By Dana Barrett
If you are ready to apply for Medicare, you may have questions about your Initial Enrollment Period (IEP) and which Medicare Plans you can enroll in at that time. The following information should help you with questions about the Medicare sign-up age, Medicare’s Initial Enrollment Period, and the Medicare application process.
When Can I Sign Up for Medicare?
The age to sign-up for Medicare is 65. The Initial Enrollment Period is a 7-month window. It starts 3 months before your 65th birthday, includes your birthday month, then ends 3 months after. The IEP always starts on the first day of the month and always ends on the last day of the month. For example, if your birthday is on May 15th, your Initial Enrollment Period would be from February 1st to August 31st. To calculate your IEP, remember:
Medicare Initial Enrollment Period (7 Full Months)
- Starts 3 months before your 65th birthday month (on the first day of the month)
- Includes your birthday month (this is month 4)
- Ends 3 months after your birthday month (on the last day)
If you apply for Medicare in the 3-month period before your 65th birthday, then your benefits will start on the first day of your birthday month. If you wait to enroll until after your birthday, your benefits start date will be delayed by 1 to 3 months.
Will I be Automatically Enrolled, or Should I Apply for Medicare?
Some seniors are enrolled in Medicare Parts A and B automatically when they turn 65. This includes people who are receiving Social Security or Railroad Retirement Board benefits. If you are enrolled automatically, expect to receive your Medicare benefits card in the mail a few weeks before your 65th birthday.
If you’re not enrolled automatically, you will have to apply for Medicare during your Initial Enrollment Period. You won’t be notified by Medicare or Social Security regarding when your enrollment period begins so it’s best to mark your enrollment date on a calendar.
When you apply during your Initial Enrollment Period, you can:
- Enroll in Original Medicare Parts A and B,
- Enroll in a Medicare (Part C) Advantage Plans
- Enroll in a Medicare Part D Prescription Drug Plan
- Apply for a Medigap Policy
If you miss the IEP Original Medicare deadline, you can sign up for Medicare during the General Enrollment Period (GEP) which runs from January 1st to March 31st of each calendar year. If you enroll during the General Enrollment Period, you may end up paying higher premiums for Part B coverage as a penalty. Unfortunately, the penalty applies for the entire time you have Medicare Part B.
Medicare IEP If You are Receiving Disability Payments
If you are under 65 and have a qualifying medical condition or disability, you’ll be enrolled in Original Medicare Parts A and B automatically after you’ve received Disability for 24 months. Your Original Medicare coverage will start on the first of the month in which you receive your 25th Disability payment. However, if you’ve been enrolled through Disability, you still have a 7-month Initial Election Period to change your coverage.
The 7-month window starts 3 months prior to receiving your 25th Disability payment, includes your payment month, and ends 3 months after. As an example, if you receive your 25th month of disability on August 1st, then your Initial Enrollment Period will be from May 1st until November 30th as the timeframe to make changes. To calculate the IEP for Disability recipients:
Medicare Initial Enrollment Period (7 Full Months)
- Starts 3 months before your 25th Disability payment month (on the first day of the month)
- Includes the month you receive your 25th payment (this is month 4)
- Ends 3 months after you receive your 25th payment (on the last day)
The types of changes you can make during this window include enrolling in a Medicare Advantage Plan (Medicare Part C) or adding Part D Prescription drug coverage. You can also enroll in a Medigap policy during this IEP, to help reduce additional out-of-pocket expenses.
Medicare Enrollment if you Have Employer-Sponsored Insurance
Many people choose to work past the age of 65. If you or your spouse have employer-sponsored health insurance, you may wonder when you should sign-up for Medicare. If the employer providing the insurance has fewer than 20 employees, you can sign up for Medicare during your 7-month Initial Enrollment Period in the year you turn 65.
If the employer has 20 employees or more, you are still able to enroll in Original Medicare Part A during your IEP. You can also choose to drop your private insurance altogether and enroll in Medicare during your 7-month Initial Enrollment Period if Medicare coverage is a better fit for your medical needs.
If you decide not to sign-up for Medicare during your Initial Enrollment Period because you have an employer-sponsored health plan, you qualify for a Special Election Period (SEP) to enroll in Medicare. This SEP allows you to postpone enrollment until the month that you or your spouse retire, or the date your group health plan coverage ends.
This 8-month Special Election Period starts the first day of the month following your last day of work or after your group health plan ends. During this 8-month SEP, you can enroll in Original Medicare Parts A and B without incurring a penalty.
It’s important to note that there is a separate 2-month Special Election Period for enrolling in Medicare Advantage (Part C) and Medicare Part D. This 2-month election period also starts the first day of the month after your last day of work or the first month after your group plan ends. So, if your last day of work is June 4th, you’ll have from July 1st to August 31st to enroll in either of these plans.
If you have retiree coverage or are currently covered under a COBRA plan, you are not eligible for either of these Special Election Periods.
How to Sign up for Medicare
You can sign up for Medicare in person at your local Social Security Office, or by calling 1-800-772-1213 Monday thru Friday from 7 am to 7 pm to make an appointment. You can also fill out an Original Medicare application online at https://www.socialsecurity.gov. You can contact one of our agents for assistance with enrolling in a Medicare Advantage Plan.