Medicare can seem overwhelming if you’re not familiar with the program. If you are new to Medicare and don’t know where to begin, you can follow these simple steps to enroll in Medicare.
Step 1: Determine your Medicare eligibility
The process for enrolling in Original Medicare, Part A and Part B. varies according to your situation. The first step is to see if you meet Medicare eligibility requirements. If you can answer “yes” to one of the following questions, then you may be eligible for Medicare.
- Are you 65 or older or about to turn 65?
- Have you been receiving disability benefits from Social Security or the Railroad Retirement Board for 24 months?
- Do you have end-stage renal disease (kidney failure that requires transplant or dialysis)?
- Do you have amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease)?
To qualify for Medicare, you must also be a U.S. citizen or a permanent legal resident of at least five years.
If you are almost 65 years old and already receive retirement benefits, then you don’t have to do anything to enroll in Medicare. You’ll be automatically be enrolled in Medicare Part A and Part B the month you turn 65. You should receive your Medicare card in the mail three months prior to your birthday. If you want to delay Medicare Part B enrollment, you can follow the instructions that accompany your Medicare card to opt out or call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. If you’re a TTY user, call 1-877-486-2048.
If you are almost 65 years old and not yet receiving retirement benefits, you have the option of applying for both retirement and Medicare at the same time. You will not be automatically enrolled in Medicare. You can also choose to enroll in only Medicare if you’re not yet ready to receive retirement benefits.
You may get Medicare automatically before 65 if you have amyotrophic lateral sclerosis or if you receive disability benefits. Medicare enrollment occurs after 24 months of disability benefits; for people with amyotrophic lateral sclerosis, enrollment happens in the first month of disability benefits.
You can also qualify for Medicare before 65 if you have end-stage renal disease, need regular kidney dialysis, or have had a kidney transplant.
Step 2: Enroll in Medicare
If you’re almost 65, you can apply for Medicare Part A and/or Part B during your seven month Initial Enrollment Period. which starts three months prior to your 65th birthday, includes the month you turn 65, and ends three months later.
You can apply for Medicare in the following ways:
- By visiting ssa.gov .
- By calling Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778. Social Security representatives are available Monday through Friday, from 7AM to 7PM.
- By visiting a Social Security office in person.
- By contacting the Railroad Retirement Board, if you worked at a railroad. You can call the Railroad Retirement Board at 1-877-772-5772, Monday through Friday, 9AM to 3:30PM. TTY users can call 1-312-751-4701.
If you didn’t sign up for Medicare Part A and Part B during your Initial Enrollment Period, you can sign up during the General Enrollment Period. which takes place from January 1 to March 31 every year. You may have to pay a late enrollment penalty for Medicare Part A and/or Part B if you didn’t sign up when you were first eligible.
If you waited to enroll in Medicare Part A and/or Part
B because you had other group coverage, you can sign up during a Special Enrollment Period. You won’t have to pay a late penalty if you sign up through a Special Enrollment Period.
Step 3: Decide if you want additional Medicare coverage
Unfortunately, Original Medicare doesn’t cover every medical need. For example, it doesn’t cover routine vision or dental services, prescription drugs, and health coverage outside of the United States.
Medicare Supplement (Medigap ) plans are additional coverage you can purchase to “fill the gaps” in Original Medicare. Medigap plans can help with cost-sharing expenses like co-insurance, copayments, and deductibles. These plans can also include benefits not covered by Original Medicare, like foreign travel coverage. Because Medigap is meant to supplement Original Medicare, you must be enrolled in Medicare Part A and Part B to join a Medigap plan.
Once you have enrolled in your Medicare Part A and Part B, you should also decide whether you want to add prescription drug coverage, also known as Medicare Part D. Original Medicare doesn’t include drug benefits, and out-of-pocket costs for medications can be very expensive without insurance. You can get Medicare prescription drug coverage through a stand-alone Medicare prescription drug plan if you have Original Medicare. If you’re enrolled in Medicare Advantage (a private Medicare health plan), you can get this coverage through a Medicare Advantage Prescription Drug plan.
Medicare Part D and Medigap plans are offered through private insurance companies, and costs can vary by plan and location. To find plans near you:
- Contact the Medicare plan directly.
- Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week.
- Contact a licensed insurance agency, such as eHealth Insurance, Medicare Consumer Guide’s parent company.
- Call an eHealth licensed insurance agent at 888-391-2659, TTY users 711; Monday through Friday, 8AM to 8PM ET, Saturday, 9AM to 6PM ET.
- Or click Compare Medical Plans above to get an online quote.
When researching Medicare Part D options, you should make a list of any drugs you currently use, including the name of drug and dosage. Make sure that any plan you join covers all of the medications you take.
Keep in mind that there’s a Medicare Part D late enrollment penalty if you don’t sign up when you’re first eligible and don’t have creditable prescription drug coverage. Creditable prescription drug coverage is coverage that’s expected to pay, on average, as much as standard Medicare Part D benefits.
Step 4: Don’t be afraid to ask for help
Medicare has many different parts, and it can be overwhelming. If you get confused, don’t be afraid to ask questions. Once you are ready to make a decision, you can enroll in the Medicare plan that best suits your needs. If or when future health problems arise, you’ll be glad you took the time.
The following resources may help you get your questions answered:
- “Medicare and You ,” an annual publication that gives an overview of the Medicare program.
- gov website
- 1-800-MEDICARE (1-800-633-4227), customer service representatives are available 24 hours a day, seven days a week. TTY users should call 1-877-486-2048.
- eHealth Insurance, the parent company of Medicare Consumer Guide, has knowledgeable licensed insurance agents available to help. Call eHealth at 1-888-391-2659. TTY users can call 711. eHealth licensed insurance agents are available Monday through Friday, from 8AM to 10PM ET, and Saturdays, from 9AM to 6PM ET.
Medicare has neither reviewed nor endorsed this information.