Enrollment

How do I know if I qualify?

Generally, if you are 65 years old or older, you can get premium-free Part A coverage if you or your spouse paid at least 10 years of Medicare taxes. Part B coverage is optional and is offered to you when you become entitled to Part A coverage. Visit medicare.gov or check with your local Social Security office to see if you are eligible.

For most people, enrollment in Medicare Parts A and B is not automatic – you must sign up – and many do so before they turn age 65. You have several enrollment options:

Apply online via Social Security
Call Social Security
  • Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
  • If you worked for a railroad, call the RRB at 1-877-772-5772.
Visit your local Social Security office

When can I enroll?

Depending on your age, employment and career plans, there are a number of windows or periods when you can enroll, including:

Plans for parts A, B, C, and D
Initial Enrollment Period

When you first become eligible for Medicare, you have a seven-month Initial Enrollment Period. This seven-month window starts three months before your birthday month and runs until three months after your birthday month.

Plans for parts C & D
Annual Election Period

The Annual Election Period runs every year from October 15 through December 7. During this period, you can add, drop or switch Medicare Advantage and/or prescription drug plans. Any coverage added or changes made during AEP are effective January 1 of the following year.

Plans for parts A, B, C, and D
Special Enrollment Periods

If you or your spouse are still working and have coverage through your employer, you may have a chance to sign up for Medicare during a Special Enrollment Period when your employer coverage ends. The month after your employment (or employer coverage) ends, your SEP begins, and you’ll have eight months to sign up for Part A and/or Part B without having to pay a late enrollment penalty.

Plans for Parts A & B
General Enrollment Period

If you don’t sign up when you are first eligible for Medicare, and you aren’t eligible for a Special Enrollment Period, you can enroll in Part A and/or Part B during the General Enrollment Period between January 1 and March 31 each year. Your coverage will begin July 1 of the same year and may include higher premiums for Part A and/or Part B coverage.

Plans for Medigap
Medigap Open Enrollment Period

This six-month window begins the month you turn 65 and enroll in Medicare Part B. You can apply for a Medicare supplement plan after this period, but if you do not have a Special Enrollment Period, you will be subject to medical underwriting.


What if I wait to enroll in Medicare?

In most cases, if you don’t sign up for Medicare benefits when you are first eligible, you will have to pay a late enrollment penalty for as long as you have Part B. You may also have to wait for the next General Enrollment Period to sign up for Part B. (Usually, if you sign up during a Special Enrollment Period, you won’t have to pay a late enrollment penalty.)

If you don’t enroll in a Part D prescription drug plan when you first become eligible, or if you have a break in coverage of at least 63 consecutive days, Medicare may add a late enrollment penalty to your Part D plan premium.


What if I turn 65, but plan to keep working?

If you have coverage through your employer and plan to work past age 65, ask your human resources administrator if you are required to sign up for Medicare right away. If you are not required to enroll upon turning 65, you can sign up for Medicare whenever your employer health coverage ends during a Special Enrollment Period. (If you plan to keep working past age 65, let us know.)


Individual/Family coverage

If you have individual or family (non-employer sponsored) coverage from a plan you purchased before the Affordable Care Act, you should drop this plan and sign up for Medicare during your Initial Enrollment Period.

If your coverage is provided through the Health Insurance Marketplace, any premium tax credits for your Marketplace plan will go away once you turn 65. (You may also have to pay back any credits received after Medicare coverage begins.)

In either scenario, if you sign up for Medicare when you first become eligible, you will avoid any penalties and possible gaps in coverage.

Employer/Union coverage

If you have coverage through your employer, you will qualify for a Special Enrollment Period when you stop working and your group health coverage ends. You will have an eight-month SEP to enroll in Medicare Parts A and/or B. If you’d like to enroll in a Medicare Part C or D plan, your SEP will last two months after your employer coverage ends.

Note: According to the federal government, COBRA and retiree health plans are not considered coverage based on current employment and do not qualify you for an SEP.

 

Additional special conditions exist that may qualify you for Medicare outside of normal enrollment periods. Visit medicare.gov to learn more.