Enrolling in Medicare can quickly become a stressful and overwhelming process if you have no knowledge of when or how to enroll. Approaching the age of 65 is synonymous with Medicare, and millions of seniors every year are faced with obtaining the right coverage for themselves. It is important to know your resources and how to navigate the process as an individual approaches eligible age. If an individual enrolls too late, or improperly, delays in their healthcare coverage can occur — placing their well-being at risk. According to AARP, one in 10 seniors relies solely on Medicare for their healthcare coverage.
Automatic Enrollment
For some individuals, Medicare enrollment isn’t something they need to worry about. For individuals already receiving benefits from Social Security or the Railroad Retirement Board, they are already entitled to Medicare Part A and Medicare Part B (upon the first day of the month they turn 65). Through these options, no enrollment steps are necessary on their part.
Initial Enrollment
If an individual is not automatically enrolled in Medicare, as they approach 65, there is a seven-month window of enrollment opportunity — three months before the individual’s birthday, the month of the individual’s birthday, and three months after the individual’s birthday. This period allows for Medicare Part A and Part B sign-ups.
However, if an individual signs up for Medicare Part B during their birthday month or the three months following, their Part B coverage will be delayed. If an individual chooses not to enroll in Part B initially, and then later on enrolls, a late fee will be included for the entire time that the Part B policy is carried.
General Enrollment Period
An individual can enroll between January 1 – March 31 for Medicare if they did not enroll when first eligible or they do not qualify for one of the special enrollment periods (listed below). Coverage will start on July 1, and higher premium fees may be enforced on their Medicare Part A and/or Part B coverage.
Special Enrollment Periods
If an individual is 65 and still working, they may choose to remain on their employment group healthcare plan if they wish. An individual falls into this special enrollment period if they or their spouse is still working and covered by a group health plan through the employer or union based on that work.
An eight month Medicare enrollment period starts for an individual when:
- The month after the employment ends (or)
- The month after group health plan insurance based on current employment ends
There is normally no late fee if Medicare coverage is obtained during this special enrollment period. If an individual has a Health Savings Account (HSA) with a High Deductible Health Plan (HDHP) based on their or their spouse’s current employment, they may be eligible for a special enrollment period, as well.
How to Enroll
Enrolling for Medicare starts with visiting Medicare.gov to view your eligibility and coverage options. From there, you will need to visit the Social Security Administration’s website to start your Medicare enrollment process: ssa.gov.