Enrollment in Medicare Part A is usually automatic starting the first day of the month you turn 65. If you don't receive an enrollment notice, call Social Security at 1-800-772-1213 (railroad retirees should call 1-800-808-0772).
If you are disabled, there is a 24-month waiting period for Medicare after you become disabled. After that, you are automatically enrolled in Medicare Part A and must decline Part B if it is not wanted. In the meantime, you may qualify for Medicaid/Medical Assistance, use COBRA coverage, or obtain services from state-specific programs.
There are three opportunities to sign up for Part B: the Initial Enrollment Period, the Special Enrollment Period and the General Enrollment Period.
- Part B Initial Enrollment Period
- Part B Special Enrollment Period
- Part B General Enrollment Period
During the Part B Initial Enrollment Period, you can enroll 3 months prior to, the month of, or 3 months after your 65th birthday. Or, if you are disabled, after your 24th month of receiving disability benefits. If you want to decline Part B enrollment during the Initial Enrollment Period, you must return your Part B notice to Social Security.
If you do not sign up, a 10 percent penalty is typically added to the Part B premium for each 12-month period you could have had Part B but didn't sign up for it when first eligible, unless you qualify for the Part B Special Enrollment Period. The penalty continues for as long as you have Part B.
If you or your spouse have medical coverage through a union or an employer group, or you did not have Part B coverage because you went back to work and had group medical coverage, you can use the Part B Special Enrollment Period to enroll. The Special Enrollment Period lasts for 8 months and begins when your employer or union coverage ends, or when employment ends, whichever is first.
To use the Part B Special Enrollment Period, contact Social Security four months before you retire or when your employer or union coverage ends, and request a form that your employer will need to complete to activate your Special Enrollment Period. Then send the employer paperwork along with your Part B enrollment form to Social Security.
If you are 65 and continue your employer coverage through COBRA, you should enroll in Part B — you will not get a Special Enrollment Period when COBRA ends. You must sign up for Part B during the first eight months you have COBRA coverage to avoid the late enrollment penalty.
If you do not enroll in Part B during the Initial or Special Enrollment Periods, you can enroll during the General Enrollment Period from January 1 through March 31 of each year, with coverage not starting until July 1 of the year you enroll. For each year you are late in enrolling, you are charged a 10 percent Part B penalty. This charge increases annually as Medicare premiums increase and will continue for your lifetime or as long as you are on Part B.
- Initial Enrollment Period
- Annual Enrollment Period
- Special Enrollment Period
If you are newly eligible for Medicare, you most likely qualify for an Initial Enrollment Period. During the Initial Enrollment Period you can enroll in a Medicare Advantage plan 3 months prior to, the month of, or 3 months after your 65th birthday, or after your 24th month of receiving disability benefits.
If you are currently a Medicare beneficiary, you can change your coverage during the Annual Enrollment Period between October 15 and December 7 of each year. This includes enrolling in or changing to a Medicare Advantage Plan with prescription drug coverage for an effective date of January 1 of the following year.
A Special Enrollment Period allows you to enroll in a prescription drug plan or Medicare Advantage plan after an Initial or Annual Enrollment Period has ended. Some reasons you might qualify for a Special Enrollment Period are:
- You are eligible for additional financial help from Social Security
- You permanently move outside your plan's service area
- Your plan's contract is terminated, or the plan goes out of business
- You lose your prescription coverage from an employer or union, or your coverage changes so that it is no longer as good as ("creditable coverage") the standard Medicare benefit
- You qualify because of other circumstances