Medicare Eligibility and Enrollment

Are you eligible for Medicare?

You are eligible for Medicare if you are:

65 or older, and a United States citizen or a permanent U.S. resident who has lived in the U.S. for five full years before applying.

under 65 but have a qualifying disability, or diagnosed with end-stage kidney disease or amyotrophic lateral sclerosis (ALS).

If you...	Then...
Plan to retire at age 65 or are already retired and don’t receive Social Security yet	You can enroll in Medicare benefits
Already receive Social Security retirement, disability or Railroad Retirement Board benefits	You'll be enrolled automatically in Medicare Parts A and B (Original Medicare)
Are currently covered by an employer-provided group health plan and plan to continue working past age 65	You can still enroll in Medicare – Talk to your human resources department before you enroll to ensure you’re making the best decision for you
Have coverage through your spouse’s employer and are over 65	You can enroll in Medicare benefits and maintain the coverage through your spouse’s employer

When can you enroll in Medicare?

There are certain times when you can enroll in Medicare or switch to a new Medicare plan. When you enroll affects what guidelines you have to follow and what type of Medicare plan you can choose. Get to know your enrollment options.

IEP
Initial Enrollment Period

AEP
Annual Enrollment Period

OEP
Open Enrollment Period

SEP
Special Enrollment Period

Initial Enrollment Period (IEP)

It all starts with your Initial Enrollment Period (IEP). This is when you first become eligible to enroll in Medicare, which for most people is around the time of your 65th birthday.

Initial Enrollment Period (IEP)

starts 3 months before the month you turn 65

includes the month you turn 65

ends 3 months after the month you turn 65

During your IEP 7-month period, you can sign up for:

Part A
Hospital Insurance

Part B
Medical Insurance

Part C
Medicare Advantage*

Part D
Prescription Drug**

Medicare Supplement
(also called Medigap)*

*You can only sign up for Part C (Medicare Advantage) and/or a Medicare Supplement (Medigap) plan if you also enroll in Original Medicare (Part A and Part B).
**You can sign up for stand-alone Part D (Prescription Drug) plans if you have Medicare Part A or Medicare Part B.

Avoid the Late Enrollment Penalty (LEP)

If you don’t enroll in Part B and Part D coverage when you’re first eligible, you may have to pay a late enrollment penalty. There are some special circumstances where you can sign up later. For example, if you’re still working and have group health insurance through your employer, you may be able to wait to enroll in Medicare.

Annual Enrollment Period (AEP)

Every year, during the Annual Enrollment Period (AEP), you can switch, disenroll or join a Medicare Advantage or Prescription Drug plan of your choosing. During AEP, you can also enroll in Original Medicare (Part A and Part B). Your new coverage will begin January 1 of the following year.

Annual Enrollment Period (AEP)

begins October 15

ends December 7

During AEP, you can sign up for:

Part C
Medicare Advantage*

Part D
Prescription Drug**

Medicare Supplement
(also called Medigap)*

*You can only sign up for Part C (Medicare Advantage) and/or a Medicare Supplement (Medigap) plan if you also enroll in Original Medicare (Part A and Part B).
**You can sign up for stand-alone Part D (Prescription Drug) plans if you have Medicare Part A or Medicare Part B.

Open Enrollment Period (OEP)

If you are enrolled in a Medicare Advantage plan, you can make a one-time change during the Open Enrollment Period (OEP).

Open Enrollment Period (OEP)

begins January 1

ends March 31

If you have a Medicare Advantage plan, during OEP, you can switch to:

Part A
Hospital Insurance

Part B
Medical Insurance

Part C
Medicare Advantage*

Part D
Prescription Drug**

Medicare Supplement
(also called Medigap)*

*You can only sign up for Part C (Medicare Advantage) and/or a Medicare Supplement (Medigap) plan if you also enroll in Original Medicare (Part A and Part B).
**You can sign up for stand-alone Part D (Prescription Drug) plans if you have Medicare Part A or Medicare Part B.

Special Enrollment Period (SEP)

Certain events allow you to make a change to your coverage during the year. For example, if you move outside your plan’s service area or lose your employer coverage, you may be eligible for a Special Enrollment Period (SEP).

You may qualify for an SEP under these circumstances (not an all-inclusive list):

If you are eligible for both Medicare and Medicaid

If you lose group health coverage from your spouse's employer

If you move away from your current plan's service area

If your insurance company cancels your health plan

If you get Extra Help from Medicare to pay for prescription drugs.

I’m working past 65. What do I do about Medicare?

A lot of people work past age 65. Many have health insurance through their employers. Depending on your situation as you turn 65, you may or may not have to enroll in Medicare. However, you may want to consider enrolling in Medicare Part A even if you are still working.

Check with your employer’s human resources department to see if signing up for Original Medicare (Part A and/or Part B would be a good idea for you. They should also be able to tell you if your employer requires you to enroll in Original Medicare.

If you don't enroll in a Medicare plan, your employer's plan may not cover services that Medicare covers. Also, you may risk having to pay a Late Enrollment Penalty for Medicare if you don’t enroll when you are first eligible.

Being New to Medicare can be confusing. We’re here to help you figure it out.

Learn more about working past 65 and Medicare

How Do You Enroll in Medicare?

Medicare enrollment doesn’t automatically happen when you turn 65. Here’s how to enroll in Original Medicare (Parts A and B).

Enrolling in Medicare Parts A & B

If you are already getting Social Security Retirement or disability (or Railroad Retirement benefits) when you turn 65:

You will be automatically enrolled in Medicare Parts A and B.
You should get a “Welcome to Medicare” packet and Medicare card in the mail from the Social Security Administration about 3 months before your 65th birthday.

If you are not yet collecting retirement benefits:

You need to contact Social Security to apply for Medicare.
It is best to apply 3 months before your 65th birthday. If you do not apply, you will not be enrolled in Medicare.

Three ways to apply for Original Medicare (Parts A and B)

Online: Visit Social Security’s website
By phone: Call the Social Security Administration national customer hotline at 1-800-722-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778.
In person: Visit your local Social Security office

What you may need

An original or certified copy of your birth certificate
Proof of United States citizenship or legal residency (if you weren’t born in the U.S.)
Any W-2 forms you have from the last two years
Your Social Security card or number