How To Apply For Medicare
Medicare is a health insurance program founded and funded by the U.S. government. This program is designed for persons aged 65 and above and persons under 65 living with disabilities and certain medical conditions.
Some people are automatically enrolled in Original Medicare if they meet certain requirements. However, others may need to sign up for Medicare on their own.
In this article, we highlight ways to apply for Medicare Parts A and B, Medicare Part C (Medicare Advantage Plan), Medicare Part D plan, and Medigap policies.
How To Enroll In The Various Medicare Plans
Medicare has several plans that have different ways of signing up. Each of these plans also have different enrollment periods. If you’re new to Medicare, delaying your enrollment could result in paying penalties. It’s helpful to set reminders for these important dates, especially when signing up for Medicare for the first time.
Determine Whether You Need to Sign Up for Medicare
Some people are automatically enrolled in Medicare Part A hospital insurance and Medicare Part B medical insurance.
You are automatically enrolled in Original Medicare if:
● You are already receiving retirement benefits from either Social Security or the Railroad Retirement Board before you turn 65 years old. Usually, your Medicare card will be mailed to you about three months before your 65th birthday.
● You are under 65 and have Lou Gehrig’s disease, also known as amyotrophic lateral sclerosis (ALS).
● You are under 65 and have End-Stage Renal Disease where you require regular dialysis or a kidney transplant.
● You have received Social Security Disability Insurance (SSDI) for at least 24 months. So, you are automatically enrolled in your 25th month.
If you fall into any of these categories, you do not have to apply manually. Your enrollment will be automatic. If you are turning 65 and already receiving your Social Security benefits then your Medicare coverage will begin on the 1st day of your 65th birth month. The only exception to this is if you were born on the 1st day of the month. In that case your Medicare coverage would begin on the first day of the month you turn 65. You can read more about this in our article “When will Medicare Coverage Begin”.
Sign Up For Medicare
Original Medicare (Part A and Part B)
There are three ways to manually sign up for Medicare Part A and Medicare Part B. The best time to apply for Medicare is during your Initial Enrollment Period (IEP), a 7-month period that spans three months before your birth month, your birth month, and three after your birth month.
During the IEP, you may apply via one of the following ways:
● Apply for Medicare only online. You fill out the online application on the Social Security Administration’s website HERE.
● Call Social Security at 1-800-772-1213 (TTY users 1-800-325-0778). Calls will be answered between 7 a.m. to 7 p.m. every working day of the week (Monday through Friday).
● Visit your local Social Security office.
If you worked at a railroad, you might call the Railroad Retirement Board at 1-877-772-5772 (TTY users 1-312-751-4701) to sign up.
Apply For Medicare Online
Signing up online via the Social Security Administration's website is the fastest way to apply for Medicare. It takes about 10 minutes to enroll.
If you would like to sign up online, here are the steps to follow:
● Create a My Social Security account. If you have one already, get the details, you'll need to input them.
● On the Social Security Administration's website, visit the "Apply for Benefits" page.
● Click “Start a New Application.”
● Follow the instructions.
You will have to input your current health insurance information or Medicaid number if you are a Medicaid beneficiary.
You may have to provide additional documentation if you are:
● Not a U.S. citizen
● Applying under your spouse’s or family member's work record
● Over age 65 and transitioning from your employer’s health coverage
After completing the process and getting enrolled, the Centers for Medicare and Medicaid Services (CMS) will mail your welcome packet, a “Medicare & You” handbook, and a Medicare card to you. You should receive your package about two-four weeks after you sign up.
Late enrollment into Medicare Part A and Medicare Part B attracts penalties. Usually, as soon as you're eligible, you should enroll in Medicare Part A. However if you have an HSA you want to delay your Part A if you plan to continue your contributions (Read more about this here).
Enrollment into Medicare Part B can sometimes be delayed if you receive group health insurance at work or through your spouse’s employer. You will want to ensure the employer coverage is creditable. (What is Creditable Coverage)
However, you should sign up for Part B once the Employer Health Insurance coverage ends. Enrollment into Part B must be within eight months of losing “creditable health coverage”, or you'll pay a lifetime late enrollment penalty. You may enroll online or via mail.
To Apply Via Mail, Follow The Following Steps:
● Print out CMS 40B and CMS L564 Forms. The CMS 40B is Application for Enrollment in Medicare - Part B (Medical Insurance), while the CMS L564 Form is needed for Employment Information.
● Complete the CMS 40B Form and provide proof of employment or group health plan coverage.
● Fill out the CMS L564 Form. Note that you are to fill out section A, while your employer must fill out Section B of the CMS L564 Form.
● You may submit by one of the following ways:
○ Mailing your CMS 40B and CMS L564 Forms together to your local Social Security office.
○ Faxing both forms to 1-833-914-2016.
Every 12 months you delay enrollment in Part B without having creditable coverage, your monthly premiums go up 10% of the standard premium. You'll have to pay this penalty for as long as you are enrolled in any of these Parts.
Medicare Advantage Plans
Medicare Part C, also known as Medicare Advantage plans, is an alternative to Original Medicare. Private insurance companies sell these MA plans.
To enroll:
● Call a company directly. (Captive agent - they work for the insurance company)
● Call a broker. (Independent agent - they work for you)
**Learn more about the important differences between Independent and Captive Agents HERE.
Enrollment into Part C plans can be done during your IEP, and during AEP which is from October 15th- December 7th every year.
Medicare Part D
Private companies contracted by CMS also sell Medicare Part D plans. To enroll in Medicare prescription coverage, you can:
● Call a company directly. (Captive agent - they work for the insurance company)
● Call a broker. (Independent agent - they work for you)
**Learn more about the important differences between Independent and Captive Agents HERE.
An independent agent is a major bonus. It saves you money, time, and headache. Contact us at Your Local Medicare Help for assistance in finding the best-suited plans for you. Our services are available at no cost. “How can we help you at no cost?”
Enrollment into Part D plans can also be done during your IEP, and during AEP which is from October 15th- December 7th every year.
Late enrollment attracts penalty fees. For each month you delay enrolling in Medicare Prescription drug coverage, you may have to pay a 1% Part D late enrollment penalty (LEP) later on when you do enroll.
Medicare Supplement Insurance (Medigap)
Medigap policies are provided by private companies as well. They are designed to fill in financial gaps in Original Medicare.
To apply:
● Call a company directly. (Captive agent - they work for the insurance company)
● Call a broker. (Independent agent - they work for you)
The ideal time to enroll into a Medigap plan is when you are first eligible, during your Medigap Open Enrollment window. Its important to note that Medigap Open Enrollment is not at all related to the Annual Election Period which runs from Oct. 15th to Dec. 7th every year. Many people often confuse these and it can result in excess cost and frustration. Read more about this common mistake in our most popular E-book, “5 Costly Medicare Mistakes To Avoid”
You must be enrolled in Original Medicare Parts A and B to buy a Medigap plan.
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Our personalized expert guidance is FREE of charge so that you can save time and money! And even better, when you take care of your Medicare plan enrollment with us, we make a donation to Operation Underground Railroad, which is pioneering the fight against Human Sex Trafficking.
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For every person we help enroll into a Medicare plan we donate to this fund.
