When do you apply for Medicare?
When you turn 65, you're typically eligible to apply for Medicare Part A (hospitalization) at no cost, provided you have paid into the Medicare program through your taxes for at least 10 years. You're also eligible for Part B (medical) if you're a citizen or permanent resident of the United States. Additionally, if you have a disability, you may qualify even if you aren't yet 65.
Apply for Medicare by your 65th birthday
It's your initial enrollment period!
The three months before your birthday, your birthday month and the three months after your 65th birthday are your initial enrollment period (IEP).
During this time, you can apply for:
- Original Medicare (Parts A and B)
- Medicare Advantage plan (Part C) and/or
- Prescription drug plan (Part D)
If you're already receiving benefits from Social Security or the Railroad Retirement Board (RRB), you'll automatically be enrolled in Original Medicare (Parts A and B) on the first day of the month you turn 65. You don't need to do anything. Watch for your red-white-and-blue Medicare card to come in the mail.
If you're not already receiving Social Security or RRB benefits, you can enroll in Parts A and B by:
- Calling the Socail Security Administration at 800.772.1213. (TTY 800.325.0778)
- Visiting your local Social Security office
- Signing up at ssa.gov
It may be best to apply for Medicare during the three months before your birthday to prevent any delays in Part B coverage.
Don't miss your opportunity to apply
If you don't apply for Medicare Part B and Part D during your initial enrollment period, you could end up paying a late enrollment penalty, delaying your coverage and paying higher premiums. However, if you have creditable coverage, you may be able to wait. "Creditable coverage" is coverage that's as good as Original Medicare. Many people have creditable coverage from an employer or union.
Applying for a Medigap plan
You'll also have a six-month Medigap open enrollment period that begins on the first day of the month in which you are both 65 or older and enrolled in Part B. During this time, you can add a Medigap plan to your Original Medicare and/or Part D plan. This is the best time to apply because it's your "guaranteed issue" period, and you'll be accepted into a Medigap plan even if you have health problems.
In some other situations, you have a guaranteed issue to purchase a Medigap plan outside of your annual enrollment period. For instance, if you have a Medicare Advantage plan and you move out of your plan's service area.
Signing up or switching plans after your guaranteed issue period has run out may not be easy. You won't have a guaranteed issue right and will be subject to underwriting, which means that the health plan will consider your health, age and other factors before accepting you into the plan. Coverage may be denied or cost more.
Switching Medicare plans
The annual enrollment period (AEP) is between Oct. 15 - Dec. 7.
If you have a Medicare Advantage or Part D prescription drug plan, AEP gives you the chance to switch to a different plan or health insurance provider. Your new plan benefits take effect on Jan. 1 of the upcoming year.
Dropping or changing your Medicare Advantage plan
You can change your coverage between Jan. 1 - Mar. 31, also known as the Medicare Advantage Open Enrollment Period (OEP).
During these three months, you can change to a different Medicare Advantage or MAPD plan or disenroll from your plan and return to Original Medicare, provided you were previously enrolled in an Advantage or MAPD plan.
When you make a change during OEP, your new plan starts on the first day of the next month. You are only allowed one plan change.
Use your special enrollment period
In some situations, you'll have a special enrollment period (SEP). The SEP allows you to change your Medicare Advantage (Part C) and prescription drug (Part D) plans or go back to Original Medicare (Parts A and B) outside of the normal time restraints.
These situations include:
- You move outside the area your current plan covers.
- You become eligible for a low-income subsidy.
- You lose creditable prescription drug coverage from your employer.
- Your plan is no longer available.