How Do I Apply for Medicare?
With the oldest Baby Boomers turning 70 and 46 million Americans age 65 or older, it’s not surprising that the number of people applying for Medicare is gathering speed.1 As of 2015, 55.5 million Americans were receiving coverage,2 and 10,000 people enroll every day.3 As more Baby Boomers transition into retirement, more will need to apply.
There are several types of coverage from which you can choose, depending on your preferences, and each has a slightly different application process. If you’re preparing to apply, follow this easy guide.
Applying for Part A and Part B
Original Medicare is the traditional coverage the federal government provides and may work well for people who don’t want to pay high premiums. This type includes Part A and Part B. Part A doesn’t have a premium and takes care of medically necessary inpatient care and some home health care. Part B covers doctor services, tests, lab work, and some preventative services. The monthly premium for Part B is based on your income.
Starting three months before the month you turn 65, you have a total of seven months to apply. If you’re eligible and didn’t sign up when you were first eligible or aren’t eligible for a Special Enrollment Period, you can sign up for Part A and Part B during the General Enrollment Period, which runs from January 1 through March 31. However, if you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty.4
To apply, you can fill out an online application. Social Security will process your application and mail your Medicare card.
Applying for Medicare Advantage (MA)
Some people may choose to enroll in an MA Plan. Also known as Part C, this optional plan combines the coverage of Part A and Part B—and sometimes additional coverage as well—but allows private insurance companies to offer the coverage. This plan is designed to benefit those who desire lower total out-of-pocket expenses and more flexibility on coverage.
Like Part A and Part B, you have seven months to apply for MA—three months before you turn 65, the month you turn 65, and three months after. You can also enroll during the General Enrollment Period, which runs between October 15 and December 7. In most cases, you must enroll first in Part A and B before you can enroll in Part C.5
Once you’re enrolled in original, research MA Plans and see if they are currently accepting new member enrollments. Unlike Part A and B, these aren’t required to accept new enrollments. If they reach capacity, you may have to join a waiting list or search for a different plan.
Finding and comparing plan rules and costs can be confusing. We have licensed insurance agents who can help you find a plan and get a quote by phone. One you’ve found a plan in which you can enroll, you can request an enrollment form from the plan provider. After filling out and returning the form, call the plan you want to join to find out your next steps.
Applying for a Prescription Drug Plan (PDP)
Also known as Part D, PDPs add drug coverage to Part A and B through private insurance companies. Coverage may also be covered by certain MA Plans. When you’re applying for Part A and B during your seven-month enrollment period, you can simultaneously search for a PDP.
If you want to add or switch plans, Open Enrollment for Part D is October 15 through December 7. Once you have chosen a drug plan, enroll on the plan’s website and complete the enrollment form. After you have completed the form, call the plan directly to learn next steps.
Applying for a Medicare Supplement (MS) Plan
MS Plans, also referred to as Medigap Plans, are available as an add-on to Part A and B and help pay for expenses that original coverage doesn’t cover, such as deductibles, copayments, and coinsurance.
When you’re applying for Part A and B, you can simultaneously search for a PDP or MS Plan. These plans are run by private companies and, like MA, require you to search for a plan available within your state and apply through a form. Use the Medigap Policy Search to review available plans, or use the Plan Finder to search for a Part D Prescription Drug Plan.1
Changing Your Plan
If you are currently enrolled in Part A and Part B, there may come a time when you want to switch plans or adjust your coverage. Most people are eligible to change their coverage during the Fall Open Enrollment Period, which runs from October 15 to December 7.6 During this period, you can join a new MA Plan, join a Part D Plan, or switch to Part A and B. To change to original coverage, call 1-800-MEDICARE or call your MA Plan directly.
You can also switch from MA to original coverage during the MA Disenrollment Period (MADP), which occurs between January 1 and February 14.7 You may be able to change your plan outside of these enrollment periods if you qualify for a Special Enrollment Period (SEP).
Rules regarding when and what changes you can make are different depending on the circumstances. Generally speaking, you may qualify for a Special Enrollment Period if you moved, you lost your current coverage, you have an opportunity to get other coverage outside of Medicare, your plan changes its contract, or other special situations.8
When to Apply
Medicare is available for people age 65 or older, although some people younger than age 65 with disabilities or permanent kidney failure may also be eligible.9 This doesn’t mean you must sign up at age 65. If you’re still working, your employer-provided plan may offer a lower premium.
If you postpone getting coverage for a later date, plan ahead to ensure you won’t have a gap in your current coverage, as there can be a waiting period for enrollment. Additionally, if you postpone getting coverage, you may have to pay a penalty of up to 20% of your Part B premium for each year you delay.10
1 Population Reference Bureau, “Fact Sheet: Aging in the United States”
2 Henry J. Kaiser Family Foundation, “The Total Number of Medicare Beneficiaries”
3 Forbes, “10,000 People Are Now Enrolling in Medicare—Every Day”
4 9 Social Security Administration, “Medicare Benefits”
5 Medicare.gov, “Part B Late Enrollment Penalty”
6 Medicare.gov, “Part A & Part B Sign Up Periods”
7 Elder Law Answers, “Entering and Leaving Medicare Advantage Plans”
8 Medicare Interactive, “Six Things to Know about Fall Open Enrollment”
10 Medicare.gov, “Special Circumstances (Special Enrollment Periods)”