When you turn 65, or meet the qualifications to enroll early, you’ll need to apply for Medicare through your local Social Security Administration office. If you’re like most Americans, you’ve seen Social Security and Medicare taxes come out of your paychecks for years. Yet, more than likely, no one ever taught you how to apply for Medicare when your time comes.
Fortunately, we are here to help walk you through the Medicare enrollment process. Whether your current healthcare coverage is through your employer, your spouse, Medicaid, or the Marketplace, we have all the information you need for a smooth transition to the federal health insurance program.
DO I QUALIFY FOR MEDICARE?
Medicare consists of four parts. Original Medicare – Part A and Part B – is the federal healthcare coverage for Americans ages 65 and older or for those under age 65 and disabled.
To qualify for Medicare, you must be a United States citizen or permanent legal resident for at least five years in addition to any of the following criteria:
- 65 years of age or older
- Receiving Social Security Disability Income (SSDI) for a minimum of 24 months
- Diagnosed with amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD) (no waiting period necessary)
Medicare Part A is inpatient (hospital) insurance and is premium-free for people who pay Medicare taxes for at least 40 working quarters. Medicare Part B is outpatient insurance that you use at the doctor’s office. You’ll pay a monthly premium for Part B that is subject to adjustment depending on your income.
THE FOUR MEDICARE PARTS
Original Medicare consists of four parts: Part A, Part B, Part C, and Part D.
Apply for Medicare Part A
Medicare Part A covers inpatient hospital care. It also covers skilled nursing facility services. If you’re eligible, learn how to apply for Part A.
read moreApply for Medicare Part B
Medicare Part B covers outpatient services. Coverage includes doctor visits, medically necessary services, and preventive care.
Read moreApply for Medicare Part C
Medicare Part C refers to Medicare Advantage plans. It provides coverage for Parts A and B, plus added benefits like dental, vision, and
read moreApply for Medicare Part D
Medicare Part D covers prescription drugs. It helps pay for the medications that are not covered under Parts A and B. Coverage varies.
Read moreHow Soon Before I Turn 65 Can I Sign Up for Medicare?
Those collecting Social Security receive Medicare automatically at age 65. But, if you’re not receiving Social Security, it’s best to enroll in Medicare as soon as you are eligible to avoid late penalties. Specifically, you should enroll during your Initial Enrollment Period. This enrollment period is unique to each person and lasts seven full months.
The seven-month window begins on the first day of the month, three months before your 65th birthday. It lasts through your birthday month and ends on the last day of the month, three months after your birthday.
For example, someone whose birthday is June 11 would have an Initial Enrollment Period of March 1 through September 30. Those eligible due to disability have a seven-month window beginning three months before the 25th month of their SSDI payments.
WHEN WILL MY MEDICARE COVERAGE START?
After you complete the process of enrolling in Medicare, you may wonder how long it takes for your application to be approved. As for your effective date, when your Medicare coverage begins depends on the point at which you sign up.
If you enroll during the first three months of your Initial Enrollment Period, your coverage starts on the first day of your birthday month. Those with a birthday on the first day of a month get to begin their coverage on the first day of the month before their birthday.
When you sign up during your birthday month or the three months following, your coverage starts the first of the next month.
How Do I Apply for Medicare Parts A and B?
You’ll need to go through Social Security to apply for Parts A and B of Medicare. There are three options for signing up: online, over the phone, and in person. In all three cases, you’ll want to have the documents you need ready ahead of time.
- Online: The Social Security Administration’s website, SSA.gov, offers an online option to sign up for Medicare. You’ll need a My SSA account, which you can use later to check on the status of your application.
- Over the Phone: To sign up for Medicare via telephone, call the Social Security Administration toll-free at 1-800-772-1213.
- In Person: Some people prefer face-to-face interaction when changing to Medicare. If this approach appeals most to you, you can enroll in person at a Social Security office. Visit the Social Security website to locate an office near you.
