Signing up for Medicare on time is one of the most important health and money decisions you will make around age 65. Sign up late and you could face a gap in coverage and penalties that last for the rest of your life. Sign up when you do not need to, and you may pay premiums you could have avoided. Here is how the timing works.
Your Initial Enrollment Period
For most people, the first chance to sign up is the Initial Enrollment Period. It lasts 7 months:
- The 3 months before the month you turn 65,
- The month you turn 65,
- And the 3 months after.
If your birthday is on the first of the month, your window starts and ends one month earlier.
When your coverage starts
| When you sign up | When coverage starts |
|---|---|
| Any of the 3 months before your birthday month | The first day of your birthday month |
| Your birthday month | The first day of the next month |
| Any of the 3 months after your birthday month | The first day of the month after you sign up |
Signing up early in your window is the simplest way to make sure coverage starts the moment you turn 65.
If you already get Social Security
If you have been receiving Social Security or Railroad Retirement benefits for at least four months before you turn 65, you will usually be enrolled in Part A and Part B automatically. Your Medicare card arrives in the mail about three months before your birthday. If you do not want Part B yet, for example because you have coverage through a current job, follow the instructions that come with the card.
If you are not receiving Social Security yet, you must sign up yourself. You can apply online at ssa.gov, by phone at 1-800-772-1213, or at a local Social Security office.
If you are still working
You may be able to delay Part B without a penalty if you have group health coverage based on current employment, either your own or your spouse's. The rules depend on the employer's size:
- Employer with 20 or more employees: the job-based plan usually pays first, so many people delay Part B. Many still take premium-free Part A.
- Employer with fewer than 20 employees: Medicare usually pays first, so you generally need Part B at 65.
When the job or the coverage ends, whichever happens first, you have an 8-month Special Enrollment Period to sign up for Part B without a penalty. Ask your employer for written proof of coverage; Social Security will ask for it.
Health savings accounts
If you contribute to a health savings account, you must stop contributions once you have any part of Medicare. Part A coverage can begin up to six months before the month you apply, if you sign up after 65, so many advisers suggest stopping contributions six months before you plan to enroll.
If you miss your window
If you miss your Initial Enrollment Period and do not qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period, from January 1 through March 31 each year. Coverage starts the month after you sign up.
You may also owe late penalties:
- Part B: 10% added to your premium for each full 12-month period you could have had Part B but did not, usually for as long as you have Part B.
- Part D: a penalty based on how many months you went without creditable drug coverage, added to your premium for as long as you have Part D.
- Part A: only if you have to buy Part A, a penalty of up to 10% for twice the number of years you could have had it.
A simple checklist
- About four months before your 65th birthday, decide whether you need Part B now.
- If you are not receiving Social Security, apply during the 3 months before your birthday month.
- Decide between Original Medicare and Medicare Advantage.
- If you choose Original Medicare, choose a Part D drug plan and consider a Medigap policy during your Medigap open enrollment period.
- Keep your new Medicare card in a safe place and guard your Medicare number like a credit card number.
