What You Should Know When Enrolling in the Medicare Program

Doing anything for the first time can be daunting, especially if you’re unsure about what exactly you should be doing. If you’re one of the millions of Americans enrolling in the Medicare program each year, you may be bombarded by information about what you could or should be doing, and it can all get a little crazy.

Whether you’re enrolling in the Medicare program for the first or tenth time, our Medicare section is a great place to check out, but to simplify the information, we’ll try to concisely lay out what you need to know in this article. After reading this, if you’re ready for more, we highly suggest checking out our Medicare section, which covers everything from the basics to more advanced topics. But for now, let’s focus on what you need to know when enrolling in the Medicare program for the first time.

When Can I Enroll in the Medicare Program?

When it comes to your first enrollment in Medicare, there’s no set timeframe like there is for Medicare insurance beneficiaries already enrolled, who can change or enroll in a plan during the Annual Enrollment Period (AEP). While you’ll eventually be able to use the AEP as a beneficiary, you can’t use it to enroll for the first time. Instead, you’ll get your own timeframe based on when you become eligible called the Initial Enrollment Period (IEP). For most people, the IEP begins three months before their 65th birthday, continues through their birthday month, and finally runs for three months after. (There is an exception if your birthday is on the first of a month.) So, it’s roughly a seven-month window. As an example, if your birthday is September 5, your window for first-time enrollment would begin in June and run until the end of December of the next year.

For most people, the IEP begins three months before their 65th birthday, continues through their birthday month, and finally runs for three months after.

People who are already receiving their Social Secuirty benefits will be enrolled in Medicare Part A and B automatically when they turn 65, but that doesn’t mean there’s nothing else to do during your IEP. During this window, you can choose to enroll in other parts of the Medicare program for additional coverage. If you miss your IEP for whatever reason, you may be able to enroll in the Medicare program during a Special Enrollment Period (SEP), which occurs in situations like having health coverage through a job and then retiring.

When Should I Enroll for the First Time?

As mentioned above, there are instances when you may not need to enroll in the Medicare program when you’re first eligible. Generally, this is if you have what’s called creditable coverage, which means you’re part of a qualified health coverage plan that’s comparable to the Medicare program. This is usually through an employer or a spouse’s employer. If you postpone enrolling in the Medicare program because you have creditable coverage, you’ll have an SEP once you no longer have that coverage (if you retire for example).

The longer you go without qualified coverage, the larger the penalty may be, so it can be advantageous to enroll as soon as you can.

If you choose to not enroll in the Medicare program during your IEP, and you don’t have creditable coverage, you may be subject to a penalty once you do enroll. The longer you go without qualified coverage, the larger that penalty may be, so it can be advantageous to enroll as soon as you can. In fact, even if you have coverage, you should consider enrolling in Medicare Part A at the very least, since most people receive Part A benefits premium-free, making it great supplementary coverage.

What is the Process of Enrolling in Medicare Parts A and B?

When it’s your time to enroll in Medicare, you can work with Social Security or a licensed sales agent to get signed up. As mentioned earlier, many people are automatically enrolled in Medicare Part A and B when they turn 65, but make sure you don’t need to enroll yourself. Enrolling in Medicare Part A and B is pretty simple, and you have a number of ways to go about it. The simplest method is probably enrolling online at SSA.gov/benefits/medicare. On this website, you’ll fill out the application form and can submit it once completed.

If you want to enroll by speaking with someone directly, you have two options. First, you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), during their normal business hours, to work with a representative over the phone. Second, you can go to your local Social Security office and apply for Medicare insurance in-person. It’s that simple!

Can I Enroll in a Medicare Advantage Plan or Part D?

You also have the option to enroll in Medicare Part C, also known as a Medicare Advantage plan. A Medicare Advantage plan is an alternative to Original Medicare (Medicare Parts A and B) that’s offered by private insurance companies (though plans are approved and regulated by the Centers for Medicare & Medicaid Services). These plans are required to offer at least what Original Medicare covers, but many have additional benefits included. For example, many Medicare Advantage plans offer prescription drug coverage.

The great part is, there is no need stress over making the commitment to a Part C plan because you have the ability to change your mind. After enrolling in an Medicare Advantage plan, you have a 12-month timeframe where you can switch back to Original Medicare should you choose.

Like Medicare Parts A, B and C, you can also enroll in Medicare Part D during your IEP or switch prescription drug plans during the AEP. Part D plans offer prescription drug coverage and pair with Original Medicare. It’s worth noting that unless you have creditable prescription drug coverage, you should enroll in a Part D, or Medicare Advantage Prescription Drug plan, when you are able, since you can receive an enrollment penalty similar to Part B.

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Enrolling in the Medicare program is something that can seem complex from the outside looking in, but once you start to understand the details, it becomes less scary. That’s what makes our Medicare section such a valuable tool. You can also reach out to the Medicare Ombudsman or a licensed sales agent for professional assistance. If you’re interested in exploring your Medicare insurance options, feel free to check out the Shop & Enroll plan finder tool. Using your zip code, you can find Medicare Advantage, Part D, and Medicare Supplement plans in your area and get in contact with a licensed sales agent who can guide you through enrollment.

Don’t forget to take advantage of your Welcome to Medicare visit once you’re enrolled in the Medicare program! This visit is an excellent preventative meeting with your doctor that’s fully covered by the Medicare program and often missed by early enrollees of the Medicare program.