Who gets Part A and Part B automatically?

If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you’ll automatically get Part A and Part B starting the first day of the month you turn 65. (If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.)

If you’re under 65 and have a disability, you’ll automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months.

If you have ALS (amyotrophic lateral sclerosis, also called Lou Gehrig’s disease), you’ll get Part A and Part B automatically the month your Social Security disability benefits begin.

If you’re automatically enrolled, you’ll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or 25th month of disability benefits. You don’t need to pay a premium for Part A (sometimes called “premium-free Part A”). If you don’t want Part B, let us know before
the coverage start date on your Medicare card. If you do nothing, you’ll keep Part B and will have to pay Part B premiums through your Social Security benefits. If you choose not to keep Part B but decide you want it later, you may have to wait to enroll and pay a penalty for as long as you have Part B.

Who has to sign up for Part A and/or Part B?

If you’re close to 65, but NOT getting Social Security or Railroad Retirement Board (RRB) benefits, you’ll need to sign up for Medicare. Contact Social Security 3 months before you turn 65. You can also apply for Part A and Part B at socialsecurity.gov/benefits/medicare. If you worked for a railroad, contact the RRB.

In most cases, if you don’t sign up for Part B when you’re first eligible, you may have a delay in getting Medicare coverage in the future (in some cases over a year), and you may have to pay a late enrollment penalty for as long as you have Part B.

If you have End-Stage Renal Disease (ESRD) and you want Medicare, you’ll need to sign up. Contact Social Security to find out when and how to sign up
for Part A and Part B. For more information, visit Medicare.gov/publications to view the booklet “Medicare Coverage of Kidney Dialysis & Kidney Transplant Services.”

Where can I get more information?
Call Social Security at 1-800-772-1213 for more information about your Medicare eligibility and to sign up for Part A and/or Part B. TTY users can call
1-800-325-0778. If you worked for a railroad or get RRB benefits, call the RRB at 1-877-772-5772. TTY users can call 1-312-751-4701.

If I didn’t get enrolled in Part A and Part B automatically,
when can I sign up?

If you didn’t get automatically enrolled in premium-free Part A (for example, because you’re still working and not yet getting Social Security or Railroad
Retirement Board (RRB) benefits), you can sign up for premium-free Part A (if you’re eligible) any time during or after your Initial Enrollment Period begins.

If you’re eligible for premium-free Part A, you can enroll in Part A anytime after you’re first eligible for Medicare. Your Part A coverage will go back
(retroactively) 6 months from when you sign up, but no earlier than the first month you’re eligible for Medicare. You can only sign up for Part B during the periods listed below.

Remember, in most cases, if you don’t sign up for Part A (if you have to buy it) and Part B when you’re first eligible, your enrollment may be delayed and you may have to pay a late enrollment penalty.

What are the Part A and Part B sign up periods?

You can only sign up for Part B (or Part A if you have to buy it) during these enrollment periods.

Initial Enrollment Period
You can first sign up for Part A and/or Part B during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.

If you sign up for Part A and/or Part B during the first 3 months of your Initial Enrollment Period, in most cases, your coverage begins the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage will start the first day of the prior month.

If you enroll in and are paying for Part A and/or Part B the month you turn 65 or during the last 3 months of your Initial Enrollment Period, the start date for your Part B coverage will be delayed.

Special Enrollment Period
After your Initial Enrollment Period is over, you may have a chance to sign up for Medicare during a Special Enrollment Period. If you didn’t sign up for
Part B (or Part A if you have to buy it) when you were first eligible because you have group health plan coverage based on current employment (your own, a spouse’s, or a family member’s—if you have a disability), you can sign up for Part A and/or Part B:
• Anytime you’re still covered by the group health plan
• During the 8-month period that begins the month after the employment ends or the coverage ends, whichever happens first

Usually, you don’t pay a late enrollment penalty if you sign up during a Special Enrollment Period. This period doesn’t apply if you’re eligible for
Medicare based on End-Stage Renal Disease (ESRD), or you’re still in your Initial Enrollment Period.

Note: If you have a disability, and the group health plan coverage is based on a family member’s current employment (other than a spouse), the
employer offering the group health plan must have 100 or more employees for you to get a Special Enrollment Period.

COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage, retiree health plans, VA coverage, and individual health coverage
(like through the Health Insurance Marketplace) aren’t considered coverage based on current employment. You aren’t eligible for a Special
Enrollment Period to sign up for Medicare when that coverage ends. To avoid paying a higher premium, make sure you sign up for Medicare when
you’re first eligible. 

General Enrollment Period
If you didn’t sign up for Part A (if you have to buy it) and/or Part B (for which you must pay premiums) during your Initial Enrollment Period, and
you don’t qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period between January 1–March 31 each year. Your
coverage won’t start until July 1 of that year, and you may have to pay a higher Part A and/or Part B premium for late enrollment.

If you’re not sure if you qualify for a Special Enrollment Period, or to learn more about enrollment periods, visit Medicare.gov, or call 1-800-MEDICARE
(1-800-633-4227). TTY users can call 1-877-486-2048.

from Medicare and You Handbook 2021, pages 15-18

 

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