medicare Part D Annual Election Period:
If you missed your IEP, you can enroll in prescription drug coverage during the AEP (Annual Election Period). This runs from October 15 — December 7 of each year.
Here’s what you can do during the AEP:
- Join a Medicare Advantage plan which will include prescription drug coverage.
- Drop a Medicare prescription drug plan.
- Enroll in a Medicare prescription drug plan.
- Change from a Medicare Advantage plan that does not cover prescription drugs to one that does and vice versa.
What is the Medicare Advantage Open Enrollment Period? It’s a period that goes from January 1 — March 31 of each year. It’s normally the only time you can make changes to your prescription drug coverage plan outside of the Part D IEP and the AEP. That is, unless you qualify for a Special Election Period.
Please be aware that Original Medicare (Part A and Part B) does not include drug coverage. If you decide to change to Original Medicare during the Medicare Advantage AEP, then you will have until March 31 to join a stand-alone Medicare prescription drug plan.
Medicare Supplement insurance plans enrollment
What are Medicare Supplement insurance (or Medigap) plans? They are extra coverage that supplements coverage for Original Medicare. The coverage is voluntary. You will have a Medigap Open Enrollment Period which is the best time to sign up for Medicare Supplement Insurance Plans. This is a 6-month period that starts on the first day of the month you turn 65 and have Medicare Part B coverage. If you postpone your enrollment for Medicare Part B for reasons like having group health coverage through employment. Then until you enroll in Part B coverage, your Medigap Open Enrollment Period will not start.
You will have a “guaranteed-issue right” during your Medigap Open Enrollment Period, to purchase any Medigap plan sold in the state you live in. So if you have any disabilities or pre-existing health conditions, insurance companies cannot reject you. Also, based on your health status, they can’t invoice you a higher premium. If you do not enroll during this OEP, then you may not join the plan you want. Also insurers can make you undergo medical underwriting. Plus, the amount you will pay can be more if you have disabilities or health problems.
Private Insurance offers Medigap plans, like Medicare Advantage plans. You can get them through brokers like Medicare Insurance Quotes Co.
If you have any more questions, connect with one of our licensed insurance agents to discuss a Medicare plan that’s right for you.