Applying For Medicare

Applying for Medicare

Applying for Medicare at 65 is an important milestone for most Americans. Around your 65th birthday, you enter your Initial Enrollment Period (IEP) — a seven-month window that begins three months before the month you turn 65 and ends three months after. During this time, you can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance) through Social Security, usually online at SSA.gov or at your local Social Security office. Most people receive Part A premium-free if they or their spouse paid Medicare taxes for at least 10 years, while Part B has a monthly premium. After enrolling in Parts A and B, you can choose to add Part D (prescription drug coverage) or join a Medicare Advantage (Part C) plan that combines hospital, medical, and often drug coverage. It’s important to apply on time to avoid late-enrollment penalties and ensure your coverage begins when you need it.

Signing-up for Medicare when Turning 65

When it comes to Medicare enrollment, whether or not you are already collecting Social Security benefits makes a big difference in how and when you’re enrolled:

✅ If You Are Already Collecting Social Security Benefits
You are automatically enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance) when you turn 65.

Your red, white, and blue Medicare card is mailed to you about three months before your 65th birthday.
Part A is usually premium-free (if you’ve worked at least 10 years).
Part B has a monthly premium, which will be automatically deducted from your Social Security check.
You can opt out of Part B if you have other creditable coverage (like employer insurance) by following the instructions that come with your card.

📝 If You Are Not Collecting Social Security Benefits

You are not automatically enrolled in Medicare.
You must apply manually for Part A and Part B through the Social Security Administration (SSA):

Apply online at SSA.gov/medicare,
Or call Social Security at 1-800-772-1213

Your Initial Enrollment Period (IEP) starts 3 months before your 65th birthday month and lasts 7 months total.
If you delay enrolling in Part B without having other creditable coverage, you may face a late-enrollment penalty.

⚖️ Key Differences (See table below)

Aspect	Already Collecting Social Security	Not Collecting Social Security
Enrollment	Automatic for Parts A & B	Must apply manually
Start Date	Automatically starts 1st of your birthday month (or month before if birthday on 1st)	Based on when you apply
Premium Payments	Part B premium deducted from Social Security check	You’ll receive a bill for Part B (usually quarterly)
Action Required	Decline Part B if you don’t want it yet	Apply for A & B during IEP
Risk of Penalty	None if automatically enrolled	Possible if you delay Part B without creditable coverage

Signing Up for Both Part A & Part B after 65

Signing up for Medicare Parts A and B after age 65 depends on your current situation — especially whether you have or recently had employer or union group health coverage. Here’s a full breakdown:

🧭 1. Determine Your Situation
If you did not enroll at 65 because you had employer coverage through your job or your spouse’s, you may qualify for a Special Enrollment Period (SEP) when that coverage ends.

✅ You can sign up:

Anytime while you’re still covered by the employer plan
Or within 8 months after the month that your employment or coverage ends (whichever comes first)
If you did not have employer coverage, you must wait for the General Enrollment Period (GEP):

January 1 – March 31 each year
Coverage begins the month after you sign up

📝 2. How to Apply for Medicare After 65
Option A – Apply Online
You can apply for Part A (Hospital Insurance) and Part B (Medical Insurance) online through Social Security:
🔗 www.ssa.gov/medicare/sign-up

Option B – Apply by Mail or In Person
If applying after 65 due to loss of employer coverage, you must complete:

CMS-18-F-5 — Application for Enrollment in Hospital Insurance (Part A)
📄 Download: www.cms.gov/files/document/cms-18-f-5-application-part-hospital-insurance.pdf
CMS-40B — Application for Enrollment in Medicare Part B (Medical Insurance)
📄 Download: www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms40b-e.pdf
CMS-L564 — Request for Employment Information (your employer must fill this out)
📄 Download: www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms-l564e.pdf

Mail or bring both forms to your local Social Security office.
Find your nearest office here:
🔗 secure.ssa.gov/ICON/main.jsp

🧩 3. Key Tips

Part A is usually premium-free if you or your spouse worked 10+ years (40 quarters).
Part B has a monthly premium (income-based; higher-income individuals pay IRMAA).
To avoid penalties, keep records showing you had creditable coverage through an employer.
If you delay both Parts A and B without qualifying coverage, you may face late enrollment penalties and delayed coverage.

Already have Part A and want to add Part B because I’m losing my job-based coverage

If you already have Medicare Part A and want to sign up for Part B after age 65, the process depends on why you delayed Part B:

🧭 1. Determine Your Eligibility Path
✅ You have or recently had employer or union group coverage

You qualify for a Special Enrollment Period (SEP) to add Part B without penalty.

You can apply for Part B:

Anytime while still covered by employer or union insurance, or
Within 8 months after the month employment or coverage ends (whichever comes first).

⚠️ If you did not have employer coverage
You must wait for the General Enrollment Period (GEP):

January 1 – March 31 each year.
Coverage begins the month after you enroll.

📝 2. What You’ll Need
Required Forms

CMS-40B — Application for Enrollment in Medicare Part B (Medical Insurance)
📄 Download: https://www.cms.gov/medicare/cms-forms/CMS-Forms/downloads/CMS40B.pdf
CMS-L564 — Request for Employment Information (your employer must fill this out)
📄 Download: https://www.cms.gov/medicare/cms-forms/CMS-Forms/downloads/CMS-L564.pdf

📌 If you’re applying during the General Enrollment Period (and not due to job-based coverage), you only need the CMS-40B form.

💻 3. How to Submit Your Application
Option A – Online
You can upload both forms through Social Security’s secure portal:
🔗 www.ssa.gov/medicare/sign-up

Option B – By Mail or In Person
Mail or bring the forms to your local Social Security office:
🔗 https://secure.ssa.gov/ICON/main.jsp

💡 4. Key Tips

Keep proof of creditable employer coverage to avoid penalties.
Your Part B premium will begin when coverage starts; it’s usually deducted from your Social Security payment or billed quarterly.
Higher-income individuals may pay an IRMAA surcharge.
If you had COBRA or retiree coverage, it does not count as active employer coverage for SEP purposes.

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