Applying for a Medicare Application: What You Need to Know

• 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 fill out a Medicare application and is there any way to be automatically enrolled?

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).
 

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. If you apply for Medicare before 65 because of end stage renal disease (ESRD), Lou Gehrig’s disease, or another reason, it isn’t mandatory but is available.

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.
 

Initial Enrollment Period: A seven-month period that includes the three months before one’s 65^th birthday, one’s birthday month, and the three months following one’s 65^th birthday.

Open Enrollment: October 15^th-December 7^th (coverage begins January 1^st)

General Enrollment Period: January 1^st-March 31^st (coverage begins on July 1^st)

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.

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 65^th birthday, one’s birthday month, and the three months following one’s 65^th birthday

• General Enrollment Period: January 1^st-March 31^st (coverage begins on July 1^st)

• Medicare Advantage Open Enrollment: January 1^st-March 31^st (coverage begins on July 1^st)

• Initial Enrollment Period: The seven-month period that includes the three months before one’s 65^th birthday, one’s birthday month, and the three months following one’s 65^th 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 15^th-December 7^th

• General Enrollment Period: January 1^st-March 31^st (coverage begins on July 1^st)

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)

If a person isn’t automatically enrolled in Medicare, then they will need to enroll themselves. There are a few ways to sign up for Medicare.

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. This is true whether they have received social security disability benefits in the past or not. 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.
 

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.

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.

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 is 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.
 

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. Additionally if you want to contact Medicare about any questions while enrolling, use a number on the www.ssa.gov website or the Medicare.gov website.

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, during the birthday month, and three months after.

What documentation does Medicare require? 

To get health care through Medicare, someone needs proof of citizenship, proof of age, and employment information or details about military service.

How do I access my Medicare?

To access part a and part b coverage through Medicare, a qualifying American needs to enroll during the initial enrollment period (three months before someone’s birthday, the month of their birthday, and three months after). If you miss this period, you can enroll in this health insurance program, though there may be a monthly late enrollment penalty. Enrollment can be completed on the Medicare website, Medicare.gov and it’s best to be ready before the initial enrollment period.

Can I get Medicare if I have end stage renal disease or Lou Gehrig’s disease?

Most people get Medicare at the age of 65 if they pay into social security for a set number of years. In some situations, they can request to join early, including if they learn they have Lou Gehrig’s disease or ESRD. As you prepare to transition to Medicare, don’t drop private or employer sponsored insurance right away since there is a 30 month coordination period where the private insurance is the primary pater and Medicare is secondary.