Before you sign up for Medicare, it is important to know if you qualify for coverage. To get coverage, you will need to meet the age requirements or have a specific health condition or disability. In some situations, you automatically get coverage once you meet the criteria, you do not need to apply for coverage on your own.
However, this is not always the case. If you are not signed up automatically, you are responsible for applying on your own. It is important that you learn all of the steps needed to apply for Medicare, as well as the application deadlines and open enrollment periods. Find out everything you need to know about Medicare applications so that you can get the coverage you need as soon as you qualify.
Discover Who Is Automatically Enrolled in Medicare
Some people are automatically signed up for Medicare, which means they do not need to fill out an application in order to start receiving coverage. The people who generally get automatic enrollment are:
- Nearing 65 years of age and already get Social Security benefits or benefits from the Railroad Retirement Board (RRB).
- Younger than 65 years of age but have a disability that qualifies for Social Security or RRB disability benefits.
- Getting Social Security disability because they have amyotrophic lateral sclerosis (ALS).
These beneficiaries will receive Medicare Part A and Part B (also known as Original Medicare) without having to apply on their own. But, even beneficiaries who are signed up automatically will need to make decisions about their coverage. For example, they may want to delay or opt-out of Part B coverage if they do not want to pay a premium, or they may want to add Part D coverage to get prescription drug insurance.
Other decisions include whether to elect for Medicare Advantage or Medicare Supplement options.
Medicare Advantage (also known as Medicare Part C) is an alternative to having Original Medicare (Parts A & B). Medicare Advantage plans are private insurance plans that are approved by Medicare. These plans must include all of the coverage of Medicare Parts A & B, and may include additional coverage.
Medicare Supplement Insurance is also known as Medigap. Those who have Medicare Parts A & B may choose to buy a Medicare Supplement insurance policy to fill any gaps in their A & B coverage. Medicare supplement insurance helps pay for any health care costs (copayments, deductibles or coinsurance) for services not covered by Parts A & B.
Note: If you live in Puerto Rico and fall into any of the categories mentioned before, you automatically get Part A coverage. After that, if you want this type of coverage you have to sign up for Part B on your own.
Learn How to Apply for Medicare
If you do not fall into one of the categories described before, then you will need to fill out a Medicare application on your own and meet the deadlines. You will need to apply for Medicare insurance on your own if you:
- Are nearing 65 years of age but do not get retirement benefits.
- Have end-stage renal disease (ESRD) and want to get Medicare coverage.
You can apply for Medicare online, in person at a Social Security office or over the phone by calling Social Security or the RRB. If you are signing up for Part B only, you can also fill out a paper application form just for this type of coverage.
Medicare’s Initial Enrollment Period
If you are not automatically signed up for Medicare, you have an Initial Enrollment Period in which you may apply. Your Initial Enrollment Period starts three months before the month that you first qualify for coverage. This period will last until three months after the month that you qualify. In other words, if you are not signed up automatically, you have a seven-month Initial Enrollment Period in which you can apply.
You may join any Medicare plan during your Initial Enrollment Period. Typically, applicants will enroll in Medicare Part A and Medicare Part B during this period, but you may also enroll in Part D or instead enroll in Medicare Advantage.
Other Medicare Enrollment Options and Timeframes
In addition to your Initial Enrollment Period, there are other times when you may enroll in different Parts of Medicare.
General Medicare Enrollment Period: If you do not sign up for Medicare Parts A and B during your Initial Enrollment Period, you may do so during the General Medicare Enrollment Period. This period occurs each year from Jan. 1-March 31. Coverage will begin on July 1.
Special Enrollment Period: Your Special Enrollment Period (SEP) will vary depending on certain circumstances. You may qualify for a Special Enrollment Period after certain life changes, such as moving to a new address or experiencing a change in your current coverage, among other reasons. You may be able to switch plans or join a new one. Your new coverage will most likely begin the following month.
Open Enrollment Period: You may enroll in Medicare Advantage or Medicare Part D during the Open Enrollment Period. This period runs each year from Oct. 15-Dec. 7. During this Period, you may join a Medicare plan, drop a Medicare plan you are enrolled in or switch to a different Medicare plan. Your new coverage will begin on Jan. 1 the next year.
Medicare Advantage Open Enrollment Period: If you already have a Medicare Advantage Plan, the allows you to switch to a different Medicare Advantage Plan or switch to Parts A and B . This Period runs from Jan. 1-March 31 each year. Additionally, you will have a Medicare Advantage Open Enrollment Period in the first 3 months after you get Medicare. To qualify for this Period, you must already be enrolled in a Medicare Advantage Plan.
Although people generally sign up for Medicare Part A as soon as they are able to do so, some choose to delay. If you postpone your Part B insurance, you should keep in mind that there is a late enrollment penalty that could affect the cost of your premiums for the rest of your life. If you wait to start your Part B insurance, you could also have a gap in your coverage. It is your decision to apply for Part A and B at the same time or wait, but make sure you know what that means for you.
Download our helpful Medicare guide and get more information on Medicare Parts A and B by
Should you apply for Medicare every year?
Once you apply for Medicare, you do not need to turn in a new application every year to keep your coverage. But you do have the option to change your coverage if you want to add or drop any part of your insurance. For example, if your needs change in the future you can switch from Original Medicare to a Part C (Medicare Advantage) plan. You can also add or drop Part D in the future if you want to.
If you want to change your coverage, Medicare applications can only be turned in during specific times of the year. For example, you can apply for Medicare Advantage during the general enrollment period. There is an additional period between October and December.
There are limitations to what you can do during these periods. Some specific changes can only be made once a year and are not available during both periods. If you want to change your coverage, make sure you know the kind of changes you can do during each period.
To learn more about when to apply for Medicare, download our informative guide for free.
