How to Apply for Medicare

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Applying for Medicare has 2 fundamental steps

Step 1: Sign up for Medicare Part A and Part B

This is done via the Social Security Administration either online, by phone, or in-person.

  • Online: Click here to go to Social Security’s webpage for Medicare enrollment.
  • By phone: 1-800-772-1213 between 8:00 a.m. – 7:00 p.m. local time, Monday through Friday. (TTY 1-800-325-0778)
  • In-person: Click here to find the Social Security office closest to you.

Part A and Part B combine to form Original Medicare. It covers a considerable amount of healthcare services, but it leaves you on the hook for a significant share of costs. You’ll want to add coverage from a private insurance company to protect yourself against those costs.

Step 2: Add coverage from an insurance company

Once Part A and Part B are in place, add either:

  • A Medicare Supplement plan and a Part D prescription drug plan
  • A Medicare Advantage plan with Part D benefits included

When should you apply for Medicare?

Should you apply when you turn 65? Or should you wait? The answer depends on how you get your current health insurance.

You should apply for Medicare at age 65 if:

  • You currently get group health insurance from a group with 19 or fewer employees.
  • You get health insurance on your own, like an ACA marketplace or other private plan not sponsored by an employer or group.

You have the option to delay Medicare enrollment past age 65 if:

  • You get group health insurance from a group with 20 or more employees.
  • That group health insurance must be from ACTIVE employment (you or your spouse). So retiree health plans and COBRA coverage don’t count.

Once your group coverage ends, usually due to retirement, you’ll need to enroll. It’s best to enroll as soon as you know the date the group coverage is ending. That way you can have Medicare start the first day of the month after the group coverage ends.

Can I apply for Part A only and delay Part B enrollment?

If you’re able to delay Medicare enrollment, you might want to apply for Part A at age 65 anyway. This is a common practice since Part A is premium-free for most people.

Warning: if you contribute to a Health Savings Account (HSA), you’ll need to stop contributing 6 months before you enroll in Part A and/or Part B.

How to enroll when you turn 65

If you’re already getting Social Security Retirement (or Railroad Retirement) benefits before age 65, you will AUTOMATICALLY be enrolled in Medicare Part A and Part B starting the 1st of your 65th birth month (July 1, 2025 in our example above).

In all other cases: you must do the enrollment MANUALLY yourself.

If you must enroll in Medicare at age 65 and you aren’t automatically enrolled, you need to enroll during your Initial Enrollment Period.

When your Medicare coverage starts

In most cases, it makes sense to enroll sometime within the 3 months before your 65th birthday. That way your Medicare coverage can start on its earliest possible date.

Here’s when Medicare coverage will start based on when you apply:

  • 1-3 months before you turn 65: The month you turn 65 (on the 1st)
  • The month you turn 65: 1 month after you sign up
  • 1-3 months after you turn 65: 1 month after you sign up
  • During the General Enrollment Period (January 1 – March 31): 1 month after you sign up
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AUTHOR

Andy Stroman is the founder of Stroman Insurance Advisors. He is a second-generation licensed health insurance broker who specializes in Medicare and Individual Health Insurance.

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