How To Apply For Medicare: A Step-by-Step Guide

More than 65 million Americans are currently enrolled in Medicare. Based on that statistic alone, you probably know someone who has dealt with the Medicare enrollment process, or you’ve done it yourself. Understanding how to apply for Medicare can be frustrating, especially when you consider that beneficiaries may be overwhelmed with their options. A 2022 study noted that the average Medicare participant has almost 40 Medicare Advantage plans to choose from.

Most people become eligible to apply for Medicare when they turn 65. There are some instances where those under the age of 65 are also eligible. Some may even be automatically enrolled in certain Medicare plans.

If you fall into one of those two categories, no further action is required because you will automatically be enrolled in Medicare Part A and Part B — often referred to as “Original Medicare.” Your Medicare coverage will begin the first day of the month you turn 65.

It’s important to note that, after enrolling, you still have options to switch your coverage to a Medicare Advantage plan or add on prescription drug coverage via Medicare Part D.

If you do not fall into one of the above categories, follow these steps to assist you in starting your Medicare journey.

And if you worked at a railroad but were not automatically enrolled, call the Railroad Retirement Board at 1-877-772-5772 (TTY 1-312-751-4701) to sign up.

Adults ages 65 and older who are not automatically enrolled in Medicare Part A and Part B must sign up through the Social Security Administration (SSA).

The best time to sign up for Medicare is during the seven-month window known as your initial enrollment period (IEP). It begins three months before the first day of the month of your 65th birthday. The window of time also includes your birth month and ends three months after your birthday. For example, if your birthday is on August 25, the window begins on May 1 and ends on November 25.

Medicare Part A is known as hospital insurance because it helps cover the costs of inpatient hospital care as well as some skilled nursing facility time, home health care and hospice care.

Most people who paid Medicare taxes for a minimum of 10 years while working in the United States can receive Medicare Part A for free.

Medicare Part B is known as medical insurance because it provides financial support to pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services.

Signing up for Part B does require a monthly premium, so applicants have the option to decline Part B during the enrollment process.

After completing your initial Medicare enrollment, you must create a MyMedicare.gov account to manage your coverage online. The account registration process is quick, easy and provides a variety of benefits, such as:

The information within this account will be useful for registering for any additional Medicare coverage, including Part C, Part D and Medigap.

Once you are enrolled in Medicare Part A and Part B, you have the option to switch to a Medicare Part C plan — also known as Medicare Advantage — to replace your Original Medicare coverage. Medicare Advantage plans offer all of the same benefits found in Parts A and B, but some plans include other benefits, such as prescription drug coverage, dental and vision. But not all Medicare Advantage plans offer the same benefits.

To complete your enrollment in a Medicare Advantage plan, you will need to provide your Medicare number and the date your Part A and Part B coverage began.

Medicare Part D is the optional prescription drug coverage available to anyone with Medicare Part A and Part B. There are a variety of Part D plans to compare and choose from.

Be sure to have your Medicare number and the date your Part A and Part B coverage started in order to sign up for your Medicare Part D plan.

Optional supplemental insurance policies known as Medigap help cover deductible costs, out-of-pocket copays and coinsurance expenses that Medicare does not cover. To be eligible for enrolling in Medigap, you must first be enrolled in Medicare Part A and Part B.

Note that prices may vary widely, so secure multiple quotes before making a purchase.

Due to the many variables involved in optimizing the Medicare enrollment process, questions often arise. These questions are some of the most commonly asked.

Most people sign up for Medicare during the seven-month initial enrollment period (IEP) around their 65th birthday. But not everyone is able to enroll in that window of time, so there are alternative Medicare enrollment periods throughout the year. It’s helpful to be aware of the specifics of each time window so you can plan accordingly.

Some people opt to initially decline enrollment in Part B because it requires a monthly premium. Others chose to delay Part B because they receive group health insurance through their — or their spouse’s — employer.

Once you stop working or that employer-based healthcare coverage ends, you have eight months to sign up for Part B. After that, you’ll face a late enrollment penalty.

To enroll in Part B after your group health insurance ends, you will need to complete Form CMS-40B (Application for Enrollment in Medicare – Part B) and return it to the Social Security Administration. You may also want to request a special enrollment period, which will require you to fill out a Form CMS-L564 (Request for Employment Information).

Individuals who have existing health insurance through their current employers — or their spouse’s employer — may choose to keep that coverage and make Medicare their secondary insurance. Because most group health plans cover the types of medical services included in Medicare Part B, many people in this situation opt to delay their Part B enrollment in order to save money on the Part B monthly premiums.

Upon your — or your spouse’s — retirement, you will be eligible for a Special Enrollment Period, during which you can then enroll in Part B. See the response above (“Should I Delay Enrolling in Part B?”) for additional details.

The enrollment process is unique for each person, but with a qualified Medicare planner in your corner, the actual application process shouldn’t take long. After submitting an application, most beneficiaries receive their Medicare card about three weeks later. If you were automatically enrolled in Medicare Part A and Part B, typically your card will arrive in your mailbox about two months prior to your 65th birthday.

Multiple Medicare Savings Programs are available to people with low incomes. The programs can help cover the costs of your Part B premium, as well as other Medicare costs, including deductibles, copays and coinsurance. These programs are operated by Medicaid at the state level. Reach out to your local Medicaid office to see if you qualify for assistance.

If you delay enrollment in Medicare Part A, Part B or Part D, you may face late enrollment penalties. Note that some of these fees will be applied to your premiums for long as you receive Medicare benefits. Considering that 66.5% of American bankruptcies are caused by medical expenses, taking steps to avoid extraneous healthcare fees makes sense.

Unless you have group health insurance from your current employer or your spouse’s current employer, the best way to avoid late enrollment penalties is to sign up for Medicare during your initial enrollment period.

Although the concept may be daunting, following this step-by-step guide to applying for Medicare should provide you with a solid footing to successfully complete your enrollment. As you begin your application, our Medicare Simulator can give you the chance to compare a variety of Medicare plans to identify the best Medicare strategy for you.