Will I automatically be enrolled in Medicare, when I turn 65?
Annual, open, general, initial or special enrollment – the time periods when Medicare beneficiaries are allowed to enroll in, switch or cancel their plans may sound overwhelming and confusing to many persons. Here is an overview about the different terms with a brief description.
Will I automatically be enrolled in Medicare, when I turn 65?
You will only be automatically enrolled in Medicare Part A and Part B, starting the first day of the month you turn 65, if you are already receiving benefits from Social Security or the Railroad Retirement Board (RRB); receive disability benefits from Social Security or certain disability benefits from the RRB for 24 months; or have ALS (Lou Gehrig’s disease).
You need to sign up for Part A and Part B yourself, if the above does not apply to you.
You may do so online, or by calling 1-800-772-1213 (TTY 1-800-325-0778). Your first chance to sign up is called the ‘Initial Enrollment period’. You have 7 months to do so, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.
Can I sign up for Medicare later?
If you miss your 7-month Initial Enrollment period, you will have to wait for the next annual General Enrollment period to sign up, and pay a monthly late enrollment penalty for as long as you have Part B coverage. The penalty goes up the longer you wait.
Can I deny Medicare coverage?
Yes, you have the option to turn it down. If you do so, be aware that you may lose benefits. Also, if you decline Medicare coverage initially, you will have to pay a penalty in case you decide to enroll in it at a later time.
What and when is the General Enrollment period (GEP)?
General Enrollment Period (GEP) is each year from January 1st through March 31st. Persons who are eligible for Medicare, but did not apply when they turned 65, may during the GEP sign up for Medicare Part B. Be aware that a 10 percent premium penalty will be added to your Part B monthly premium for each year you could have enrolled but did not.
Do I qualify for Special enrollment?
However, if you are covered by an employer or union group health plan through you or your spouse’s current or active employment, you may qualify for a special enrollment period. If you meet the requirements for a special enrollment period, you do not have to wait for a GEP, or pay a premium penalty. You have an eight-months special enrollment period if you have group health plan coverage from a current employer at the time you first became eligible for Medicare. This special enrollment period begins with the month after employment ends or the month after your group health plan coverage ends, whichever comes first.
| Who can sign up? | When can I sign up? | What can I do? | |
| Initial Enrollment Period (1) | Persons who are newly eligible for Medicare because they turn 65 | During the seven months period, 3 months before through 3 months after the month you turn 65 | Sign up for original Medicare Part A and B, Medigap or a Medicare advantage plan, and/or a Medicare prescription drug plan |
| Initial Enrollment Period (2) | Persons with disabilities, your Medicare coverage begins 24 months after you get Social Security or Railroad Retirement Board (RRB) disability benefits | During the seven months period, 3 months before through 3 months after your 25th month of getting Social Security or RRB disability benefits. | Sign up for original Medicare Part A and B, Medigap or a Medicare advantage plan, and/or a Medicare prescription drug plan |
| Initial Enrollment Period (3) | Disabled persons already on Medicare and turning 65 | During the seven months period, 3 months before through 3 months after the month you turn 65 | Sign up for original Medicare Part A and B, Medigap or a Medicare advantage plan, and/or a Medicare prescription drug plan. Switch from your current plan to another plan; Drop a plan completely |
| General Enrollment Period (GEP) | Persons eligible for Medicare, but did not apply when they turned 65 | January 1st through March 31st | Sign up for original Medicare Part A and B, Medigap or a Medicare advantage plan, and/or a Medicare prescription drug plan. A late enrollment penalty may apply. |
| Open Enrollment Period | Persons enrolled in Medicare | October 15 through December 7 | Change from original Medicare to a Medicare advantage plan; Change from a Medicare advantage plan back to original Medicare; Switch from one Medicare advantage plan to another Medicare advantage plan; Switch from a Medicare advantage plan that doesn’t offer drug coverage to a Medicare advantage plan that offers drug coverage; Switch from a Medicare advantage plan that offers drug coverage to a Medicare advantage plan that doesn’t offer drug coverage; Enroll in a Medicare prescription drug plan; Switch from one Medicare prescription drug plan to another Medicare prescription drug plan; Drop your Medicare prescription drug coverage completely |
| 5 Star Enrollment Period | Persons enrolled in a Medicare advantage plan | All year | Switch to a 5-star Medicare advantage plan once each year |
| Dis-Enrollment Period | Persons enrolled in a Medicare advantage Plan; Persons enrolled in a prescription drug plan | During Open Enrollment, October 15 through December 7 | Leave your Medicare advantage or prescription drug plan and switch back to original Medicare; If you switch back to original Medicare during this period, you’ll have until February 14 to also join a Medicare prescription drug plan to add drug coverage. |
| Special Enrollment Periods (SEPs) | Specific circumstances, specific persons.
Examples: Persons eligible for Medicare until now insured by group health coverage through an employer or union; Persons moving to a new address that is not in the current plan’s service area; Persons moving back to the U.S.; Persons Moving in/out of an institution |
Contact Social Security or Medicare for more information. | |
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