Enrolling in Medicare
After reviewing ALL of the information on this webpage, click on Enroll Now for detailed enrollment instructions based on your situation.
Since Medicare is most likely your PRIMARY Insurance, and you may have penalties and deadlines for not enrolling in Medicare, you may want to...
Your enrollment process depends on if you are already collecting social security income before your 65th birthday.
Not previously collecting Social Security Income
The easiest way to enroll is to visit www.ssa.gov/medicare.
Click here for step by step Directions – How to Enroll Online
Already collecting Social Security Income
You should not have to take any action to enroll in Medicare. Please expect to see your new Medicare ID card in the mail approximately 3 months before your 65th birthday. Your effective date will be the first of the month of your 65th birthday (unless your birthday is on the 1st, then it will be effective the 1st of the prior month).
Your Roadmap is based on…
- You are approaching age 65
- Your Primary Insured IS NOT (or WILL NOT be) actively working at the employer providing your benefits
- You are NOT (or WILL NOT be) covered under group benefits
Recommendation Summary
Since you do not have creditable coverage (group coverage based on current active employment), you are required to enroll in Medicare during your Initial Enrollment Period (IEP).
If you do not enroll in Medicare A and B at this time, you will start to accrue a penalty on your Part B premium which will be added when you enroll later, you will only be permitted to enroll once a year in the future, and you may not have full coverage.
Will I receive a penalty if I don’t enroll now?
Yes. You will receive a late enrollment penalty because you will not have creditable coverage for Medicare. Creditable coverage is defined as group coverage based on current active employment.
Part A: If you are eligible for Premium-Free Part A (you or your spouse has paid 40 quarters of Medicare taxes), you WILL NOT receive a Part A Penalty for enrolling after age 65.
- Since Part A is Premium-Free for many people, they commonly enroll in Part A even if not necessary (special considerations apply if you have an HSA account).
Part B: You will receive a Part B Late Enrollment Penalty if you do not have creditable coverage after age 65.
- Creditable coverage is group health insurance coverage while the Primary Insured is actively working for the employer providing the Group Health Plan.
- Severance, COBRA and/or Retiree Plans are not creditable for avoiding the penalty.
A 10% penalty added for every 12 months you go without creditable coverage. Months need not be consecutive. See Details on how the penalty is calculated.
- The penalty will be assessed on the Base Medicare Premium for as long as you are enrolled in Medicare.
Part D: You will receive a Part D Late Enrollment Penalty if you do not have creditable prescription coverage after age 65.
- Creditable prescription coverage is drug coverage that is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.
A 1% penalty added for every 1 month you go without creditable prescription coverage. Months need not be consecutive.
- The penalty will be assessed on the Average Medicare Part D Premium for as long as you are enrolled in Medicare Part D.
What is my deadline to enroll?
Your Initial Enrollment Period (Turning 65) is 7 months surrounding your 65th birthday to enroll online. Your effective date will be automatically assigned to you based on which month you enroll online.
Do I need Medicare to have full coverage?
Medicare “Who Pays First” Law states that Medicare becomes your primary insurance once you are age 65 or older and are no longer Actively Employed.
Additional Considerations
Spouse Under Age 65- If your spouse relies on your group health plan for benefits, please be mindful that if you come off your group plan, your spouse will have to go on COBRA, seek benefits through their respective employer, or purchase individual health insurance until they become Medicare eligible.
Effective Date Considerations- Reminder, when you apply for Medicare at age 65, you cannot choose a specific effective date for the benefits (and premiums) to start. The only way to influence the effective date is by which month you enroll online. Please contact us ASAP if you are trying to achieve a specific start date that is something other than the first of the month of your 65th birthday (possibly to coordinate with your group plan ending).
Important HSA Considerations– You cannot continue to contribute to your Health Savings Account (HSA) once you enroll in Medicare Part A. If you are enrolling in Medicare after age 65, your Part A effective date may be back dated up to 6 months. Please contact us to discuss the HSA maximum contribution rate for you circumstances. Click Here for Details and Rules.
- This does not apply to Flexible Spending Accounts (FSA) or Health Reimbursement Accounts (HRA). Medicare does not have any restrictions on these types of accounts.