Medicare Enrollment: How and when to enroll in Medicare
You have several options for enrolling in Medicare. For some people, it's automatic. For others, it may depend on when and how you become eligible.
If you are already collecting Social Security retirement benefits when you turn 65 years old, you will be automatically enrolled Medicare Part A (hospital insurance) and/or Part B (medical insurance). Those who do not live within the 50 United States or D.C. (for example, if you live in Puerto Rico) will be automatically enrolled in Medicare Part A, but not Part B.
If you are automatically enrolled in Medicare Part B, but do not wish to keep it because you already have creditable medical insurance (that is, medical insurance that covers at least as much as Medicare Part B) you will have the opportunity to refuse it.
For those who are not automatically enrolled, there are various enrollment periods for you to sign up. Be aware that, with certain exceptions, there are penalties for not signing up when you should.
Enrolling in Medicare Part A
For most people, enrolling in Medicare Part A is automatic. If you delay your Social Security retirement benefits (or Railroad Retirement Benefits (RRB) beyond age 65, you will have to initiate the enrollment in Medicare Part A when you become eligible.
Contact Social Security or RRB three months before you turn 65. You can stop by your local office, log on to the website, or call 1-800-772-1213 for Social Security or 1-877-772-5772 for RRB.
Enrolling in Medicare Part B
If you declined the automatic enrollment for Medicare Part B, or if you were not automatically enrolled, you have several enrollment periods to enroll later.
The Initial Enrollment Period begins three months before you first become eligible for Medicare and lasts for seven months. For most, that means three months before your 65th birthday. If you are disabled, your Initial Enrollment Period begins on the 25th month after you first start collecting Social Security disability benefits. If you have Amyotrophic Lateral Disease (ALS or Lou Gehrig's Disease), your enrollment into Medicare would automatic while those diagnosed with End Stage Renal Disease (ESRD or kidney failure) would need to call for Medicare enrollment.
If you did not enroll during the Initial Enrollment Period, you should do so during the General Enrollment Period. General enrollment begins January 1 and runs through March 31 each year. Stop by your local Social Security or RRB office, log on to their respective websites, or call 1-800-772-1213 for Social Security or 1-877-772-5772 for RRB.
You may choose not to initially enroll in Medicare Part B because you already have group medical insurance through an employer or union. In this case, you will not have to pay a penalty. If you lose your group insurance, or if you decide you want to switch from your group coverage to Medicare, you are given a Special Enrollment Period in which to do so.
Once you become eligible for Medicare, the eight-month Special Enrollment Period begins anytime you decide you no longer want to be covered under your group insurance plan. If you lose your group insurance coverage (for example, you terminate your employment), your eight-month Special Enrollment Period begins the month you lost your employment. However, if you lose your employment during what would normally be your Initial Enrollment Period, then the timing and rules apply for initial enrollment. The Special Enrollment Period does not apply if you are eligible for Medicare because you have ESRD.
Enrolling in Medicare Part C (Medicare Advantage)
Medicare Part C is an alternative to Medicare Parts A and B and is offered through private insurance companies. The enrollment process varies by insurer. You must have Medicare Parts A and B to enroll in Medicare Part C during the Annual Enrollment Period through a private insurer.
You can also add, drop, or change your Medicare Advantage plan during Annual Enrollment Period. During this period you may change your enrollment in any Medicare Part C or Part D plans without any penalties. The Annual Enrollment Period will be changing in 2011. In 2010 (for 2011 plans), it was from November 15 through December 31. In 2011 (for 2012 plans), this period will begin October 15 through Dec 7.
If you enroll in Medicare Part C during the Annual Enrollment Period, you can drop that plan and revert to Original Medicare (Parts A and B) only during Medicare Annual Disenrollment Period (MADP), which runs from January 1 through February 14. If you do not disenroll during this time, you must keep your plan for the rest of the year unless you eligible for a Special Enrollment.
Enrolling in Medicare Part D (prescription drug insurance)
Once you are eligible for Medicare, you must have creditable prescription drug coverage (that is, prescription drug coverage that is at least as good as Medicare Part D) to avoid paying a penalty. You may have prescription drug coverage through a private insurer or through Medicare Part C.
If you do not have creditable prescription drug coverage, you must enroll for Medicare Part D during your Initial Enrollment Period (see Enrolling in Medicare Part B) or during the Annual Enrollment Period. Those who drop out of the Part C plan and return to Original Medicare during Medicare Annual Disenrollment Period are also allowed to sign up for a stand-alone Part D plan.
Enrolling in a Medigap plan
Medigap plans are voluntary. You have a guaranteed right to buy a Medigap supplemental insurance policy during the Open Enrollment Period. The Medigap Open Enrollment Period is the six months beginning with the first month your turn 65 and are enrolled in Medicare Part B. If you enroll in Medicare Part C, you do not need a Medigap policy. You can buy a Medigap plan through a qualified Medigap insurance agent.
