- Medicare is open to anyone 65 or older and those with disabilities and end-stage renal disease.
- You have several chances 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 when you lose your group health insurance, or the annual general enrollment period.
- When you sign up for Medicare, you’ll have to choose between Original Medicare plus Part D drug coverage or a single Medicare Advantage plan.
- Use the resources at Medicare.gov to learn more about your options.
When you reach retirement, you’ll finally be eligible for Medicare, the universal health insurance program run by the federal government. That’s the good news. The bad news is that figuring out how and when to sign up for Medicare can be a tough slog. Like other parts of the health care system, Medicare can be difficult to navigate.
To cut through the confusion, follow this guide to who’s eligible for Medicare, when you can sign up and the different ways you can enroll.
Inside this article
Who’s eligible for Medicare
Before diving into how to sign up for Medicare, let’s step back and talk about who is actually eligible. Since Medicare was designed to provide health insurance coverage to seniors during retirement, you generally have to be at least 65 to enroll. There are a few exceptions. You can enroll in Medicare before 65 if you have a disability or end-stage renal disease.
When you can enroll in Medicare
As with just about any health insurance plan, there are only certain times when you can enroll in Medicare. Add to that other regular Medicare open enrollment periods when you can change and sign up for plans, and it gets confusing.
“You have certain windows to initially sign up for Medicare,” says 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 sign up for Medicare. That includes Original Medicare (Parts A and B), Medicare Advantage (Part C) and a 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,” says Devries. “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.”
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. In that case your coverage will start July 1.
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.
During the annual fall open enrollment that runs from Oct. 15 through Dec. 7, you can switch between Original Medicare and Medicare Advantage, switch Medicare Advantage plans, sign up for a Medicare drug plan or switch Medicare drug plans. You can’t sign up for Medicare coverage for the first time during this time.
The second open enrollment period lasts from Jan. 1 through March 31. During this open enrollment period, which coincides with the general enrollment period, you can switch Medicare Advantage plans or switch from Medicare Advantage to Original Medicare.
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 65, you automatically trigger a six-month open enrollment period for buying any available Medigap policy, regardless of how healthy you are. After that, 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 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,” says 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 getting your care from a particular network of health care providers. You may need to get approvals beforehand for certain medical services. Additionally, 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 actually 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 (call 1-800-772-1213) or in person (when available).
“I always recommend signing up online,” says 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 are still 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 application takes between 10 and 30 minutes to complete, depending on your situation. The website allows you to save your application if you don’t finish and 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.