How to enroll in Original Medicare

The Social Security Administration automatically enrolls most people in Original Medicare when they request Social Security benefits, usually at age 65. You can enroll in Original Medicare up to three months before your 65th birthday. You don’t have to be retired or collecting Social Security benefits to enroll. Just know that if you are not collecting Social Security benefits, you will not be automatically enrolled in Medicare and will need to contact Social Security to do so.

If you or your spouse are still working and have health coverage through an employer or union you may want to consider postponing enrollment in Part B. This will allow you more flexibility in Medicare coverage at a later date and delay your Part B premium cost while you’re covered by your employer or union.

To find out more about how to enroll in Medicare, visit ssa.gov.

Initial Enrollment Period

The first time you are eligible to sign up for Medicare is called the Initial Enrollment Period (IEP). You are eligible to enroll in Medicare Part A, Part B, Part D drug plan or a Medicare Advantage plan (with or without drug coverage) during this time. The IEP begins 3 months before your 65th birthday month and ends 3 months after your 65th birthday month.

Your coverage will start no sooner than your birthday month. If your birthday falls on the first day of the month, your effective date may be the first day of the month prior to your birth month.

General Enrollment Period

If you miss signing up for Medicare Part A or Part B during your initial enrollment period, you will have another chance to enroll. You are allowed to enroll between January 1 and March 31 of each year. Your coverage will begin in July.

Note: You will be charged a 10 percent penalty for each year you delay enrolling in Part B. This charge may increase as Medicare premiums increase and will continue for as long as you are enrolled in Part B.

Medicare Cost plans

Most Medicare Cost plans have open enrollment year round. If you’re newly eligible for Medicare, you can enroll during the three months before your Part B becomes effective. You can also enroll at other times of the year without providing a health history. If you are locked into a Medicare Advantage plan, you cannot enroll in a Medicare Cost plan until you are allowed to disenroll from the Medicare Advantage plan.

Medigap (Medicare supplement) plans

You have a six-month Open Enrollment Period to enroll in a Medigap plan. It begins on the first day of the month your Medicare Part B coverage begins. If you enroll during this period, you don’t need to provide a health history to your health plan. If you enroll in a Medigap plan, you should not enroll in a Medicare Advantage or Cost plan. If you delay Medigap coverage, you may need to provide your health history and could be denied coverage.

Note: If you want to enroll in a Cost or Medigap plan and a stand-alone prescription drug plan, you must enroll in each plan separately.

Special Enrollment Periods

Medicare Part B

A Special Enrollment Period allows you to avoid the penalty for late enrollment. You may qualify for a Special Enrollment Period if:

• You delayed Part B because you or your spouse has medical coverage through a union or employer with more than 20 employees, or
• You cancelled Part B coverage because you went back to work and have group medical coverage

The Special Enrollment Period lasts eight months. It begins when your employer or union coverage ends or when your employment ends, whichever is first. Contact Social Security four months before you retire or when your employer or union coverage ends. Request a form that your employer will complete to begin your Special Enrollment Period. Then send the form with your Part B enrollment form to Social Security.

If you are age 65 and continue your employer coverage through COBRA, you should enroll in Medicare Part B. You will not get a Special Enrollment Period when COBRA ends. You must sign up for Part B during the first eight months of your COBRA coverage to avoid the late enrollment penalty.

Postponing Part B enrollment while you or your spouse are employed and covered by employer or union coverage will not result in a penalty.

Medicare Advantage and Part D

There are circumstances that may allow you to enroll in a prescription drug plan or Medicare Advantage plan after an Initial or Annual Election Period has ended.

Some common reasons you might qualify for a Special Enrollment Period include:

• You become eligible for financial help from Social Security or your state, or you lose eligibility for this help
• You move outside your plan’s service area
• Your plan’s government contract ends, or the plan goes out of business
• You lose prescription drug coverage from an employer or union, or your drug coverage is no longer as good as the standard Part D benefit

The time frame for a Special Enrollment Period can vary, but it typically begins on the first day of the month in which the qualifying event occurs and lasts for three months.

When will my Part A coverage begin?

Most people are enrolled automatically in Medicare Part A on the first day of the month they turn 65. If you don’t receive an enrollment notice from Social Security a few months before your 65th birthday, please call 1-800-772-1213, (Railroad Retirees call 1-800-808-0772), TTY users call 1-800-325-0778.

If you are disabled, there is a 24-month waiting period for Medicare after you become disabled. During this time, you may qualify for Medical Assistance, COBRA coverage or services from state programs.

When will my Part B coverage begin?

Your effective date will depend on the month you enrolled in Part B during IEP. Your coverage will start no sooner than your birthday month.

When will my Medicare Advantage (Part C) coverage begin?

Your effective date will depend on the month you enrolled in Medicare Advantage during your IEP. Your coverage will start no sooner than your Part B effective date and will generally be the first of the month after your enrollment.

When will my Part D coverage begin?

Your effective date will depend on the month you enrolled in Part D during IEP. Your coverage will start no sooner than your Medicare Part A effective date and will generally be the first of the month after your enrollment.

Note: You may be charged a one percent penalty per month for each month you delay enrolling in Part D. This charge may increase as Medicare Part D premiums increase and will continue for as long as you are enrolled in Part D.

When you can switch

For Medicare Advantage and Part D:
During the Annual Election Period from October 15 to December 7, you can enroll in or change stand-alone prescription drug plans and Medicare Advantage plans with and without prescription drug coverage. Your coverage will start January 1 of the following year.

Medicare Advantage Disenrollment Period:
The Medicare Advantage Disenrollment Period runs from January 1 through February 14. During this time you can disenroll from a Medicare Advantage plan (with or without drug coverage) and return to Original Medicare and a stand-alone prescription drug plan.