Applying for Medicare: Details, Tips, and Tricks

Applying for Medicare may seem like an intimidating task, but it’s easier than you think. Each year, we help thousands of people enroll in Medicare, and they’re always surprised by the process. Signing up for Medicare is especially easy when you have a trusted insurance advisor helping you along every step of the way.

Our job at Bobby Brock Insurance is to make Medicare as simple as possible. Today, we’re going to tell you everything you ever wanted to know about enrolling in Medicare. We’ll cover timelines, what to do if you have employer coverage, and go over every option you have to enroll in Medicare.

When to Apply for Medicare

One common Medicare myth is that you have to apply for Social Security when you enroll in Medicare and vice versa. It’s easy to see why some people make that mistake since the two programs are closely related. However, you do not have to do both things at the same time. You are eligible to enroll in Medicare at age 65, but you do not have to begin taking Social Security benefits if you want to wait until your full retirement age.

The majority of people “age into” Medicare at 65, but younger people can also become eligible if they have been on disability for two years or were diagnosed with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease). People who fall into one of these categories can get Medicare prior to turning 65.

So, when should you apply for Medicare? That depends on your situation. Let’s talk through a couple of different scenarios.

You Have Creditable Coverage

We see lots of people continue to work past the age of 65. In many of these cases, their employer offers a group health plan. If that group health plan is creditable, meaning that it offers at least as much coverage as Medicare Parts A and B, you are allowed to stay on the plan and delay Medicare with no penalties. The same is true if you are the spouse of an employed person and you are also covered on that plan.

The key is determining if your other coverage is creditable. If your employer has at least 20 employees, the plan will be creditable. Employers who have smaller teams may not be creditable. In either case, you should check with your HR manager or plan provider to ensure you have creditable coverage before deciding to delay your Medicare enrollment.

If you decide to postpone Medicare, you may still want to consider enrolling in Medicare Part A. Most beneficiaries don’t pay a premium for Part A. Since you won’t pay anything for the coverage, it usually makes sense to enroll in Part A only. The exception to this is if you are actively contributing to an HSA, a Health Savings Account. You cannot have Medicare and continue to contribute to an HSA.

Lastly, you can choose to enroll in Medicare and drop your creditable plan at 65 if you want to. Sometimes, it can be more cost-effective, depending on how much you pay for your employer-sponsored plan. You should compare the cost and benefits of both options to decide which one is right for you.

Of course, you can choose to keep your group health plan and enroll in Medicare. If your insurance is creditable, it will remain your primary insurance, and Medicare will be your secondary. If it’s not creditable, Medicare will become your primary insurance.

You will have the opportunity to enroll in Medicare later if you don’t enroll when you’re 65. As long as you have creditable coverage, you’ll be eligible for a Special Enrollment Period when you decide to terminate that coverage. Be sure to work with an advisor at Bobby Brock Insurance to create an enrollment timeline that avoids any gaps in coverage.

You Do Not Have Creditable Coverage

If you do not have creditable coverage, you need to enroll in Medicare as soon as you turn 65. Delaying coverage will cause you to incur late enrollment penalties, and you’ll be without insurance for a period of time. Some of the penalties stay with you for life, so it’s important to enroll in Medicare on time.

The first opportunity to apply for Medicare is during your Initial Enrollment Period (IEP). Your IEP begins three full months before your birthday and ends three full months after your birthday. For example, if your birthday is on August 19, your IEP runs from May 2 through November 30. You can enroll in Original Medicare and any other Medicare plans at that time.

As long as you enroll before your birthday month, your coverage will begin on the first day of the month you turn 65. In our example, that means your coverage could start as early as August 1. The exception to this is if your birthday falls on the first day of the month. In that case, your coverage can start one month prior to your birthday month.

If you miss your 7-month enrollment window and don’t have creditable coverage, you’ll have to wait until the General Enrollment Period to apply for Medicare. The GEP runs from January 1 through March 31. If you enroll during this time, your coverage will begin on the first day of the following month you enroll. Keep in mind that if you utilize the GEP to enroll, it’s likely you’re going to be paying late enrollment penalties.

How to Apply for Medicare

It’s important to understand your enrollment timeline and rules. Medicare will not notify you when it’s time to signup. However, some people are automatically enrolled in Medicare.

Automatic Medicare Enrollment

If you are already receiving Social Security benefits, you will be automatically enrolled in Medicare Part A and Part B. You’ll get a Medicare card in the mail shortly before your birthday month. If you want to proceed with your enrollment, you don’t have to do a thing. Social Security will begin taking your Part B premium from your monthly benefits. You will need to choose other policies like Medicare Part D, Medicare Advantage plan, or Medigap plan if you want additional coverage.

However, if you don’t want to be enrolled in Medicare, you will need to fill out the form that will come along with your Medicare card. You can choose to unenroll in both parts or just Part B.

Those of you who aren’t yet drawing Social Security benefits will need to enroll in Medicare. There are three ways to submit your application.

Apply for Medicare Online

We highly recommend applying for Medicare online. You won’t have long hold times or have to wait weeks to get an appointment at your local Social Security office. Plus, you’ll be able to track your enrollment status. In most cases, your application will be processed faster than by using one of the other methods.

To apply for Medicare online, you’ll need to create a “my Social Security” account. Once you’ve got an account, the site will walk you through the enrollment process. It should take ten minutes or less to complete your application. Plus, if you’d like to start taking Social Security benefits, you can submit that application at the same time.

The main hiccup we see clients have when they try to enroll in Medicare online is when the information they enter doesn’t match what Social Security has on file. In this case, you’ll need to call the Social Security Administration and get the information corrected or just apply by phone.

Apply for Medicare by Phone

Applying for Medicare by phone is just as simple as applying online. You can contact the Social Security office at 1-800-772-1213 (TTY 1-800-325-0778). If you get your retirement benefits through the Railroad Retirement Board, you should call 1-877-772-5772 instead.

You may be lucky enough to get a representative that day. However, if they are experiencing a high call volume, they will schedule a phone appointment within the next few weeks.

Once you do get a phone appointment, the process is fairly straightforward. It does take longer than applying online because the representative will have to mail you some forms to sign. After you complete the forms, you’ll need to mail them back to the office. If you are on a tight timeline, this could delay your enrollment, and you may have gaps in coverage. You should only use this method if you have a month or two before you need your Medicare to be effective.

Apply for Medicare In Person

Some people prefer to do things in person. You can find a local Social Security office and make an appointment to enroll in Medicare. At the end of your appointment, you can ask the representative for a confirmation of your enrollment, which should have the information you need to begin applying for other Medicare plans.

As you wait for your Medicare ID card to come in the mail, you can begin looking at other Medicare plans. One of the experts at Bobby Brock Insurance can teach you about Medicare Advantage plans, Medigap plans, and Part D plans. We’ll help you compare your options and then help you enroll in the one that works best for you.

Applying for Medicare: Frequently Asked Questions

Who can apply for Medicare?

You may apply for Medicare if you are 65 years of age or older. You may also apply if you have been on disability for 24 months or if you have been diagnosed with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease).

 Will I be automatically enrolled in Medicare?

If you are already receiving Social Security benefits, you will be automatically enrolled in Medicare. If you are not taking Social Security or Railroad Retirement Benefits, you’ll need to enroll in Medicare online, by phone, or in person at your local Social Security office.

 When should I apply for Medicare?

You should apply for Medicare as soon as you’re eligible, usually three months before your 65th birthday. If you have creditable coverage, you can postpone your enrollment without penalty.