Getting Started with Medicare
Who qualifies for Medicare?
Upon reaching the age of 65, all US citizens are eligible for Medicare. Additionally, non-citizen permanent residents become eligible at 65, provided they have resided in the country for at least five years.
Individuals under 65 may also qualify for Medicare if:
They are permanently disabled and have received Social Security Disability benefits for a minimum of 24 months.
They have been diagnosed with end-stage renal disease (kidney failure).
They have been diagnosed with Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease) and are receiving Social Security Disability benefits.
Navigating Medicare, like many extensive government programs, can initially seem daunting. Hence, we've designed this guide to assist you in navigating the application process, annual enrollment, and more.
Medicare Initial Enrollment Period: When should you enroll in Medicare?
Eligibility for Medicare begins at age 65. However, if an individual has already claimed Social Security benefits by that time, they will be automatically enrolled in Medicare upon turning 65, receiving Parts A and B. To enroll in other Medicare programs such as Part C (Advantage) or Part D (prescription), one must consult with an insurance professional to elect those benefits.
For those who haven't commenced drawing Social Security benefits, enrollment in Medicare is necessary at age 65. The Initial Enrollment Period (IEP) starts three months before one's 65th birthday, extends throughout the birthday month, and continues for three months afterward. Thus, individuals have a total of seven months to complete the enrollment process.
There is one exception: If the birthday falls on the first day of the month, the IEP will commence one month earlier.
Important Note:
It's imperative to apply for Medicare at age 65, even if Social Security benefits aren’t being claimed yet. Failure to enroll during this initial period may result in higher premiums for life unless under specific conditions permitting delayed enrollment without penalties.
What if you miss the Initial Enrollment Period?
The Medicare General Enrollment Period, occurring from January 1 to March 31 each year, allows those who missed their IEP to enroll in Medicare.
Apart from qualifying for a Special Enrollment Period due to a life event, this is the sole opportunity to apply for Original Medicare after the Initial Enrollment Period.
Upon signing up for Original Medicare during the General Enrollment Period, coverage commences on the first day of the month following enrollment. For instance, enrolling on February 3rd initiates coverage on March 1.
Important Note:
The General Enrollment Period is not a substitute for missing the IEP. Utilize this enrollment period solely as a backup if the Initial Enrollment Period is missed. Late penalties may apply if enrolling during the General Enrollment Period, necessitating budgeting for additional fees.