Medicare enrollment at a glance
- Enrolling in Original Medicare
- Enrolling in Medicare Advantage
- Enrolling in Medicare Part D
- Enrolling in Medigap
How do I enroll in Medicare?
With Original Medicare (Medicare Part A and B), enrollment can be as easy as opening your mail and putting your Medicare card in your wallet. For some other plans, you’ll have to do a bit more to enroll, but it’s important to thoroughly research your options prior to enrolling.
Enrolling in Original Medicare
When it comes to Original Medicare, enrollment could be a piece of cake. If you’re already receiving Social Security or Railroad Retirement Board benefits and you’re a U.S. resident, the government automatically enrolls you in both Medicare Part A and Medicare Part B at age 65. Three months prior to your 65th birthday, your Medicare card will arrive in the mail with instructions.
At this point, you’ll actually have the option to turn down Medicare Part B (which has a monthly premium — for most enrollees, it’s $135.50/month in 2019), but you probably won’t want to do that unless you have another means of coverage for Part B expenses. You may, for instance, be receiving coverage from your own or your spouse’s employer-sponsored insurance, which is a valid reason for delaying your enrollment in Medicare Part B.
If you decide to not enroll in Part B, but plan to enroll at a later date, know that you could end up having to pay a higher premium – 10 percent higher for each year you could have enrolled, but didn’t. The penalty doesn’t apply, however, if the reason you didn’t initially enroll in Part B coverage was that you had employer-sponsored health insurance from your (or your spouse’s) current employer, including TRICARE from current military employment.
If you are turning 65, but you’re not yet receiving Social Security or railroad retirement benefits, you won’t be automatically enrolled in Original Medicare. Instead, you’ll be able to enroll during a seven-month open enrollment period that begins three months prior to the month you turn 65, and includes the month you turn 65 as well as the three following months. So if you’ll be 65 on July 14, your open enrollment period will be April, May, June, July, August, September, and October.
If you’ll be eligible for Social Security at age 65, you’ll enroll at a local Social Security office or by mailing a signed and dated letter with your name, Social Security number and the date you’d like to be enrolled to Social Security.
If you’ll be eligible for railroad retirement benefits, you can enroll by contacting your Railroad Retirement Board field office.
Enrolling in Medicare Advantage
To join a Medicare Advantage Plan, you will need to have or be eligible for Original Medicare (Part A and Part B) coverage and live in an area where an Advantage Plan is offered. (A plan may be offered in a state, but not in every county in that state; there are some rural areas of the U.S. that don’t have any Medicare Advantage plans available at all.)
You’re also limited as to when you can enroll in a Medicare Advantage plan. You can enroll when you’re first eligible for Medicare. If you have Social Security Disability Insurance, you can enroll in the 25th month of your disability or during the three months before or after that month. Each year, you’ll have an option to switch to a different Medicare Advantage plan (or switch from Original Medicare to a Medicare Advantage plan) during the open enrollment period that runs from October 15 to December 7, with coverage effective January 1.
And if you have a Medicare Advantage plan, you can switch to a different Advantage plan or to Original Medicare during the annual Medicare Advantage open enrollment period, which runs from January 1 to March 31 (this is new starting in 2019; note that it only applies to people who are already enrolled in Medicare Advantage plans — a person with Original Medicare cannot switch to a Medicare Advantage plan during this window).
If you plan to enroll through a carrier’s Web site, you may want to compare Medicare Advantage Plans first at Medicare’s site. Often, you can also get enrollment information at seminars hosted by the plan carriers.
Since Medicare Advantage Plans generally cover most of your Medicare-related expenses – including, with most Advantage plans, prescription drug coverage – you may not need any additional coverage beyond the Medicare Advantage plan (although you’ll still need long-term care insurance to guard against future costs, because long-term care isn’t covered by Original Medicare or Medicare Advantage). Instead of a regular Medicare ID card, you’ll simply use the insurance card issued by the private carrier when you obtain medical treatment.
Note that you’ll although your Medicare Advantage plan wraps Medicare Part A and Part B into one private plan, you’ll continue to pay your Medicare Part B premium in addition to your Medicare Advantage premium. For most enrollees, Part B premiums are deducted from Social Security checks, although you’ll have to pay it directly if you’re not receiving Social Security (in 2019, the Part B premium for most enrollees is $135.50/month).
If you already have a Medicare Advantage plan and want to switch to a different Advantage plan during open enrollment (October 15 to December 7), your existing plan will disenroll you with no lapse in coverage, and your new plan will take effect January 1.
Enrolling in Medicare Part D
Medicare Part D covers prescription drugs. You can add a stand-alone prescription drug plan (PDP) to augment your Medicare A and B, or you can choose a Medicare Advantage plan that provides all of the benefits of Medicare A and B, plus prescription drugs and often other benefits as well.
You’re first eligible to enroll in Part D when you’re first eligible for Medicare. When you apply, you will enroll in a private plan and must enroll during a seven-month period that starts three months prior to the month that you reach age 65. If you don’t enroll during this period, you may pay a late-enrollment penalty that will raise your Part D premium when you do decide to purchase coverage.
If you’re Medicare eligible because you’re disabled AND you’ve reached age 65, you can enroll in a Part D plan, switch Part D plans, or drop your Part D plan during this seven-month period.
If you’re newly eligible because you’re disabled, you can enroll starting 21 months after you began receiving RRB or Social Security benefits and have through the 27th month to enroll. Your Part D coverage will start at the beginning of your 25th month of receiving RRB or Social Security benefits.
If you don’t have Part A and enroll in Part B during the Part B General Enrollment period, you can enroll in Part D between April 1 and June 30. Or, if you have Part A coverage and then enroll in Part B during the Part B General Enrollment Period, you can enroll in Part D between April 1 and June 30.
And if, later on, you want to change to a different Part D plan, you can do that during Medicare’s Open Enrollment period that runs from October 15 to December 7 each year.
If you’re enrolled in a Medicare Advantage plan and use the Medicare Advantage open enrollment period (January 1 to March 31) to switch back to Original Medicare, you’ll also have the option to sign up for a Part D plan to supplement your Original Medicare coverage.
After you’ve chosen from the various PDP offerings, you can enroll by:
- calling 1-800-MEDICARE to locate PDPs in your area
- logging in to Medicare’s Prescription Drug Plan Enrollment Center
- filling out the paperwork sent by mail from Medicare, or
- calling the private insurer with the specific PDP you want to join.
- calling one of medicareresources.org’s partners at 1-855-593-5633 to discuss your coverage options with a licensed agent.
Once you apply for Plan D, it generally takes about five weeks for your membership card to arrive. During that time, if you need prescription medications, most pharmacies will accept the initial letter you received from Medicare acknowledging your upcoming membership, or an enrollment confirmation number.
Enrolling in Medigap
It’s essential that you learn about enrolling in Medigap well in advance of your application. During your initial enrollment period (the six months starting with the month you turn 65) you can’t be denied Medigap coverage or be charged more for the coverage because of a past medical condition.
If you’re under 65 and eligible for Medicare because of a disability, there are 32 states that provide some sort of guaranteed issue period during which you can purchase a Medigap plan, but in the majority of those states, the carriers can charge additional premiums for people under 65. You can click on a state on this map to see how Medigap plans are regulated in the state.
If you miss your enrollment period, you may still be able to buy a policy, but a carrier may charge you more for the policy. Or worse, a carrier could decline to issue a Medigap policy entirely. But some states have consumer protections that require guaranteed issue access to at least some Medigap plans:
- In New York, and Connecticut, Medigap plans are not medically underwritten, regardless of when an applicant enrolls.
- Massachusetts has an annual guaranteed-issue Medigap open enrollment period that runs from February 1 through March 31.
- Maine requires each Medigap insurer to designate one month per year when all applicants have guaranteed issue access to at least Medigap Plan A.
- Missouri has an “anniversary rule” that allows Medigap enrollees to switch to the same letter plan with a different Medigap insurer, guaranteed issue, during the 30-day period preceding the policy anniversary.
- California and Oregon Medigap enrollees have 30 days each year, following their birthdays, when they can switch to any other Medigap plan that provides equal or lesser benefits without medical underwriting.
- In Washington state, people who are already enrolled in Medigap plans can to switch to another Medigap plan at any time (guaranteed-issue), as long as they’ve had coverage for at least 90 days. People with Medigap Plan A are limited to switching to only another Plan A. But people with Medigap Plans B through N can switch to any other Plan B through N.
To find out about Medigap policies in your state, contact your State Department of Insurance or your State Health Insurance Assistance Program, or call 1-855-593-5633 to speak with one of our partners, who can help you find a plan in your area.