In addition to learning the options available to apply for Medicare, many people are unsure of when to sign up for Medicare. Just like the application process, this can be a bit confusing since there are a number of factors that will determine the answer to this question. In most cases, you will need to evaluate your current situation and get to know the rules and regulations related to Medicare coverage. Learning a bit more can help you figure out the right time to sign up for Medicare.
Automatic Enrollment
There are some people who will be enrolled in Medicare automatically when they turn 65. In fact, they will receive their red, white and blue identification card in the mail approximately three
months prior to their 65 birthday after their 25th month of disability.
When You will Have to Manually Sign Up for Part A and Part B Medicare
There are some situations when a person will have to sign up manually for Medicare benefits. Some of the situations that indicate a person has to sign up and enroll themselves include:
- If they are not receiving RRB benefits or Social Security benefits (for example, if you are still actively working)Important note: If you have health insurance coverage from your former or current employer, then you need to understand how the coverage will work with Medicare prior to making any decisions.
- You have qualified for Medicare because you suffer from ESRD (end-stage renal disease)
- If you live in Puerto Rico and need to sign up for Medicare Part B ( you will automatically receive Part A)
- Important note: You have to have Part A to be eligible to apply for Part B. The application to apply for enrollment in Part B is CMS-40B, which is available in English and Spanish.
When to Sign Up for Medicare Part A and Part B
This is one of the most pressing questions that a person needs to learn the answer to – when to sign up for Medicare?
When you first become eligible for Medicare you will have a period of seven months, referred to as the initial enrollment period, where you can enroll in both Parts A and B. For example, if you are deemed eligible for Medicare when you first turn 65, you will be able to sign up during the seven-month period that starts three months prior to the month that you turn 65, and includes your birthday month, as well as the 90 day period after your 65th birthday.
You can sign up, at no cost, for Part A, if you are eligible any time during or after the Initial Enrollment period begins. Your actual Medicare coverage will begin depending on the date you sign up. If you have to purchase Part A or Part B, you will only be able to sign up during the valid enrollment period.
It is important for you to understand that if you don’t enroll in Part B coverage when you are first deemed eligible, then you may have to pay a penalty for late enrollment for as long as you have the Part B coverage, which means you may have a gap in your health coverage.
General Enrollment Period
When trying to figure out when to sign up for Medicare you will find there is the Initial Enrollment Period, as well as a General Enrollment Period. If you failed to sign up for Part A and/or Part B when you were first eligible, and you are not eligible for the Special Enrollment Period, then you will be able to sign up during the General Enrollment Period, which is between the dates of January 1st and March 31st each year.
If you sign up during this period, your coverage will begin on July 1st. You may have to pay a premium that is higher since it is considered late enrollment for Part A, or a higher premium for enrollment in Part B.
Special Circumstances and the Special Enrollment Period
Once the seven months Initial Enrollment Period is over, you might have the opportunity to enroll in Medicare coverage during the Special Enrollment Period. If you are actively covered based on a group health plan that is provided by your current employer, then you will be eligible for a Special Enrollment Period that allows you to sign up for both Parts A and B as long as you, or your spouse is working and covered by the group health plan.
There is also a Special Enrollment period that lasts for a period of eight months. It allows you to sign up for coverage under Part A or Part B that begins the month following the end of your employment or when the group health insurance plan no longer covers you – whichever occurs first. In most cases, you will not have to pay any late enrollment penalties if you are able to use the Special Enrollment Period to sign up for coverage.
- Important Note about Special Enrollment Periods
- Retiree health plans, including COBRA, are not considered coverage that is based on a person’s current employment. You will not be eligible for a Special Enrollment period when this coverage ends. Also, Special Enrollment Periods do not apply for those suffering from ESRD.
As you can see, there is quite a bit of information available regarding when to sign up for Medicare. Being informed and understanding your specific situation will help you determine when the right time to sign up is. Since everyone faces different situations, evaluating your needs and knowing it is time to take action is a must.
The fact is, if you don’t sign up during the proper periods of time, you may find that you have to pay additional fees or penalties to receive coverage. These penalties will be ongoing for the entirety of your coverage period. Over the years, it can equate to quite a bit of money, simply because you did not sign up for Medicare in the appropriate amount of time. Learning how to apply for Medicare and when to do it will ensure you get the coverage you need and deserve.
Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.
