Automatic Enrollment in Medicare (before you turn age 65):  

  • If you are 62 to 64 years old and collecting monthly Social Security payments, you do not need to apply for Original Medicare, Parts A & B, because Social Security will automatically send your Medicare Card one month before your 65th birthday.

  • If you are under 65 years old and receiving disability benefit payments from the Social Security Administration for 24 months, you will automatically be enrolled in Medicare Parts A & B, on your 25th month. 

Enrollment in Medicare (as you approach age 65):  

  • If you are 64 years old, not yet collecting monthly Social Security payments, and are either unemployed, self employed, or retired, and do not receive health insurance coverage from an employer, the veteran's administration, or some other source, you should apply for Medicare Parts A & B prior to your 65th birthday. 
     

Special Enrollment in Medicare: 

  • If you are approaching your 65th birthday and are receiving health care coverage through an employer, the veteran's administration, or any other source, you are welcome to call Susana to help you assess your unique situation and determine the specific requirements for filing for Medicare Parts A and/or B.

  • If you are over 65 and are experiencing a change in life circumstances (i.e., a divorce, retirement, relocating your home, etc.), call Susana to help you assess your unique situation and determine the specific requirements for filing for Medicare Parts A/B.  

Annual Enrollment Period (AEP) / Open Enrollment:

  • Each year, between October 15th and December 7th, all individuals currently enrolled in a Medicare plan are welcome to re-evaluate their coverage needs and choose new coverage, if desired.  If you are satisfied with your current plan, no action is required and your existing plans continue as is.  

  • If you would like to explore options for other plans or additional coverage, call Susana to assist you in identifying the plan that will most effectively meet your needs. 

Eligibility for Original Medicare, Parts A & B:

When to Apply for Initial Enrollment in Original Medicare,
Parts A & B?

If you are turning 65 and are not currently covered under an insurance plan offered by an employer, the veteran's administration, or some other source, you are required to apply for Medicare to avoid any potential penalties.  There is a 7-month window, called the Initial Enrollment Period (IEP), during  which you should apply for Medicare coverage (the 3 months prior to the month you turn 65 PLUS the 3 months following the month in which you turn 65). 

 

Regardless of when you apply during this 7-month window, your Medicare coverage will begin on the first day of the month you turn 65.  Therefore, it is much more cost effective to apply during the 90-day window PRIOR to your 65th birthday, so that you ensure that you will not have to pay for back premiums for the months that have already passed.  

90 Days Before Age 65: Initial Enrollment Period (IEP) Begins

​For Those Individuals Required to Apply for Medicare (see above):

  • Three months before your 65th birthday and three months after your 65th birthday is your “Initial Enrollment Period” (IEP) .  For example, if your birthday is on August 9th,  the beginning date of your Initial Enrollment Period is May 1st, and the end date of your Initial Enrollment Period is November 1st.

When does your coverage begin:

  • If you enrolled in Medicare during the first three months of your Initial Enrollment Period (prior to our birthday):

    • And your birthday falls after the first of the month:  Your start date will be on the first day of your birthday month. For example, if your birthday is on August 9th and you applied between May 1st and July 31st, your start date will be August 1st.

    • And your birthday is on the first day of the month:  Your coverage will start the first day of the prior month.  For example, if your birthday is on August 1st, the beginning date of your coverage is July 1st.

  • If you enrolled in Medicare after your birthday month when you turned 65, and prior to the last three months of your Initial Enrollment Period (IEP), your start date will be the first day of your birthday month.  However, your premiums for that coverage will be billed retroactively back to the first day of your birthday month.  Therefore, any medical expenses incurred during that period are not eligible for Medicare coverage.  For example, if your birthday is August 9th, and you enroll between August and November,  your start date will be August 1st.

How to Apply for Medicare:

  • Due to Covid 19, Social Security Administration offices are closed to the public. Therefore, you need to apply for Medicare Parts A & B coverage online through the Social Security Administration website at:  http://ssa.gov. 

  • Select:  "Medicare Enrollment."

  • Click on “Apply for Medicare Only.”  This will take you to the Medicare Application.  It will walk you through the steps to create your online Social Security Account and fill out the Medicare application.

  • Once you’ve submitted your Medicare application, it will take 3 to 4 weeks for the Social Security Administration (SSA) to mail you your Original Medicare card (a red, white, and blue card with your Medicare Number, indicating that you are now covered for Part A and Part B). 

  • You can log into your Social Security Account to retrieve your Medicare Number within 10 business days, if needed.

Penalties for Not Enrolling on Time:

Part A (Hospital Insurance):

  •  If you haven't worked for 10 years (40 quarters) and are therefore required to pay a pro-rated premium for Part A, you are still required to enroll during the Initial Enrollment Period (IEP).  If you do not enroll during that period, you will be penalized with higher premium rates, retroactive to your 65th birthday. 
     

Part B (Medical Insurance):  

  • If you don’t sign up for Part B during the Initial Enrollment Period (IEP), your monthly Part B Premium may go up as high as 10% for each 12-month period that you could have had Part B but didn’t sign up.  In most cases, you may have to pay this late enrollment penalty for as long as you have Part B, which may be the remainder of your life, and the penalty increases the longer you go without Part B coverage.  

When & How to Apply for Medicare

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