Initial Enrollment Period
If you are receiving Social Security or Railroad Retirement Benefits, then you will automatically get Medicare Part A starting the first day of the month you turn 65. You have the option of enrolling in Part B, with the Initial Enrollment Period beginning three months prior to the month when you turn 65, and ending 3 months after the month when you turn 65; if you sign up prior to your 65th birthday, then Part B coverage begins on the first day of your birthday month. If you are not eligible for automatic Part A coverage, then you also have the option of enrolling in Part A during the Initial Enrollment Period by paying a monthly premium. In 2022, the Part A premium is $499 per month.
If you are under 65 and disabled, then you will automatically receive Part A and Part B beginning 24 months after you begin receiving Social Security Disability payments (SSDI) or disability payments from the Railroad Retirement Board.
If you have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease, then you will automatically receive Part A and Part B the month your disability payments begin.
If you are not automatically enrolled, then you can sign up for Medicare at your local Social Security Office during any of the enrollment periods described in this section.
Special Enrollment Period
Some people do not sign up for Medicare Part A and/or Part B because they are still employed and covered under an employer’s group health plan. If so, then you may sign up for Medicare at any time while you are still covered by a group health plan, or during the 8 month period beginning the month after employment ends or coverage ends, whichever happens first. Your employer will need to complete Form CMS-L564 to qualify for the special enrollment period.
COBRA and retiree health plans are not employment based coverage and do not qualify you for the Special Enrollment Period.
Typically, there is no penalty for late enrollment if you are eligible to enroll during a Special Enrollment Period and you enroll during that time.
General Enrollment Period
If you are not automatically enrolled, or if you did not sign up for Medicare during an Initial Enrollment Period or a Special Enrollment Period, then you Can sign up for Medicare during a General Enrollment period. The General Enrollment Period is January 1 through March 31 each year, with coverage beginning on July 1st. Your monthly Medicare premium will be higher because a penalty is imposed for late enrollment.
Open Enrollment (Making Changes)
Each year you have the option of making changes in your coverage. The period during which you can make changes is known as “Open Enrollment.” This year, open enrollment is from October 15th through December 7th, with changes becoming effective on January 1st. You can use the Plan Finder tool at www.medicare.gov if you are thinking about changing the way you get Medicare.
Medigap Open Enrollment
If you decide to purchase a Medicare Supplement, known as a Medigap policy, then you should know you can be denied coverage through medical underwriting UNLESS you purchase your policy during the initial Open Enrollment Period. This is different from the Open Enrollment period described in the preceding paragraph. The Medigap initial Open Enrollment Period is a six month period which begins on the first day of the month in which you are 65 or older and are enrolled in Part B. During this initial period, you cannot be denied coverage based on pre-existing conditions.
Penalty for Late Enrollment
If you delay enrolling in Medicare and you were not covered under an employer’s group health plan, then you will likely pay a penalty. The reason is because you did not participate in the risk pool along with everyone else. The way insurance works, many people come together to pool their risk, while only a few people need assistance and file claims. The system doesn’t work properly unless healthy people pay premiums while they are healthy so the risk is spread among all beneficiaries.
The penalty for delaying Part A is 10%, but you should only assessed that penalty for twice the number of years you delayed taking Part A. For example, if you were eligible for Part A and delayed taking it for 2 years, then you would pay a penalty for 4 years after signing up.
The penalty for delaying Part B is 10% for each 12 month period that you could have had Part B, but didn’t sign up for it.
