Most people I know are looking forward to signing up for Medicare as soon as they can.
When you are first eligible for Medicare, you have a seven-month initial enrollment period in which to sign up for Medicare’s Part A and/or Part B benefits and services. Part A covers hospitalization; Part B covers doctor visits, outpatient care, and other medical goods and services.
Many people become eligible on their 65th birthday. They can sign up during the seven-month period that begins three months before the month in which they turn 65, includes the month they turn 65 and ends three months after the month in which they turn 65.
But what happens if you miss that window?
If you did not sign up for Part A and/or Part B (for which you must pay premiums) when you were first eligible, and you are not eligible for a special enrollment period (more on that below), you can sign up during the general enrollment period, which is Jan. 1 to March 31 each year.
Your coverage will start July 1. However, you may have to pay a higher premium for late enrollment in Part A and/or Part B.
How do you actually enroll? You can call Social Security (1-800-772-1213) or visit a local Social Security office. Or, you can apply online at www.ssa.gov.
After your initial enrollment period ends, you may have the chance to sign up for Medicare during a special enrollment period.
If you are covered under a group health plan based on current employment, you have a special enrollment period in which to sign up for Part A and/or Part B anytime as long as you or your spouse (or family member if you are disabled) are working and you are covered by a group health plan through the employer or union based on that work.
You also have an eight-month special enrollment period to sign up for Part A and/or Part B. It starts the month after the employment ends or the group health insurance based on current employment ends, whichever happens first. In most cases, you do not have to pay a late enrollment penalty if you sign up during a special enrollment period.
Important note: COBRA and retiree health plans are not considered coverage based on current employment. You are not eligible for a special enrollment period when such coverage ends. Additionally, the special enrollment period does not apply to people with End-Stage Renal Disease (ESRD).
You may also qualify for a special enrollment period for Part A and Part B if you are a volunteer serving in a foreign country.
Some people get automatically enrolled in Medicare. Among them are people with certain disabilities and those who are already getting benefits from Social Security or the Railroad Retirement Board.
If you are automatically enrolled, you will get your red, white and blue Medicare card in the mail three months before your 65th birthday or your 25th month of disability.
Also, Social Security is now processing some Medicare enrollments for same-sex spouses, including:
- Enrollments for premium-free Part A for uninsured spouses age 65 or older based on the work history of a current or former spouse;
- Enrollments for people with End-Stage Renal Disease based on the work history of a current or former spouse;
- Reductions in Part A premiums based on the work history of a current or former spouse;
- Requests for special enrollment periods based on group health plan coverage from current employment of a same-sex spouse;
- Reductions in late-enrollment penalties based on group health plan coverage from current employment of a same-sex spouse.
David Sayen is Medicare’s regional administrator for Hawai‘i, California, Nevada, Arizona and the Pacific Territories. You can get answers to your Medicare questions 24/7 by calling 1-800-MEDICARE (1-800-633-4227).
