Enrolling in Medicare

When you turn 65, you can enroll in Medicare* — a federal, national health insurance plan. Your initial enrollment period is three months before your 65th birthday, the month your turn 65, and three months after your 65th birthday. If you’re already collecting Social Security Benefits, you will automatically be enrolled. If you’re not collecting Social Security Benefits you must actively enroll. Below are the steps to get you started:

1. Set up a Social Security account at their website, in person at your local Social Security office, or by calling 1-800-772-1213 (TTY #: 1-800-325-0778). Click on “Apply for Medicare Only.”
   • While Medicare is the insurance coverage, Social Security (or the Railroad Retirement Board) will need to confirm you are eligible.
   • You can start the process three months in advance of your 65th birthday even if you are not currently collecting Social Security Benefits.
   • Select whether you are enrolling in just Part A or Parts A and B. (see Delaying Medicare below.)
2. When your eligibility is verified, and you’ve completed the application process, our red, white, and blue Medicare card should then be mailed to you.
3. Set up a Medicare.gov account after getting your red, white, and blue card.
4. If you are choosing to fully enroll during your initial enrollment period, enroll in additional coverage such as Medicare Advantage or Medigap and/or a Prescription Drug Plan.

When Does My Coverage Start?

If you enroll before your 65th birthday your coverage begins the first day of the month you turn 65. If you enroll the month of or after your 65th birthday, your coverage begins on the first day of the month after you’ve applied.

Delaying Enrollment

You may delay Medicare enrollment if you are currently insured through a spouse who is actively employed, or through your own employer and want to keep that coverage. This may save you money on monthly premiums, which are calculated based on income, and also allow you to continue contributing to your Health Savings Account (HSA). However, the plan you’re staying on must be a large group plan that covers at least 20 or more employees and provides benefits that Medicare Parts B and D will cover. It is important to check with your current plan administrator that your plan is eligible to delay Medicare enrollment because penalty fees for late enrollment can be costly and last the rest of your life.

To delay Medicare enrollment, all you have to do is not sign up when you are first eligible. Or, if you’d only like Medicare Part A, which is generally free to most Americans, you simply enroll only in Part A and delay your Part B enrollment. The benefits of enrolling in Part A when you are first eligible are:

1. There is no cost to you to do so.
2. You will be assigned your permanent Medicare number so when you are ready to enroll in Part B you will already have your Medicare number which can expedite that process.
3. Your employer coverage is primary for your out-patient care, and Medicare Part A is primary only if you are hospitalized and will coordinate with your employer benefits.

The disadvantage of enrolling in Part A if you or your spouse are still working is that you can no longer contribute to an HSA account.

When your coverage through your or your spouse’s active employment ends, this will trigger a Special Enrollment Period, for which you will have eight months to sign up for Medicare Part A and/or Part B, and two months to sign up for additional coverage (Medigap or Medicare Advantage) and/or a Prescription Drug Plan. Because of the difference in schedules, and the fact that you must have Medicare Parts A and B to sign up for additional coverage, you can plan on a two-month period to enroll in Medicare after active employer benefits end. Two forms must be submitted with your Part B application if you have delayed your Part B enrollment: CMS40B and [CMS-L564](https://www.cms.gov/cms-l564-request-employment-information#:~:text=This form is used for,coverage and dates of employment.).

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