How to sign up for Medicare in 2024

Key points

• Medicare is open to anyone age 65 or older. 
• You have several opportunities to sign up for Medicare, starting with your initial enrollment period, a seven-month window surrounding your 65th birthday.
• Other enrollment windows include a special enrollment period for situations like losing your group health insurance and the annual general enrollment period.

At age 65, you are eligible for Medicare, the universal health insurance program run by the federal government. That’s the good news. The bad news is Medicare can be difficult to navigate. Here we’ll cover who’s eligible for Medicare, when you can sign up and the different ways you can enroll.

Who’s eligible for Medicare

Before diving into how to sign up for Medicare, let’s step back and talk about who is eligible. Since Medicare was designed to provide health insurance coverage to seniors throughout retirement, you generally need to be at least 65 to enroll. There are a few exceptions. You may be eligible for Medicare before age 65 if you receive Disability benefits or have end-stage renal disease.

When you can enroll in Medicare

As with just about any health insurance plan, there are only certain times you can enroll in Medicare. 

“You have certain windows to initially sign up for Medicare,” said Kyle Devries, a Medicare advisor at Health Benefits Associates, an online insurance brokerage based in Reno, Nevada. “There are also a lot of different enrollment periods, and all of them can run together for individuals who don’t deal with Medicare on a daily basis.”

These are the key Medicare enrollment periods, each of which applies in different situations and allows you to take different actions.

Initial enrollment period

The three months before your 65th birthday, your birthday month and the three months after are known as your initial enrollment period. This seven-month window is when you can first enroll in Medicare. The parts of Medicare you can sign up for include:

• Original Medicare (Parts A and B).
• Medicare Advantage (Part C).
• Medicare prescription drug plan (Part D). 

As long as you sign up no later than the month before you turn 65, Medicare coverage will begin in your birthday month. If you wait any later, coverage will start the following month.

“The biggest pitfall I see is people waiting too long to sign up. Make sure you sign up when you are first eligible. This way, even if your ID cards get delayed, you still have three months before the start of your Medicare.” 

Kyle Devries, Medicare advisor, Health Benefits Associates

Special enrollment period

If you have health insurance from another source when you turn 65 — say you’re still working and covered by your employer plan, or you’re covered by your spouse’s plan — you can postpone signing up for Medicare.

In this case, you’ll qualify for a special enrollment period, which will begin when you or your spouse stops working or you lose your group health insurance coverage for some other reason, whichever happens first. Once that occurs, you’ll have eight months to sign up for Medicare.

General enrollment period

If you miss your initial enrollment period and aren’t eligible for a special enrollment period, you can sign up for Medicare during the general enrollment period, which runs every year from Jan. 1 through March 31. Your coverage begins at the start of the following month after enrolling. 

You may have to pay a monthly late enrollment penalty if you don’t qualify for a special enrollment period. 

Open enrollment periods

Outside of the three periods during which you can initially sign up for Medicare, there are two periods during the year when you can make changes to your plan. 

Oct. 15 to Dec. 7. 

• Switch from Original Medicare to a Medicare Advantage plan.
• Join, drop or switch your Medicare Advantage plan.
• Join or switch your Medicare drug plan if you have Original Medicare. 

Jan. 1 to March 31. 

• Switch to another Medicare Advantage plan.
• Join a Medicare drug plan.
• Switch from Medicare Advantage to Original Medicare.

Tip: You can’t sign up for Medicare coverage for the first time during the fall open enrollment, from Oct. 15 to Dec. 7. If you didn’t enroll in Medicare when you were first eligible, you’ll have to wait to sign up during the general enrollment period, which coincides with the second open enrollment period, from Jan. 1 to March 31. 

Medigap open enrollment

With Original Medicare, you may want a private Medigap policy to fill the gaps in coverage. When you enroll in Medicare Part B and you’re at least 65, you automatically trigger a six-month open enrollment period for buying any available Medigap policy, regardless of how healthy you are. 

After that six-month period, you can still buy a Medigap policy, but the insurer can turn you down for health reasons, or charge more.

What you need to decide before you enroll

When you sign up for Medicare, one of the most important decisions you’ll have to make is whether to choose Original Medicare — meaning Medicare Part A and Part B, plus Medicare Part D drug coverage — or Medicare Advantage, also known as Medicare Part C.

Give yourself time to consider your choices. “We typically sit down with clients about six months before their 65th birthday so they have time to take it all in and weigh out their options,” said Devries.

Medicare Advantage plans, which are offered by private companies, roll all three parts of Medicare into a single plan (Parts A, B and D). One benefit is that Advantage plans often cover services that Original Medicare doesn’t, including dental, vision and hearing. Many plans also include prescription drug coverage (if not, you’ll have to get Medicare Part D, too).

That said, there are also downsides to Medicare Advantage plans: 

• You’re typically limited to a network of health care providers. 
• You may need to get approvals before certain medical services. 
• Certain plans only serve specific parts of the country. If you live elsewhere part of the year, travel or move, you may have to switch plans or forgo coverage for the care you need.

Premiums and out-of-pocket costs also vary widely depending on what Medicare plans you choose.

How to sign up for Medicare

Once you decide on a Medicare plan, here’s how to enroll.

If you opt for Medicare Part A and Part B, you sign up for that coverage through the Social Security Administration. There are three ways to do that: online, over the phone at 1-800-772-1213 or in person (when available).

“I always recommend signing up online,” said Devries. “It is the easiest and quickest way to get through the application. Calling in tends to have long wait times, and most Social Security offices may be closed to walk-ins.”

When you sign up, you’ll have to provide your name and address, date of birth, Social Security number, tax information and more. The website allows you to save your application if you don’t finish and want to return to it later.

To enroll in a Medicare Part D, Medigap or Medicare Advantage plan, you can sign up directly through the insurer or via the Medicare website.

How to find enrollment help

Choosing the right type of plan can be difficult, especially when you’re just getting started. You need to think about your current and future health care needs, including what prescription drugs you take, how much you care about vision and hearing coverage and whether or not your doctor is in-network for a Medicare Advantage plan.

With the Find a Medicare Plan tool on Medicare.gov, you can explore the different Medicare Advantage and Medicare Part D plans in your area. You can compare these plans to the coverage and costs of Original Medicare to determine which is a better fit for you.

Your state’s Office of the Aging may offer help signing up, including one-on-one counseling. The nonprofit Medicare Rights Center has a free interactive tool to help you learn about and navigate the system. Or you can consult with a financial planner who is well-versed in retirement planning since they are very familiar with the various Medicare options.