Applying for a Medicare Application: What You Need to Know
Article at a glance
Enrollment in Medicare may happen automatically when a person turns 65.
Even if a person is automatically enrolled, they may have the option to change their coverage during certain enrollment periods.
Enrollment in Medicare can be done in person, over the phone, or online through the Social Security Administration website.
It is safe and secure to enroll in Medicare online.
Enrolling in Medicare is an often discussed subject as a person gets closer to turning 65. While there are plenty of questions that are often asked during the process, there is one key question that must be answered before a person can even begin—how does one apply for a Medicare application?
What is Medicare?
Medicare is a federal program from the United States government that provides health insurance for Americans ages 65 and older, along with certain younger people suffering from disabilities or end-stage renal disease (ESRD).
Medicare benefits come in multiple parts: hospital insurance (known as Part A) and medical insurance (Part B). There is also a possibility to enroll in Medicare prescription drug coverage (known as Part D).
Does a Person Have to Enroll In Medicare?
The answer is that it depends. Depending on whether a person is eligible for Social Security or Railroad Retirement by the time they turn 65, they likely will automatically be enrolled in Medicare Part A (hospital insurance) without needing to do anything—the Medicare card will be mailed directly to them.
Social Security
If a person is receiving SS benefits by the time they enter their Initial Enrollment Period (IEP), the Social Security Administration will automatically enroll them in Medicare Part A. Individuals may also choose to enroll in Medicare Part B for a monthly premium price.
Railroad Retirement
If a person worked in railroad construction for at least 10 years, or five years if they started after 1995, then they receive Railroad Retirement Benefits. In this case, the Railroad Retirement Board will enroll the person in Medicare.
If a person isn’t receiving Social Security or Railroad Retirement benefits by the time they turn 65, then they will have to enroll in Medicare themselves.
When Are the Enrollment Periods for Medicare?
Initial Enrollment Period: A seven-month period that includes the three months before one’s 65th birthday, one’s birthday month, and the three months following one’s 65th birthday.
Open Enrollment: October 15th-December 7th (coverage begins January 1st)
General Enrollment Period: January 1st-March 31st (coverage begins on July 1st)
Special Enrollment Period (SEP): If they have medical insurance coverage under a group health plan based on your or your spouse’s current employment, they may not need to apply for Medicare Part B at age 65. They may qualify for a “Special Enrollment Period” (SEP) that will let them sign up for Part B during:
Any month a person remains covered under the group health plan and their or their spouse’s employment continues.
The 8‑month period that begins with the month after their group health plan coverage or the employment it is based on ends, whichever comes first.
Enrollment Periods for Medicare Advantage (MA) Plans
It’s important to note that a person can only sign up for a Medicare Advantage Plan if they are eligible for Original Medicare.
Initial Enrollment Period: The seven-month period that includes the three months before one’s 65th birthday, one’s birthday month, and the three months following one’s 65th birthday
General Enrollment Period: January 1st-March 31st (coverage begins on July 1st)
Medicare Advantage Open Enrollment: January 1st-March 31st (coverage begins on July 1st)
Enrollment Periods for Medicare Part D (Prescription Drug Coverage)
Initial Enrollment Period: The seven-month period that includes the three months before one’s 65th birthday, one’s birthday month, and the three months following one’s 65th birthday.
Special Enrollment Period: If they have medical insurance coverage under a group health plan based on your or your spouse’s current employment, they may not need to apply for Medicare Part B at age 65. They may qualify for a “Special Enrollment Period” (SEP) that will let them sign up for Part B under certain conditions.
Annual Open Enrollment (if a person missed their IEP and SEP windows): October 15th-December 7th
General Enrollment Period: January 1st-March 31st (coverage begins on July 1st)
What are the Qualifications for Newly Eligible Medicare Applicants?
Certain qualifications must be met before being eligible for Medicare. These include:
A person turned 65 (sign up for Medicare of MA plan)
A person has a disability (can be under 65) (Medicare or MA plan)
Eligible for Medicare because of disability and has turned 65 (Medicare or MA plan)
Person doesn’t have Part A but enrolled in Part B during general enrollment (Medicare)
Person has Part A and enrolled in Part B during general enrollment (MA plan)
How Does a Person Enroll in Medicare?
If a person isn’t automatically enrolled in Medicare, then they will need to enroll themselves. There are a few options to choose from.
Contact Social Security to Set Up Medicare Coverage
This can be done by:
Visiting the local Social Security office
Calling Social Security at 800–772-1213.
When applying at the Social Security office, a person may potentially need to show proof of identity via eligible documents. These can be:
Social Security card
Original birth certificate
Proof of U.S. citizenship or legal citizenship status documentation if not born in the U.S.
A copy of W‑2 form
Apply for Social Security Benefits
At 65, if a person isn’t receiving Social Security Benefits, they may opt to apply for them. Once approved, a person will automatically be enrolled in Original Medicare.
Apply Online
Many people opt to apply online for their Medicare enrollment—particularly because it is easy, free, and saves time.
A person can log into www.ssa.gov and create a Social Security account. After creating the account, a person can fill out an application. The application will ask for sensitive information such as:
Name
Date of Birth
Social Security Number
Current Insurance, if any (Including Medicaid Services)
Country born in (if not the United States)
After filling out the application, the person submits and waits to hear if they qualify. Social Security will contact a person directly if any additional information is needed for the application. A person can log into their account to check on the process of their application to see its status at any time.
Take Action: CMS, HHS Websites—Helpful Links
The website of the United States Center for Medicare and Medicaid Services (CMS) along with the website for the U.S. Department of Health and Human Services (HHS) provide plenty of information regarding enrolling in Medicare, the benefits of doing so, and breaking down plenty of information a person may have about Medicare coverage.
Note: Visit these websites to access information from the CMS or HHS resources.
Is It Safe to Enroll In Medicare Online?
Yes, if they apply using the official Social Security Administration website.
The SSA website is www.ssa.gov. Websites ending in .gov are official websites belonging to an official government organization.
While there is always concern about secure websites, the information used to fill out an account through the SSA will be kept safe if the official website is used.
How to Decide on Enrolling in Parts A and B
If a person is automatically enrolled, they can opt to alter their coverage during their IEP or another enrollment period. Most people choose to enroll in at least Part A to cover hospital expenses, given that it doesn’t usually come with a monthly premium.
A person can sign up for Part A and Part B separately, but signing up for Part B, later on, can delay that coverage. Additionally, there is an opportunity to sign up for Part B annually, yet each year that a person doesn’t sign up for it and were eligible, the premium goes up by 10%
If a person does not qualify automatically for Part A, they may have to purchase it. To do so, though, they must also apply for Part B.
If a person is still working or spouse is working and are covered by the job’s health insurance, they may only need to sign up for Part A to cover certain expenses.
Most people simply decide to enroll in both parts upfront, yet the most important factor to keep in mind is what most benefits the person. While choosing to not enroll in Part B initially can feel like it’s saving money, it can cost more down the line.
FAQs
Is it safe to enroll in Medicare online?
Yes, if they apply using the official Social Security Administration website. The SSA website is www.ssa.gov. Websites ending in .gov are official websites belonging to an official government organization. While there is always concern about secure websites, the information used to fill out an account through the SSA will be kept safe if the official website is used.
What is the rule for applying for Medicare?
In general, you are eligible to apply for Medicare coverage (Medicare Parts A and B) three months prior to turning 65 and three months after your 65th birthday.
