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Applying For Medicare

Applying for Medicare at the right time is critical to obtaining coverage in a timely manner, while avoiding any unnecessary penalties.

If you apply for Medicare before you become eligible, you won’t be able to receive coverage. On the other hand, if you apply for Medicare after the deadline, you may have to pay penalties on your Medicare Part A and/or Medicare Part B premiums.

This article explains when to apply for Medicare, how to enroll, and what documents are needed. You must fill out a Medicare application regardless of when you apply (details below).

Medicare And Social Security

It’s important to note that applying for Medicare and applying for Social Security benefits are two separate processes. While you can begin receiving Social Security retirement benefits as early as age 62, the standard age to qualify for Medicare is 65.

If you postpone your Social Security benefits, you must enroll in Medicare Part A and Part B before you turn 65. However, if you start receiving your Social Security retirement benefits before 65, you will automatically be enrolled in Medicare.

In some cases, individuals under 65 can also be eligible for Medicare due to being disabled for a consecutive two-year period (24 months). Those with certain disabilities like ALS (Lou Gehrig’s Disease) or ESRD (End Stage Renal Disease) requiring dialysis treatment or a transplant may also qualify for Medicare.

We often hear stories about the complexities of applying for Medicare, but you don’t have to go through it alone. Our team of licensed agents is here to assist you in understanding when to apply for Medicare and how to sign up for it. Our services are free of cost, so don’t hesitate to call us at 866-MEDIGAP (633-4427).

When To Apply For Medicare

Understanding when to apply for Medicare is a crucial initial step in your healthcare journey. Here are some typical situations and inquiries to help you determine if enrolling in Medicare is appropriate for you:

  • You are about to turn 65.
  • You are over 65 and planning to retire or lose creditable insurance.
  • You are under 65. Can you register for Medicare?

Let’s explore each of these most common situations in more detail below.

Applying For Medicare When You’re Turning 65

When you turn 65, you become eligible for Medicare, which is referred to as your Medicare Initial Enrollment Period (IEP). This enrollment period lasts for seven months, beginning three months before your 65th birthday, the month of your 65th birthday, and three months after your 65th birthday.

The initial enrollment period is usually the optimal time to enroll in Medicare. Applying for Medicare during this period will help you avoid Medicare penalties and guarantee the health insurance coverage you select (with no pre-existing conditions or waiting periods when you apply for Medicare and Medicare Supplemental Plans).

Most people believe they are automatically enrolled in Medicare, but this only applies if they are receiving Social Security retirement benefits or are under 65 and qualify for disability. If you are not receiving Social Security benefits and are nearing the age of 65, applying for Medicare and completing the Medicare application should be on your to-do list.

Applying For Medicare After Age 65

If you plan to apply for Medicare after age 65, our team at Senior HealthCare Solutions will inquire about the following:

  • Are you still employed?
  • Have you already retired?
  • Do you currently possess creditable insurance?
  • Have you previously enrolled in Medicare Part B?

It’s crucial that we understand your particular situation to inform you about the cost of Medicare, any potential penalties, and available Medicare health insurance plans.

When you apply for Medicare after 65, not everyone has identical options or Medicare premiums. Premiums may be automatically deducted, paid through Easy Pay, or via Medicare bill by mail.

For example, if you postponed your Part B due to employment, you may be eligible for a Special Enrollment Period to sign up for Medicare Part B after retirement and the loss of group insurance.

In other cases, individuals were unsure of when to apply for Medicare and missed their Initial Enrollment Period. In this situation, you would need to register for Medicare Part B during the General Enrollment Period (more information on the General Enrollment Period is provided below).

Applying During The General Enrollment Period

If you’re applying for Medicare during the General Enrollment Period (GEP), it means that you’ve missed your Initial Enrollment Period and aren’t qualified for a Special Enrollment Period (e.g. losing creditable insurance).

The GEP enables individuals to enroll in Medicare Part B (apply for Medicare Part B) from January 1st to March 31st. You must complete a Medicare application during this time, and if approved, your Medicare coverage will commence on July 1st.

During this period, you may not have creditable health insurance, which could result in significant out-of-pocket expenses. At Senior HealthCare Solutions, our team excels at finding alternative methods to safeguard you and limit out-of-pocket costs while waiting for your Medicare Supplement or Medicare Advantage plan to take effect.

Applying For Medicare Under Age 65

If you’re below 65 years of age and have been on Social Security disability for 24 months, you will be enrolled in Medicare automatically. Medicare will send you a welcome package and Medicare card by mail.

Individuals with specific disabilities such as ALS (Lou Gehrig’s Disease) and ESRD (End Stage Renal Disease) may apply for Medicare benefits. If you choose to sign up for Medicare, you have several options to choose from.

How To Apply For Medicare

Great news! You have choices when it comes to applying for Medicare. Below we give clear and easy directions on three ways to register for Medicare (filing for Medicare). Remember, don’t feel you have to sign up for Medicare by yourself. No matter which method you choose, if you need help applying for Medicare, just give the Senior HealthCare Solutions team a call, 866-MEDIGAP (633-4427).

However, before you dive into the Medicare application process, take a quick look at the documents that may be necessary to complete the Medicare application.

What Documents Do I Need To Apply For Medicare?

When applying for Medicare and completing your Medicare application, you will need information and/or copies from the following:

  • Birth Certificate
  • Driver’s license or state I.D. card
  • Proof of US citizenship

If you already have Part A and only need to complete your Medicare Part B enrollment, you should also be prepared to have the following:

  • Social Security card
  • Proof of current employment (if applicable), usually in the form of a W-2
  • Proof of current insurance, such as a formal notice on company letterhead with the insured’s name and coverage dates
  • Military documents

Additionally, if you have delayed your Part B enrollment, the Social Security office requires additional forms be completed with your Medicare application. The form you need to complete is determined by the reason for your delayed Part B enrollment:

  • Form 40B: Provides the ability to apply for Medicare B only. This form can be uploaded if you are applying for Medicare online. Or can you mail it to the Social Security office.
  • Form L564: If you delayed your Part B enrollment due to having creditable insurance through your employer, then your employer is required to complete this form. This form can be included when applying for Medicare online. Or can you mail it to the Social Security office.

It’s crucial to have the necessary documents ready when applying for Medicare to ensure a smooth and successful application process. Remember to check the specific requirements based on your situation, and don’t hesitate to seek assistance from the Senior HealthCare Solutions team or the Social Security office if needed.

Applying For Medicare Online

Yes, you can conveniently apply for Medicare benefits online in just 10-20 minutes. By completing your Medicare application online, you can avoid the hassle of waiting on hold or scheduling an appointment.

To sign up for Medicare online, simply click on this link: This page provides step-by-step instructions to effortlessly enroll in Medicare.

Applying For Medicare In Person

Applying for Medicare in person might be challenging due to COVID-19, which has resulted in the closure of some Social Security offices and limited the available locations where you can apply in person.

If you prefer to apply for Medicare in person, use this link to find a Social Security office near you. Once you reach the Social Security website, enter your zip code and click “Locate.” You’ll receive a list of locations, along with their phone numbers, addresses, and driving directions.

Applying For Medicare By Phone

Although applying for Medicare by phone may seem convenient, there may be delays if the Social Security representative needs to send you forms to complete and mail back.

In addition, there may be extended wait times, which can be inconvenient. However, if there are no required forms or long wait times, applying for Medicare by phone can be a simple process. Just like other methods of applying for Medicare, you will need to contact the Social Security office.

To apply for Medicare by phone, call 1-800-772-1213. For TTY users, call 1-800-325-0778. Make sure to inform the representative clearly that you want to apply for Medicare only. If you receive Railroad Retirement Benefits, call 1-877-772-5772.

What Happens After I Apply For Medicare?

Congratulations on applying for Medicare and obtaining Part A and Part B. However, this is only the first step in securing your health insurance coverage.

If you were automatically enrolled in Medicare, you should have received your Medicare card 1-3 months before turning 65. If you applied for Medicare after turning 65, you can expect to receive your card about 2-4 weeks after approval.

It’s crucial to understand that Original Medicare Part A and Part B do not cover 100% of your out-of-pocket costs for hospital and doctor services, including outpatient care and durable medical equipment. Additionally, they don’t cover self-administered prescription drugs.

To reduce the costs that Medicare doesn’t cover, you can enroll in a Medicare Supplement Plan and a Medicare Part D plan for prescription drug coverage. Alternatively, you can choose a Medicare Part C plan (Medicare Advantage).

How To Get Help With Medicare

With over 25 top-rated Medicare insurance companies and multiple plan options to choose from, deciding on the right plan can be overwhelming. Our family-friendly staff is here to assist you in comparing Medicare plans and finding the best fit for your needs. Contact us today at 866-MEDIGAP (633-4427) to schedule an appointment. We take a personalized approach to each client’s needs because there is no one-size-fits-all Medicare plan.

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Frequently Asked Questions

What is the best age to apply for Medicare?

The best time to apply for Medicare is during your Initial Enrollment Period (IEP), which is a seven-month window surrounding your 65th birthday. This period includes the three months before your birth month, your birth month itself, and the three months following your birth month. Applying during the IEP ensures that you’ll get the coverage you need without incurring any late enrollment penalties. It’s important to note that if you’re already receiving Social Security benefits, you may be automatically enrolled in Medicare Part A and Part B when you turn 65.

Do you have to apply for Medicare every year?

No, you do not have to apply for Original Medicare (Part A and Part B) every year. Once you are enrolled in Original Medicare, your coverage generally continues automatically from year to year, unless you choose to disenroll for any reason. Your Medicare Part D drug plan will automatically renew each year as well. Just keep in mind, the benefits may change over time, so it’s important to review your plan every year during the Annual Election Period (AEP).

Does your Medicare premium change yearly?

Medicare premiums can change yearly, as they are subject to adjustments based on various factors. These factors can include changes in healthcare costs, inflation, and legislative decisions. Higher-income individuals may also pay an Income-Related Monthly Adjustment Amount (IRMAA) for both Part B and Part D, which is an additional premium based on your modified adjusted gross income. The thresholds for IRMAA can change each year as well.

When will I get my Original Medicare card?

When you first enroll in Original Medicare (Part A and Part B), you should receive your Medicare card in the mail within a few weeks of your enrollment. If you’re automatically enrolled in Medicare, which happens for most people when they turn 65 or have been receiving Social Security disability benefits for 24 months, your Medicare card should be mailed to you within 3 months before your coverage begins.

Can you get Medicare with a pre-existing condition?

Yes, you can get Medicare coverage with a pre-existing condition. Medicare does not deny coverage or charge higher premiums based on pre-existing conditions. When you become eligible for Medicare, either by turning 65 or due to disability, you can enroll in Original Medicare (Part A and Part B) regardless of your health status. Additionally, for Medicare Advantage (Part C) and Prescription Drug (Part D) plans, you can’t be denied coverage or charged higher premiums due to a pre-existing condition.