Do I Need to Enroll in Medicare?
Here are the criteria that determine automatic enrollment.
If you're nearing eligibility for Medicare at age 65, you may be wondering if you need to sign up for the program or if you will be enrolled automatically.
The short answer is that it depends.
In particular, whether or not you need to actively enroll in Medicare to receive coverage will depend on your current benefit coverage.
Here’s how you can tell. Determine your answer to the following coverage question:
Are you already receiving benefits from Social Security or the Railroad Retirement Board?
Yes. If your answer is yes, then you will automatically be enrolled in Medicare.
A few months prior to your 65th birthday, you will receive information from Medicare that details your coverage.
The information will be sent to the address you have on file with the Social Security Administration.
No. If your answer is that you are not currently receiving any benefits from Social Security or the Railroad Retirement Board, then you will not be automatically enrolled.
In this case, you will need to sign up online or contact a Social Security office to enroll in Medicare.
Signing up in the months before you turn 65 is the best way to avoid any gaps in coverage.
Am I Automatically Enrolled in Part B?
Most people enroll in Part A when they become eligible because it is free. Part B, on the other hand, requires that you pay a monthly premium.
So, some people turn down Part B coverage or delay their Part B enrollment until a later date.
Do I Need to Enroll If I’m Still Working?
If you are still working when you turn 65 and are insured through your company health plan, you may still need to sign up for Medicare. It will depend on the number of people your company employs.
If your company employs 20 or more people:
Then your company plan can serve as your primary coverage and you do not have to enroll in Medicare at this time.
Medicare Part A is free for most people, so many choose to enroll when they become eligible at 65 anyways.
However, they may hold off on enrolling in Part B, as this comes with a monthly premium. There is no late penalty for delaying Part B in this scenario.
Once you retire from your job, you will receive a special enrollment period that runs for 8th months. You can enroll in Part B at this time.
If your company employs less than 20 people:
Then Medicare will be your primary coverage and you will need to sign up for Part A and Part B during your Initial Enrollment Period.
Be sure to sign up during this period to avoid an increase in your Part B costs.
Do I Need to Enroll if My Spouse Is Still Working?
The same applies if you receive health insurance through your spouse’s employer. You have the option of delaying Medicare enrollment until the end of that employment.
At that point, you will be entitled to a special enrollment period. It is important to note that this must be active employment.
If the employer coverage comes from retiree benefits or COBRA, then you must enroll in Medicare for your primary coverage.
Do I Have to Enroll if I Have Private Insurance?
If you have a private health insurance plan (not through an employer), you do not have to enroll in Medicare when you become eligible at 65.
However, choosing to postpone your Medicare enrollment will come with late penalties. Remember that Part A is premium-free for most enrollees.
Also, the late enrollment penalty for Part B increases the longer you wait to enroll and the penalty is permanently applied to your monthly premium.
How Do I Enroll in Medicare?
To enroll in Medicare, you must sign up through Social Security.
There are three options for signing up:
Sign up online at the Social Security website.
Phone call: 1-800-772-1213 (TTY: 1-800-325-0778)
Local Office Visit: Find your local office using the Social Security Office Locator. It's best to first call and make an appointment before visiting.
How Do I Know My Enrollment Was Successful?
Once the Social Security Administration receives your Medicare application, they will review your information and contact you if they need any missing or additional documentation. You will receive a decision letter from them once complete.
If you're uncertain about your enrollment status, you can check it at MyMedicare.gov.
You will need to sign into your account to check your enrollment status.
If you haven’t yet created an account at MyMedicare.gov, click on the “Create Account” button located beneath the user sign in.
To create an account you'll need your Medicare number and your effective date for Part A (month and year), which is listed on the lower right corner of your Medicare Card.
Up Next: Guide to Medicare Enrollment
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