Applying for Medicare

Applying for Medicare at the right time is critical to obtaining coverage in a timely manner. Its also important as you’ll want to avoid any potential, unnecessary penalties.

Apply for Medicare too early and you’re not eligible for coverage. Apply for Medicare too late, and you may have penalties to pay on your Medicare Part A and/or Medicare Part B premium(s).

The objective in this article is to help you better understand when to apply for Medicare, how to sign up for Medicare and documents needed to apply for Medicare (if applicable).  Regardless of you apply for Medicare, there is a Medicare application that is required to complete (We discuss how to enroll in Medicare below)

To be clear, applying for Medicare is not the same as applying for Social Security benefits. Remember, you can start drawing your Social Security retirement benefits as early as age 62.  Whereas the standard age to be eligible for Medicare is age 65.

If you delay your Social Security benefits, you need to sign up for Medicare Part A and Part B before you turn 65.  If you elected to receive your Social Security retirement benefits before age 65, you will be enrolled in Medicare automatically. 

In some instances, people under age 65 are also eligible for Medicare due to being disabled for two consecutive years (24 months).  You may also be eligible for Medicare if you have certain disabilities, such as ALS (Lou Gehrig’s’s Disease) or ESRD (end Stage Renal Disease) and need a transplant or require dialysis treatment.

We hear stories all too often from people about the complexities of Applying for Medicare.  Remember, you aren’t in this alone. Our friendly team of licensed agents are here to provide their services and assist you with knowing when to apply for Medicare and how to sign up for Medicare (there are never any cost for our services, EVER)! Call us at 866-MEDIGAP (633-4427).

When to Apply for Medicare

Knowing when to apply for Medicare is a very important first step when beginning your journey. Below are some common scenarios and questions that should help determine if signing up for Medicare Is right for you.

• You are turning age 65
• Over age 65 and plan on retiring and/or losing creditable insurance
• You are under age 65. Am I eligible to sign up for Medicare?

Let’s take a deeper look at each one of the most common scenarios below.

Applying for Medicare when you are turning 65 (Initial Enrollment Period)

You become eligible for Medicare when you turn 65.  This is known as your Medicare Initial Enrollment Period (IEP).  This enrollment period last for 7 months, beginning 3 months before your 65^th birthday, the month of your 65^th and 3 months following your 65^th birthday. 

The initial enrollment period is typically the best time to sign up for Medicare. Applying for Medicare during this time will help you avoid Medicare penalties and will guarantee health insurance coverage you choose (there are no pre-existing conditions or waiting periods when you apply for Medicare and Medicare Supplemental Plans during this time).

It’s not uncommon for folks to think they are enrolled in Medicare automatically. You are only enrolled in Medicare automatically if you are collecting Social Security retirement benefits or are under age 65 and qualified for a disability.  Otherwise, if you are not collecting Social Security benefits, and approaching age 65, applying for Medicare and completing the Medicare application needs to be on your to-do list.

Applying for Medicare after age 65

If you’ve decided to apply for Medicare after age 65, our team at Senior HealthCare Solutions will ask some of the following questions:

1. Did you previously enroll in Medicare Part B?
2. Are you still working?
3. Are you retired?
4. Do you currently have creditable insurance?

It’s important we understand your specific scenario so that we can help educate you on how much you will pay for Medicare, if there are any penalties and what Medicare health insurance plans are available to you.

When you apply for Medicare after 65, not all people have the same choices or will pay the same Medicare premiums. Some people have premiums deducted automatically, some use Easy Pay and other by the Medicare bill by mail.

For instance, if you delayed your Part B because you were still working, you will have a Special Enrollment Period to enroll in Medicare Part B as you retire and lose your group insurance.

In other cases, we’ve spoken with people that just didn’t know when they should be applying for Medicare and missed their Initial Enrollment Period.  In this instance, you would need to apply for Medicare Part B during the General Enrollment Period (more on the General Enrollment Period below).

Applying for Medicare during the General Enrollment Period

If you find yourself applying for Medicare during the General Enrollment Period (GEP), it means you have missed your Initial Enrollment Period and are not eligible for a Special Enrollment Period (such as losing creditable insurance).

The Medicare General Enrollment Period allows folks to sign up for Medicare Part B (apply for Medicare Part B) between January 1-March 31. You are required to complete an application for Medicare during this time and if approved, your Medicare coverage will begin July 1.

During this time, it’s likely you will not have creditable health insurance, which could cause significant out-of-pocket cost.  Our team at Senior HealthCare Solutions is great at finding alternative ways to protect yourself and limit out-of-pocket costs, while you wait for your Medicare Supplement or Medicare Advantage to begin.

Applying for Medicare for under age 65

If you are under age 65 and you have been on Social Security disability for 24 months, you will not need to apply for Medicare.  Instead, your enrollment for Medicare will be automatic. Medicare will mail you a welcome package and Medicare card.

For certain disabilities, such as ALS (Lou Gehrig’s Disease) and ESRD (End Stage Renal Disease), you can file for Medicare benefits.  If you choose to sign up for Medicare, you have several options to choose from. 

How to Apply for Medicare (Filing 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).

Before you get too excited about applying for Medicare, be sure you take a quick peak at some of the document that may be required when completing your 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 active employment (if applicable). Typically, in the form of a W-2
• Proof of current insurance. Typically, this is a formal notice that is written on company letterhead, including name of insured and coverage start and end dates.
• Military documents

Additionally, when you have delayed your Part B enrollment, the Social Security office requires additional forms be completed with your Medicare application. Depending on why your Part B enrollment was delayed will determine the form you need to complete.

• 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.

Applying for Medicare Online

That’s right, you can sign up for Medicare benefits online in about 10-20 minutes. By completing your Medicare application online, you can save time and hassle of waiting on hold or schedule an appointment. 

To sign up for Medicare online: Click the link,  https://secure.ssa.gov/iClaim/rib. This page has step-by-step directions for you to easily enroll in Medicare.

Applying for Medicare in Person

If you want to apply for Medicare in person, this might be difficult.  COVID-19 has forced some SS offices to close, thus limiting the locations where you can apply for Medicare in person.

To apply for Medicare in person: Click the link provided below to find a Social Security office close to you.  When you get to the Social Security site, enter your zip code, and click “Locate”. A list will be provided with locations, phone, address and driving directions: https://secure.ssa.gov/ICON/main.jsp

Applying for Medicare by Phone

While it may seem convenient applying for Medicare by phone, it can sometimes be delayed if the Social Security representative needs to mail you forms.  You will have to complete and mail back to Social Security.

Periodically, there can also be long wait times, which may inconvenience you. Otherwise, if there are no required forms, or long wait times, applying for Medicare by phone can be simple.

Like other methods used to register for Medicare, you will contact the Social Security office.

To apply for Medicare by phone, call: 1-800-772-1213.  For TTY users, the phone number is 1-800-325-0778.  Be sure to be clear with the representative that you’d like to apply for Medicare only.

If you receive Railroad Retirement Benefits, you need to call 1-877-772-5772.

I applied for Medicare, now what happens?

Congratulations!  Applying for Medicare and obtaining Part A and Part B is a great victory, but only part of the journey to securing your health insurance coverage (more on that to come).

If you were enrolled in Medicare automatically, you should have received your Medicare card in the mail 1-3 months before turning 65.

Otherwise, if you delayed to register for Medicare and applied for Medicare after age 65, you can expect to get your Medicare card about 2-4 weeks after the Medicare application has been approved by the Social Security office.

Now, back to the part about securing your health insurance coverage. It’s important to understand that Medicare Part A and Part B do not cover 100% of your out-of-pocket cost for services rendered at the hospital and doctor (including outpatient services, durable medical equipment and more). 

You should also note that Original Medicare Part A and Part B does not cover prescription drugs that are self-administered (medication you pick up from the pharmacy and take at home).

You can reduce the cost that Medicare doesn’t pay by enrolling in a Medicare Supplement Plan and adding a Medicare Part D plan (prescription drug coverage). Alternatively, you can enroll in a Medicare Part C plan (Medicare Advantage Plan). 

Because there are so many Medicare Insurance Carriers and Medicare plan options to choose from, trying to determine if you should enroll in a Medicare Supplement or Medicare Advantage Plan is challenging. 

Our family-friendly staff helps lift that burden from you and they can compare Medicare plans from over 25 top-rated Medicare insurance companies in just minutes.  We take a hands-on, tailored approach with each client we speak with. There are no one-size-fits-all Medicare plan, and we get that.  Schedule your appointment today or call now.  866-MEDIGAP (633-4427).

Frequently Asked Questions