How to Apply for Medicare: What to Do So You Don’t Miss the Benefits You’ve Earned

There are many ways to apply for Medicare benefits.

Find out what you should do so you don’t miss out on the benefits you’ve earned.

And just as important, learn how to avoid Medicare late enrollment penalties. 

​Confused about your Medicare coverage options? Watch our free video: How to Find the Best Medicare Coverage Without Paying More Than You Need To… ​​

​For answers to your specific Medicare questions and to objectively compare all available Medicare plans where you live, please feel free to call our office at 877-312-1414 or schedule a free, no obligation Medicare plan consultation. Our services are always free and enrolling through our office does not increase the cost of any insurance.

How to Apply For Medicare : Medicare Eligibility

You are eligible for Medicare if you are

1. Age 65 or older
2. US citizen or permanent legal resident who has lived in the US for at least 5 years
3. Receiving Social Security or railroad retirement benefits OR are eligible for those benefits but are not taking them yet
4. You or your spouse has paid Medicare payroll taxes while working Under Age 65 Medicare Eligibility: Entitled to Social Security disability benefits for at least 24 months OR Have ALS (Lou Gehrig’s disease) OR Have permanent kidney failure

Medicare Part A Premiums

If you or your spouse worked and paid Medicare payroll taxes for at least 10 years, you qualify for premium-free Medicare Part A.

If you paid Medicare payroll taxes for less than 10 years, you may still qualify for Medicare, but you will have to pay a monthly premium for Medicare Part A. Here is a link to more information on what your Medicare Part A premium will be if you are in this situation.

How to Apply for Medicare

Now, we’re going to look at how you enroll in Medicare. This is not the same for everyone. How you apply depends on when you take Social Security and whether you have continuing access to group health insurance. More info…

If you are

Turning 65 and Taking Social Security

If you started taking Social Security before age 65 or applied to start taking Social Security at age 65, you will automatically be enrolled in Medicare Parts A and B. Your Medicare ID card will arrive in the mail a few months before you turn 65.

If you will not have other health insurance at age 65, such as from a group employer health plan, you keep that Medicare card and comparison shop for Medicare coverage from Medicare Advantage, Medicare Part D, and Medicare Supplement carriers in your zip code. You will want to enroll so that your Medicare plan coverage starts the same date as your Medicare Parts A and B effective date. More info…

If you have the option to keep a group health plan, through your or your spouse’s employer or some other source, you have some extra issues to consider.

Here’s how to decide whether to stay with your group plan or go with Medicare for health coverage.

The first thing to find out is whether your group plan is considered creditable coverage by Medicare. The HR department or benefits administrator will be able to give you that information.

Generally, if your employer group plan covers more than 20 employees, it is considered creditable coverage by Medicare, but it’s always a good idea to check.

If your employer plan is not creditable coverage for Medicare, you are usually better off going with Medicare coverage to avoid late enrollment penalties and save on overall costs.

If your group plan is creditable coverage for Medicare, compare your group health costs and benefits with available Medicare plans in your area.

In the past, group health insurance was usually a better deal financially for people turning 65, but that isn’t the case anymore. More than half the people we’ve spoken to in the last couple years have saved money and gotten better coverage by leaving their group plan and enrolling in Medicare and Medicare plans instead.

If your creditable coverage group plan is better in terms of costs and benefits than any available Medicare plans in your zip code, you will want to decline Medicare Part B by calling Social Security.

There are two reasons to decline Part B.

1. You have to pay a premium for Part B. This year, most people pay $170.10 per month. If you have creditable coverage, you don’t need Part B coverage, so there’s no reason to pay for it. You won’t be charged a late enrollment penalty for enrolling in Part B later.
2. Your first 6 months on Medicare Part B are your Medicare Supplement Open Enrollment Period. During this time, no Medicare Supplement company can refuse to sell you a policy regardless of your health conditions. This is a one in a lifetime open enrollment period, and if your first six months of Part B coverage are spent while you are in a group plan, you may not get a chance to purchase a Medicare Supplement later without going through health questions and possibly being denied a policy in most states. Preserve that Medicare Supplement Open Enrollment Period until you need it. 

​Most people who stay on a group health plan keep Medicare Part A even if they decline Part B. Part A has no monthly cost if you worked ten years and paid Medicare taxes during that time.

The only reason to decline Part A in addition to Part B is if your group health plan is a qualified high deductible plan with a Health Savings Account. You can’t contribute to a health savings account once you’re on any part of Medicare, so if you would like to continue with your employer plan that has HSA contributions, you should decline both Medicare Parts A and B.

If Medicare plans in your area are better than your group coverage, you will want to keep your Medicare ID card and Medicare Parts A and B and enroll in the Medicare plan or plans of your choice to start when your Medicare eligibility begins.  

Turning 65 and Delaying Social Security

If you are not taking Social Security at or before age 65, you will not be automatically enrolled in Medicare. You will need to apply for the Medicare Parts and plans of your choice.

You can do that beginning three months before your Medicare eligibility date. I recommend doing this as early as possible. Processing Medicare applications has been taking much longer than usual this year.

You are eligible for Medicare on the first day of the month in which you turn 65. If your birthday is the first day of the month, your Medicare eligibility starts on the first day of the month before you turn 65.

You can apply for Medicare online at ssa.gov/benefits/medicare, by calling Social Security at 800-772-1213, or at a local Social Security office.

If you have the option of remaining on a group plan, you will want to go through the same decision process noted earlier to figure out which, if any, Medicare parts and plans are best for you.

If you are declining Part A and/or Part B because of group creditable coverage, you can note that on the Medicare application with Social Security.

If you will not have group coverage available once your Medicare coverage begins, you will want to apply for both Medicare Parts A and B and then comparison shop for the appropriate Medicare plans that best fit your financial and healthcare needs. These include Medicare Supplements, Medicare Advantage plans, and Medicare Part D plans.

If you do not have other creditable prescription medication coverage, you will want to enroll in a plan that has Part D coverage, even if you do not take any medications, to avoid the Part D late enrollment penalty later. 

Under Age 65 Medicare Disability

If you are under age 65 and have been entitled to Social Security or Railroad Retirement Board disability payments for 24 months, you will be eligible for Medicare and typically you will be automatically enrolled in Medicare Parts A and B.

If you have ALS or permanent kidney failure, your Medicare eligibility starts immediately at diagnosis with no waiting period.  

The Medicare Part B premium will start to be deducted from your monthly Social Security benefits once Part B coverage is effective.
If you have group health insurance that you can keep once your Medicare coverage starts, you should compare the group plan with available Medicare options as discussed earlier.

If you don’t have group coverage, you will want to look at the Medicare plans in your area. Medicare Supplements, Medicare Part D, and Medicare Advantage plans are available to people who are under age 65 and on Medicare.

Questions? We can Help!

If you have questions about applying for Medicare and Medicare plans, please give us a call at 877-312-1414 or schedule a no obligation Medicare plan consultation.