If you’re nearing your 65th birthday, it’s time to start thinking about enrolling in Medicare, the federal health insurance program that helps tens of millions of older adults and younger people with disabilities pay for their health care.
If you’re not receiving Social Security benefits, you’ll need to take steps to enroll. Keep in mind, you can enroll only at certain times. If you sign up late, you could end up with gaps in coverage and costly penalties for the rest of your life.
Signing up is, at its most simple, a five-step process. We’ll walk you through each step in detail.
1. Do your homework before turning 65
You can start exploring your Medicare options in your early 60s, but you should look more closely as soon as you turn 64. Consider taking the following steps.
- Meet with your benefits manager, if you’re still working, to discuss health insurance options.
- Determine your Medicare enrollment window. This is the seven-month initial enrollment period that begins three months before the month you turn 65 and ends three months after.
- Check out the Medicare website and master the online tools.
- Create a my Social Security account if you don’t have one already. You can use it to enroll in Medicare online.
Six months before you turn 65, you can take a deeper dive. One key task is to consider how you’ll get your coverage. You might opt for original Medicare, also known as traditional Medicare, which includes Part A hospitalization coverage and Part B doctor and outpatient services. Many people who have original Medicare purchase Part D prescription drug coverage and a supplemental Medigap policy, which can help pay some of your out-of-pocket costs, such as deductibles, copayments and other expenses.
Another option is to sign up for a Medicare Advantage plan, which includes Parts A and B and usually Part D.
It’s also a good time to learn about the programs that may be able to help you afford Medicare and Part D coverage. See Get Help Paying for Medicare Premiums, Deductibles, Copays for more information.
2. Look at enrolling — if you're not already getting Social Security
If you’re not receiving Social Security benefits yet, you’ll have to take action to enroll in Medicare. Use this checklist to make sure the time is right to sign up.
- You’re within three months on either side of the month you turn 65.
- You’ve decided whether you’ll keep any health insurance you’re receiving through your job or your spouse’s job.
- You’ve made the choice between original Medicare and Medicare Advantage.
- You’ve decided whether you’ll buy a Part D plan if you’ve opted for original Medicare and don’t have prescription drug coverage from an employer or retiree plan.
3. Sign up for Parts A and B of Medicare
Whether you’ve decided to get coverage through original Medicare or Medicare Advantage, you need to sign up for Parts A and B as the foundation for either option. The way you enroll and the timing depend on your personal situation.
If you or your spouse is working for a company that has fewer than 20 employees, you should usually sign up for Medicare at age 65 to avoid coverage gaps. Determine what applies to you below and click the link for a step-by-step guide to signing up.
- I’m already receiving Social Security retirement benefits. If so, you’ll be enrolled automatically in Parts A and B of Medicare. (But if you live in Puerto Rico, be aware that the rules for this U.S. territory are different.)
- I’m signing up during my initial enrollment period, the three months before to the three months after the month you turn 65. If you aren’t receiving Social Security benefits at 65, you’ll need to enroll in Medicare.
- I’m signing up during a special enrollment period, a time you can enroll in Medicare outside the initial enrollment period when certain conditions are met. For instance, you can sign up for Medicare anytime, as long as you or your spouse is still working and you have coverage from that employer. You also can enroll in Part B up to eight months after you or your spouse stops working and you lose that health insurance. If you miss that eight-month window, you may have to pay a late-enrollment penalty or have a gap in coverage.
- I’m signing up during a general enrollment period. If you don’t enroll in Medicare during your initial enrollment period, you can do so during the general enrollment period, which runs Jan. 1 to March 31 annually.
As you head to the Social Security website to apply for Parts A and B benefits online, be sure to have handy your group health insurance information (if you have coverage) and your Social Security number.
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4. Decide if you need financial help
Medicare isn’t free to those who participate. You’re expected to share costs by paying Part B and Part D premiums, sometimes Part A and Medicare Advantage premiums, deductibles, copayments for services you use, and sometimes coinsurance.
- Original Medicare doesn’t have a limit on its out-of-pocket costs.
- Medicare Advantage plans do have out-of-pocket limits. But you’ll still have to pay premiums for Part B, sometimes Part A and sometimes the plans themselves; deductibles; copays; and sometimes coinsurance.
- Part D prescription drug plans have their own monthly premiums and often have deductibles and copays.
- And to be covered for dental, hearing and vision if you choose original Medicare, you’ll have to buy separate insurance plans with their own cost sharing or pay as needed from your savings. Keep in mind, Medicare Advantage plans often provide dental, hearing and vision coverage.
If your income is low and you don’t have much savings or other assets, you may qualify for financial assistance. Several federal and state programs may help reduce the costs of Parts A and B and make Part D more affordable.
5. Choose your additional coverage
After you’ve signed up for Parts A and B of Medicare, it’s time to enroll in the additional coverage you need.
- Do you want a Medicare Advantage plan? We’ll walk you through a sample search using Medicare’s Plan Finder tool.
- Do you need Part D prescription drug coverage? We’ll show you how to use Medicare’s Plan Finder tool to search for a plan.
- Do you want a Medigap policy? You can see a sample search using Medicare’s Plan Finder tool.
Confused? A real person can help you navigate
We’ve tried to demystify some of Medicare’s complex systems, but sometimes it’s nice to talk with a person who can help you through the process. Call 800-MEDICARE (800-633-4227), or if you're comfortable using live chat on your computer, you can click on the Chat Now button on Medicare's Talk to someone webpage.
Kimberly Lankford is a contributing writer who covers personal finance and Medicare. She previously wrote for Kiplinger's Personal Finance Magazine, and her articles have also appeared in U.S. News & World Report, The Washington Post and the Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers.