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When to Apply for Medicare

November 12, 2020 By Matt Wolleat Comments are Off

Signed into law in 1965, Medicare is a national health insurance program created for Americans over the age of 65. In general, there’s no type of Medicare plan that you can get on “at any time,” so it’s important to know when you’re eligible for Medicare, as well as the deadlines you’ll need to meet to access various types of coverage and avoid penalties.

At Minnesota Benefit Association, it’s our mission to help individuals understand and select the best insurance options for their needs. Let us be your Medicare advocate! Read on to learn when to apply for Medicare, then get in touch with one of our licensed agents to discuss your questions and concerns.

Who Can Apply for Medicare?

Before we get into the deadlines to apply for Medicare, it’s important to cover who is eligible in the first place:

  • People over the age of 65 – Most people become eligible for Medicare around their 65th birthday. You’ll qualify for full Medicare benefits at this age, so long as you’re a U.S. citizen or permanent legal resident for at least five years.
  • People with disabilities – No matter how old you are, you may be eligible for Medicare due to a disability. Eligible individuals must have received Social Security Disability benefits for 24 months or have End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).

When Can I Sign Up for Medicare?

Some people get Medicare automatically, while others have to sign up. You may have to sign up if you’re approaching 65 and not getting Social Security.

If you’re eligible for Medicare, there are three times you can sign up:

  1. Initial Enrollment Period – Most people get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) during their initial enrollment period when they age into Medicare.
  • If you’re eligible when you turn 65, your initial enrollment period is spread across seven months: three months prior to your birthday, the month of your birthday, and the three months after your birthday month.

As mentioned above, if you’re 65 (or almost 65) and you’re not already collecting Social Security benefits before your Initial Enrollment Period starts, you’ll need to sign up for Medicare online or contact Social Security.

If you do already get benefits from Social Security, you’ll get Medicare Part A and Part B automatically when you’re first eligible and don’t need to sign up. Medicare will send you a “Welcome to Medicare” packet three months before your 65th birthday – which you should read for other important deadlines and actions to take!

  • If you’re eligible for Medicare because you have a disability, your coverage automatically begins 24 months after you get Social Security or Railroad Retirement Board (RRB) disability benefits.
  1. General Enrollment Period – If you don’t sign up for Medicare during your Initial Enrollment Period, and you aren’t eligible for a Special Enrollment Period (explained below), you can sign up during Medicare’s General Enrollment Period from January 1 to March 31.
  • You may have to pay a higher Part A or Part B premium for late enrollment.
  1. Special Enrollment Period –  After your Initial Enrollment Period ends, you may be eligible to enroll during a Special Enrollment Period. In most cases, you get a Special Enrollment Period if you didn’t sign up for Medicare when you first became eligible because you were covered under a group health insurance plan.
  • If you’re eligible for a Special Enrollment Period, you can sign up for Medicare anytime you’re still covered by the group health plan, or during the eight-month period that begins the month after the employment ends or the coverage ends – whichever happens first.
  • Most of the time, you will not have to pay a late penalty for signing up during a Special Enrollment Period.

When Can I Get Medicare Advantage or Prescription Drug Coverage?

When you first become eligible for Medicare during your Initial Enrollment Period, you can choose to add prescription drug coverage to your Original Medicare plan, or join a Medicare Advantage Plan that includes drug coverage (instead of an Original Medicare plan).

Your Initial Enrollment Period is the best time to sign up for a Medicare Advantage Plan or a prescription drug plan, because signing up when you’re first eligible can help you avoid paying a Part D late enrollment fee for LIFE! (Penalties may be added to your monthly premium for Medicare Part B or D if you fail to join Medicare when you first become eligible. As long as you have Medicare, you will continue to pay this additional fee, unless you meet a special exception.)

If you don’t sign up for a Medicare Advantage Plan or drug coverage during your Initial Enrollment Period, there are two other times to sign up (or make changes to coverage you already have):

  1. General Enrollment Period – If you miss your Initial Enrollment Period, you can sign up during Medicare’s General Enrollment Period from January 1 to March 31, and your coverage will start July 1.
  1. Open Enrollment Period – From October 15 to December 7, you can join, switch, or drop a Medicare Advantage Plan or Medicare drug plan. Your coverage will begin on January 1.

Need Medicare Enrollment Assistance? Contact the MBA

When you have questions, our licensed advisors have answers, so give us a call at 651.358.2990