All about enrolling in Medicare

What is Medicare?

  • Government based health insurance for individuals 65 years or older, managing a disability or diagnosed with End-Stage Renal Disease.
  • It is divided into multiple parts
    • Part A: Hospital coverage, including hospitalization, skilled nursing facility, hospice and may cover home health
    • Part B: Medical coverage, including outpatient office visits, preventative care and medical supplies
    • Part C: Advantage Plans, private organization (HMO, PPO, etcetera) contracted with Medicare to cover services traditional coverage may not offer.
    • Part D: Prescription medication coverage
  • You will choose if you would like both part A and B coverage or additional coverage through supplemental insurance.

When do I sign up?

  • Prior to your 65th birthday
    • The enrollment period begins 3 months prior to an individual turning 65 years old and ends after 3 months following his or her birthday.
    • If you apply on or in the 3 months following your birthday, there will be a delay in Part B coverage
    • You may visit the Medicare website below to determine your exact eligibility period
  • What happens if I do not enroll in the appropriate time period?
    • A Part B penalty will be applied if an enrollee does not apply within the eligibility period.
    • The penalty may be an increase in your insurance premium by 10% for each year you were eligible for coverage but were not enrolled. This penalty will be included in your premium for as long as you have Part B insurance.
    • The general enrollment period for late applicants is from January 1 to March 31 of each year.
  • What are special enrollment periods?
    • If you have insurance coverage through your employment (including spouse employer insurance) by a group health plan
    • You may be eligible for the Special Enrollment
      • This is an 8 month window that begins:
        • The month after employment ends
        • The month after the group health insurance plan ends
      • If you enroll in SEP, you likely will not have to pay the late penalty

When will my coverage begin?

  • The first day of your birthday month, if you enrolled during the first 3 months of eligibility. If you enroll at another time, refer to the chart below.

Medicare chart

  • After you are enrolled:
    • Schedule a “Welcome to Medicare” physical with your primary care provider within the first year

If you have questions or are interested in more information, please visit https://www.medicare.gov/people-like-me/new-to-medicare/getting-started-with-medicare.html


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