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  • Medicare Experience

Medicare Enrollment: Your Comprehensive Guide 2021

Learn about the Medicare Enrollment process.
Medicare Enrollment Comprehensive Guide 2021, Medicare Experience

Just as we covered in our Guide to Medicare Eligibility, you are eligible for Medicare once you turn 65. But simply being eligible may not necessarily take care of your enrollment. There are still a few steps you will need to complete in order to receive your Medicare health insurance coverage.


Throughout this guide, we’ll help you better understand the Medicare enrollment process, so that you’re ready to enroll when the time comes.


Topics Covered:

  • How Do I Sign Up for Medicare?

  • When Should I Enroll in Medicare?

  • When Are the Medicare Enrollment Periods?



How Do I Sign Up for Medicare?


Step 1: Sign Up Through Social Security


If you’re already receiving benefits from Social Security then there’s no further sign up required of you, as Social Security beneficiaries automatically receive Medicare coverage. Three months prior to your 65th birthday, your Medicare card will arrive in the mail.


If you’re not already receiving benefits from Social Security then your first step will be to sign up for Medicare through Social Security. You can do so online at the Social Security website.


Medicare sign up options: online, by phone, in person.

Signing up online is likely your quickest and most convenience option. However, there are other sign up options available to you, as well. You can call Social Security at 1-800-772-1213, or find your find your local Social Security office to sign up in person.


The online sign up process usually takes less than 10 minutes. You can sign up for both Part A and Part B with your online application.


Once you submit your electronic application, Social Security will review and process your application. When this is complete, you’ll receive your Medicare card in the mail.


Step 2: Choose Your Medicare Coverage


We'll first take a look at Original Medicare, which is the coverage you’re signing up for through Social Security is Original Medicare. This consists of both Medicare Part A and Medicare Part B.


Medicare Part A


Part A is often referred to as hospital insurance. It covers a wide-range of inpatient and nursing facility care. Part A has no monthly premium, so it is free for eligible enrollees.


Part A Covers:

  • Skilled nursing facility care

  • Long-term care hospitals

  • Hospice care

  • Home health care


Medicare Part B


Part B is often referred to as medical insurance. It helps to pay for medical services and preventative treatment. Most people sign up for Part B at the same time they sign up for Part A.


Parts A and B together form your Original Medicare coverage. However, because Part B requires that you pay a monthly premium, you’re not required to sign up for it.


Part B Covers:

  • Medically Necessary Services – Services or supplies needed to diagnose or treat medical conditions.

  • Preventive Services – Prevent or detect illnesses at an early stage for best chances at treatment.


Medicare Advantage (Medicare Part C)


Medicare Part C, also known as Medicare Advantage, is an alternative option to Original Medicare. Part C includes all the benefits covered under Parts A and B, and in many cases also includes Part D prescription drug coverage. In this way, Part C is like a bundled plan option.


Medicare Advantage plans oftentimes include benefits not covered by Original Medicare. Such benefits might include vision, dental, hearing, wellness programs, and more.


Medicare-approved private insurance companies provide Medicare Advantage plans, so they have their own enrollment process separate from the Original Medicare enrollment through Social Security.


Medicare Advantage (Part C) includes:

  • Benefits covered under Part A

  • Benefits covered under Part B


In many cases, Medicare Advantage also includes:

  • Benefits covered under Part D

  • Additional benefits


Medicare Part D (Prescription Drug Coverage)


Medicare Part D helps to cover the cost of your prescription drugs. Part D plans vary in coverage. Each plan comes with a list of the prescription drugs it covers called a formulary, which allows enrollees to choose a plan that covers their specific prescription drugs and medications.


Similar to Part C, Medicare-approved private insurance companies provide Part D plans, which come with their own enrollment processes separate from Original Medicare.


Part D Covers:

  • Generic Drugs

  • Brand-Name Drugs


Medicare Supplement Plans (Medigap)


Original Medicare won’t cover all of your healthcare costs. So, many enrollees add to their coverage with a supplement plan, also known as Medigap.


This supplemental coverage can help pay for your out-of-pocket costs. Medigap plans vary in coverage to meet differing care and financial needs.


Private insurance companies offer Medigap plans, so they have their own enrollment process separate from Original Medicare.


Medigap Plans Cover:

  • Costs and benefits not covered by Original Medicare



When Should I Enroll in Medicare?


You should enroll in Medicare 3 months before you turn 65.


Sign up for Medicare in the 3 months prior to your 65th birthday.

Your initial enrollment period begins in the three months prior to your 65th birthday. It includes your birthday month then extends for the three months after it.


At this time, you can enroll in Original Medicare Parts A and B. At the very least, you should enroll in Part A, as you’re not required to pay a monthly premium.



When Should I Enroll in Part B?


Many Medicare recipients choose to enroll in Part B at the same time they enroll in Part A during their Initial Enrollment Period at age 65. However, some individuals choose to postpone their Part B enrollment. Often times these are individuals retiring at a later date and do not want to start paying the Part B monthly premium.


While you have the option of postponing Part B enrollment, be aware that delaying enrollment will result in a higher monthly premium when you later enroll. For each 12-month period in which you’re eligible for Part B but delay enrollment, your monthly premium cost will increase by 10 percent.


If you qualify for a Special Enrollment Period, however, this premium increase will not apply to you.



When Should I Enroll in Part C or Part D?


Once you’re eligible to enroll in Original Medicare, you’re also eligible to enroll in Medicare Part C or Medicare Part D.


While it’s not necessary that you enroll when first eligible, keep in mind that delaying enrollment for Part D will result in an increased premium if you choose to enroll later on. For each month that you delay enrollment once you’re eligible, your monthly premium will increase by 1 percent.



When Should I Enroll in a Medicare Supplement?


Once you have enrolled in Original Medicare, you have the option of purchasing supplemental coverage. However, the best time to purchase a supplement plan is during your Medicare Supplement Open Enrollment Period. This is the six-month period that starts on the month of your 65th birthday.


During this period, you have a guaranteed right to purchase any supplement plan available in your state, regardless of your current health status.


If you don’t enroll during this period, you can still purchase coverage later. However, the guaranteed right to purchase no longer applies. You may also experience higher premiums or a denial of coverage due to your health status.



When Are the Enrollment Periods for Medicare?


Initial Enrollment Period:


Your Initial Enrollment Period for Medicare is a 7-month period that surrounds the month of your 65th birthday. It includes the three months prior to your birthday month, your birthday month, and the three months after your birthday month. Initial Enrollment is your first opportunity to enroll in Medicare.


Your 7-month Initial Enrollment Period, 65th birthday.

For Example: Say your birthday is in January, your initial enrollment period would begin in October. This period would include the month of January and extend three months afterwards until the end of March.


If you enroll prior to your birthday month, your coverage will begin on the 1st of your birthday month. If you enroll in your birthday month or in the three months following it, coverage will begin on the 1st of the following month.



Open Enrollment Period:


The Medicare Open Enrollment Period runs from October 15 – December 7.


Medicare Open Enrollment Period runs from October 15 to December 7.

During this period, any Medicare recipient can make the following changes to their coverage:


1. If you currently have Original Medicare coverage, you can switch to a Medicare Advantage plan. Or, if you currently have a Medicare Advantage plan, you can switch to Original Medicare.


2. If you currently have a Medicare Advantage plan, you can switch to a different Medicare Advantage plan. Or, if you currently have a Medicare Part D plan, you can switch to a different Medicare Part D plan.


3. For those that did not enroll in a Medicare Part D plan when first eligible during their Initial Enrollment Period, you can enroll in a Medicare Part D plan.


If you enroll in a plan or change your plan during this enrollment period, your coverage begins January 1st of the following year.



General Enrollment Period:


The Medicare General Enrollment Period runs from January 1 – March 31. If you did not enroll during your Initial Enrollment Period or during a Special Enrollment Period, this is a chance to enroll.


Medicare General Enrollment Period runs from January 1 to March 31.

Your coverage will begin on July 1st of the same year that you enroll.



Supplement Open Enrollment Period:


The Medicare Supplement Open Enrollment Period is the 6-month period that begins the month of your 65th birthday and extends for 5 months after. This is the best time to purchase supplement insurance as you have a guaranteed right to purchase.


Your coverage begins the 1st of the following month.



Special Enrollment Periods


If you did not enroll during your Initial Enrollment period and you meet certain requirements, you may qualify for a Special Enrollment Period.


If you (or a spouse) are covered under an employer group health plan:


You will receive a Special Enrollment Period to sign up for Part A, Part B, or both. You will also have an 8-month Special Enrollment Period starting the month after your employment ends.


If you’re leaving your Medicare Advantage Plan (Part C):


You can leave your plan and switch to Original Medicare during the period of January 1 – February 14. If you wish to add Medicare Part D, you must do so within this period. Your coverage begins the 1st of the following month.



Medicare Enrollment: Late Penalties


Part A Late Penalty


If you don’t qualify for premium-free Part A coverage and you didn’t purchase it when first eligible (Initial Enrollment Period), then you may face a late penalty when you enroll.


How the Medicare Part A late penalty is applied.

Your Part A monthly premium will go up by 10%. This penalty will apply for double the amount of years that you were eligible to enroll but did not.


Example: If you enroll in Part A 2 years late, then you must pay a higher premium for 4 years. If you enroll 3 years late, then you must pay a higher premium for 6 years. And so on.



Part B Late Penalty


If you didn’t sign up for Part B when first eligible (Initial Enrollment Period), you’ll likely face a late enrollment penalty. This late penalty will apply to your premium for as long as you have Part B coverage.


How the Medicare Part B late penalty is applied.

For each full 12-month period that you were eligible to enroll but did not, your premium amount will increase by 10%.


Example: If you enroll in Part B two and a half years late (or 30 months), then your late penalty is a 20% increase in the standard premium price. It is 20% because there were 2 full 12-month periods during this time.


If you had waited 36 months, the late penalty would have been 30% because 3 full 12-month periods occurred.



Part D Late Penalty


If your Initial Enrollment Period has ended and you have gone without Part D coverage, Medicare Advantage coverage, or creditable prescription drug coverage for a continuous period of 63 days then you may be assessed a late penalty to your Part D monthly premium.


How the Medicare Part D late penalty is applied.

The amount of the penalty is determined by how long you went without prescription drug coverage. The late penalty is 1% of the national base beneficiary premium ($33.06) times the number of full months you went without creditable drug coverage.


Example: Say that your Initial Enrollment Period came to a close at the end of March in 2018 and you did not join Part D or have any other source of creditable drug coverage.


Instead, you waited to enroll in Part D during the 2020 Open Enrollment Period, meaning that your coverage will take effect on January 1, 2021. In other words, you went for 33 months without creditable drug coverage.


In this case, your Part D late enrollment penalty is $10.90. This amount will be added to your Part D monthly premium.


Breakdown:

33 months without coverage (April 2018 – December 2020)

1% for each month without coverage (1% x 33 = 33%)

33% times the 2021 national base beneficiary premium of $33.06

$10.91 rounded to the nearest $.10 = $10.90


Note: Monthly penalties are always rounded to the nearest $.10.



Medicare Enrollment Options


To enroll in Medicare, you must sign up through Social Security. There are three options for signing up:


1. Sign up online at the Social Security website.


2. Phone call: 1-800-772-1213 (TTY: 1-800-325-0778)


3. Local Office Visit: Find your local office using the Social Security Office Locator.



Medicare Enrollment Questions


If you have any additional questions throughout your enrollment process, you can contact Medicare or your State Health Insurance Assistance Program (SHIP).


Medicare Phone Number: 1-800-MEDICARE (1-800-633-4227)


For SHIP visit: https://www.shiptacenter.org/


Or, you can use: https://www.medicare.gov/contacts/


To find contact information that will address your specific need, use the search field on the left side of the page:

  1. Select your state

  2. Select an organization

  3. Select your topic of interest



Medicare Enrollment Status & Verification


If you would like to check the status of your Medicare enrollment, you can do so at MyMedicare.gov.


You will need to sign into your account to check your enrollment status.


If you haven’t yet created an account here, click on the “Create Account” button located beneath the user sign in.


To create your account you will 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.





Helpful Resources:

HHS: How Do I Enroll in Medicare?

SSA: Medicare Benefits

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