- General Information
- Medicare enrollment is automatic for some of us
- Some of us have to contact the Social Security Administration (SSA)
- When can you add or drop forms of Medicare coverage?
General Information. Yes, believe it or not, the Social Security Administration is responsible for enrolling eligible individuals in the Medicare program. As a matter of fact, the SSA takes care of the following Medicare items:
- Sign up for Medicare Part A and Part B
- Ask for a replacement Medicare card
- Change your address
- Apply for Extra Help with Medicare Prescription Drug costs if you have limited income and resources
- Ask questions about Medicare Part A and Part B eligibility and enrollment
- Ask Medicare premium questions
- Report a death
Medicare enrollment is automatic for some of us. In fact, anyone who is receiving a Social Security or Railroad Retirement Board (RRB) check is automatically enrolled in Medicare Part A and Part B. Part A is Hospital Insurance; Part B is Medical Insurance. However, if you are not planning on drawing a Social Security retirement check when you turn 65, you must contact Social Security to enroll in Medicare.
In most cases, if you're already getting benefits from Social Security or RRB, you will automatically get Part A and Part B starting on the first day of the month you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the previous month.
If you're under 65 and disabled, you automatically get Part A and Part B after you get disabiity benefits from Social Security or certain disability benefits from the RRB for 24 months.
You will get your red, white, and blue Medicare Health Insurance ID card in the mail about 3 months before your 65th birthday or your 25th month of disability. If you don't want Part B, following the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums.
NOTE: If you live in Puerto Rico and you get benefits from Social Security or RRB, you will automatically get Part A. If you want Part B, you will need to sign up for it. Contact your local Social Security office or RRB for more information.
NOTE: If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease), you automatically get Part A and Part B the month your disability benefits begin.
NOTE: If you have Part A and TRICARE (coverage for active duty military or retirees and their families), you must have Part B to keep your TRICARE coverage.
Oh yes, there is another important criterion: you must be a U.S. citizen or a legal resident of this country for five years or longer to be eligible for Medicare.
Some of us have to contact the Social Security Administration (SSA). If you’re coming up on 65 and are not currently receiving Social Security benefits (regardless of whether you plan to enroll in Social Securty Retirement benefits now or at a later date; remember, full retirement benefits are no longer available at age 65 for people born in 1938 or later), SSDI, or benefits from the Railroad Retirement Board, you can still apply for Medicare coverage. As a matter of fact, Part A (Hospital Insurance) is free if you have worked for at least 40 calendar quarters. You can visit your local Social Security Administration office or call (800) 772-1213, TTY users should call 1-800-325-0778 or go to www.ssa.gov to enroll in Medicare.
CAUTION: If you or your spouse (or a family member if you're disabled) is still working and you have coverage through an employer (including the Federal Employee Health Benefits Program) or union, contact your employer or union benefits administrator to find out how your insurance works with Medicare. It may be to your advantage to delay Part B enrollment. If you want Medicare Part A and Medicare Part B, then you should sign your Medicare card and keep it in your wallet. If you don’t want Part B, you put an "X" in the refusal box on the back of the Medicare card form, and send the form to the address shown right below where your signature goes. About four weeks later, you will get a new Medicare card indicating that you only have Part A coverage.
When can you add or drop forms of Medicare coverage? Medicare has enrollment periods that allow you to do this.
The Initial Enrollment Period (IEP) is seven (7) months long. It starts three months before the month in which you turn 65 and ends three months after that month. You can enroll in any type of Medicare coverage within this seven-month window – Part A, Part B, Part C (Medicare Advantage Plan), and Part D (prescription drug coverage). If you don’t sign up for some of this coverage during the initial enrollment period, it may cost you more to add it later.
The Medigap Open Enrollment Period is a six (6) month period which starts the first month you are both age 65 and enrolled in Part B. This period gives you a guaranteed right to buy any Medigap (Medicare Supplement) policy sold in your state. Once this period starts, it cannot be delayed or repeated.
The Annual Coordinated Election Period (AEP) runs from October 15 to December 7 each year. You can join, switch, or drop a Medicare Advantage (Part C) plan or Prescription Drug (Part D) plan.
The Medicare Advantage Annual Disenrollment Period (MADP) runs from January 1 to February 15 each year. If you are covered by a Medicare Advantage Plan, whether or not it includes prescription drug coverage, this is the time you can return to Original Medicare. You will then have the opportunity to enroll in a stand-alone Part D Prescription Drug plan. Lastly, you can apply for a Medigap policy, but you may not be guaranteed coverage (refer to Medigap Open Enrollment Period and Special Enrollment Periods for exceptions).
The General Enrollment Period is for people who did not sign up for Part A and/or Part B when they were first eligible. It runs from January 1 to March 31 each year. Your coverage will begin July 1. You may have to pay a higher premium for late enrollment.
Special Enrollment Period. There are several situations that may occur to place you in a Special Enrollment Period. The most common is for people who didn't sign up for Part B when they were first eligible because they were covered under a group health plan based on current employment. You may also qualify for a SEP if you're a volunteer serving in a foreign country.
Citation: 2013 Medicare & You Booklet