Timing is everything. It’s especially important when enrolling in Medicare. As you approach 65, you generally want to sign up during your initial enrollment period — unless you’re receiving Social Security and are automatically enrolled. This seven-month period includes the three months before the month in which you turn 65 and the three months after.
If you’re among the large majority of people who don’t have to pay for Part A, you can enroll at any time during and after your initial enrollment period. Coverage will be retroactive for six months but no earlier than the first month you became eligible for Medicare.
If you don’t get on board with Part B during your initial enrollment period, your monthly premiums for this part of Medicare—which covers doctor visits and other outpatient services—may cost you more for the rest of your life. You will get a chance to enroll during Medicare’s annual general enrollment period, which runs from Jan. 1 to March 31 each year. However, if you sign up then, your coverage won’t begin until July 1.
Here is some additional information to understand before you enroll.
Want to delay? If you or your spouse continue to work past age 65 and have health insurance through your or your spouse’s employer, you may not need to sign up for Medicare yet. But you’ll have to sign up within eight months of stopping that job-based coverage to avoid a late-enrollment penalty. You can sign up before your employer coverage ends to ensure you have no gap in coverage.
Size matters. If you or your spouse work for a company with 20 or more employees, you can delay signing up for Medicare. But if your employer has fewer than 20 employees, you usually need to sign up at age 65 to avoid a gap between the end of your primary health care coverage at work and the start of Medicare. For those who work at the smallest companies, Medicare usually becomes the primary coverage at age 65 and an employer plan is secondary, whether you sign up for Medicare or not.
Special rules for Tricare beneficiaries. If you're receiving benefits through Tricare military health care, you generally need to sign up for parts A and B of Medicare during your seven-month initial enrollment period to keep your coverage. There are a few exceptions: If you're among the small number of people who aren't eligible for premium-free Part A, you don't need to sign up. Also, if you or your spouse still serve on active duty, you don't have to enroll in Part B. However, you must enroll in Part B before the active-duty service member retires to avoid a break in coverage.
Rounding out VA coverage. If you have health care benefits through the U.S. Department of Veterans Affairs (VA) and no other coverage, sign up for parts A and B of Medicare within your initial enrollment period so you'll have coverage for non-VA doctors and hospitals.