Medicare is health insurance for those who are turning 65 or older, retiring, or living on disability (for 24 months). Medicare has many parts to it, eligibility requirements, enrollment periods, additional coverage like Medigap and Medicare Advantage plans, AND penalties. It can get overwhelming because everyone has a unique path in the process - based on your medical needs and comfort level.
The first thing you need to know is there are penalties if you wait to enroll. You might need to actively enroll or, if you are receiving Social Security benefits, you will be automatically enrolled. If you're eligible to enroll, you have to do so during a specific enrollment period. Your enrollment period starts 3 months before your 65th birthday and ends 3 months after (unless you have creditable coverage elsewhere). So let's look at the steps to enroll in Medicare...
When are you eligible to enroll in Medicare?
Of course, there are exceptions, however for most individuals, you will be eligible to enroll in Medicare when you are turning 65. Your Initial Enrollment Period is a total of 7 months, including the month of your 65th birthday. As long as you are a U.S. citizen or a permanent resident for 5 years, you can enroll in Medicare.
If you are under 65, you can also qualify if:
- You are permanently disabled and have been receiving Social Security disability income benefits for 24 months.
- You have end-stage renal disease.
- You have Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease).
schedule an appointment
Don't wait to speak with one of our Licensed Insurance Agents, we will guide you every step of the way.
Determine if you need more coverage than offered by Original Medicare offers.
step 3
Check your eligibility.
steps to enroll
Work with an independent agent to learn what plans are best for you & offered in your area.
step 4
Apply for Original Medicare Part A and Part B with your local Social Security office.
step 2
step 1
when to enroll
- Medicare enrollment periods are specific times when eligible individuals can enroll in or make changes to their Medicare coverage.
- Your Initial Enrollment Period is when you should enroll with Medicare Part A & Part B to avoid a late enrollment penalty.
- There are specific enrollment periods to sign up for Medicare Advantage Plans, Medigap (Medicare Supplements), and Part D Plans.
SEE SPECIFIC ENROLLMENT PERIODS & WHICH APPLIES TO YOU
The Initial Enrollment Period (IEP) is a 7 month period that begins 3 months before the month of an individual's 65th birthday and ends 3 months after the month of their 65th birthday. During this time, individuals can enroll in Medicare Parts A and/or B, as well as Medicare Advantage (Part C) and prescription drug coverage (Part D) or a Medicare Supplement/Medigap Plan.
It's important to note that if an individual doesn't enroll in Medicare during their IEP, they may have to pay a late enrollment penalty if they decide to enroll later on. Additionally, there are certain circumstances, such as delaying retirement or having employer-sponsored health coverage, that may allow an individual to delay enrolling in Medicare without penalty.
The Annual Enrollment Period (AEP) is the period of time each year when Medicare beneficiaries can make changes to their Medicare coverage. It runs from October 15 to December 7 of each year.
During the AEP, Medicare beneficiaries can change from Original Medicare to a Medicare Advantage plan, or vice versa; switch from one Medicare Advantage plan to another; change from a Medicare Advantage plan that doesn't offer drug coverage to one that does, or vice versa; join a Medicare Prescription Drug Plan, or switch from one Medicare Prescription Drug Plan to another
It's important to note that any changes made during the AEP take effect on January 1 of the following year.
The Open Enrollment Period (OEP) is from January 1 to March 31 each year when individuals can enroll in Medicare Parts A and B if they missed their initial enrollment period or did not sign up during a special enrollment period.
During this period, individuals who are eligible for Medicare can enroll in Part A and/or Part B. It is important to note that if you enroll in Medicare during the Open Enrollment Period, your coverage will not start until July 1 of that year. Additionally, you may be subject to late enrollment penalties for Part B if you did not sign up when you were first eligible.
It is recommended that individuals enroll in Medicare during their initial enrollment period, which is typically the seven-month period that starts three months before their 65th birthday month, in order to avoid any late enrollment penalties and gaps in coverage.
There are several situations that may qualify an individual for a Special Enrollment Period, including:
- Moving to a new area that is not in your current plan’s service area.
- Losing your current health coverage, such as employer-based insurance.
- Qualifying for Medicaid.
- Becoming eligible for Extra Help paying for Medicare prescription drug coverage.
- Losing coverage through a Medicare Advantage plan because the plan is no longer offered, the plan leaves the Medicare program, or you move out of the plan's service area.
It is important to note that the length of the Special Enrollment Period varies depending on the qualifying event. Some SEP periods last for a few months, while others can last throughout the year. If you think you may qualify for a Special Enrollment Period, it’s important to contact Medicare or a licensed insurance agent to learn more about your options.
Join thousands of monthly readers for Medicare updates, special resources, announcements and Michele's favorite recipes.
📢 By submitting your email, you are giving us explicit permission to email you. By submitting the information above, you are agreeing to be contacted by a licensed sales agent by email or phone to discuss information about Medicare, health, life and other insurance plans. This is a solicitation for insurance.
🔒 Any information you share is secure. It will not be sold or reused. You can always unsubscribe at anytime on the bottom of our emails.