How to Apply for Medicare at 65
Medicare provides health insurance for Americans aged 65 and older and certain younger individuals with disabilities. Navigating the application process can seem daunting, but with the right information, enrolling in Medicare can be straightforward. This guide covers everything you need to know about applying for Medicare, from eligibility requirements to the step-by-step application process.
Before applying for Medicare, it’s important to understand if you’re eligible and when you should apply. Most people become eligible for Medicare when they turn 65, though some qualify earlier due to disabilities or specific medical conditions.
You typically qualify for Medicare Part A (hospital insurance) without paying a premium if you or your spouse worked and paid Medicare taxes for at least 40 quarters (10 years). For those who don’t meet this requirement, you may still be able to enroll through your spouse’s work record if applicable.
Some individuals are automatically enrolled in Medicare. If you’re already receiving Social Security benefits at least 4 months before turning 65, you’ll be automatically enrolled in Medicare Parts A and B. Your Medicare card will arrive approximately 3.5 months before your 65th birthday. If you live in Puerto Rico or outside the U.S., the automatic enrollment rules may differ.
Methods to Apply
If you are not automatically enrolled, you have three primary methods to apply for Medicare
When to Apply
When you apply for Medicare is important to avoid both gaps in coverage and penalties or fees from going without coverage.
There are some exceptions though that allow you to delay enrollment. Give us call directly so we can help review your situation and determine if you need to enroll at 65 or if you can delay until a later date.
Initial Enrollment Period
If you’re turning 65, you have a 7-month Initial Enrollment Period (IEP) that includes:
- The 3 months before your 65th birthday month
- Your birthday month
- The 3 months after your birthday month
You can submit your Medicare enrollment application up to four months prior to your birthday month. For example, if you turn 65 on July 1st, you can submit your application as early as March 1st.
General Enrollment Period
If you miss your Initial Enrollment Period, and do not qualify for a Special Enrollment Period, you must wait to apply for Medicare until the General Enrollment Period.
The GEP is every year from January 1st through March 31st and coincides with the Annual Open Enrollment Period.
Unlike the IEP, when you enroll in Medicare during the GEP, coverage is not retroactive and instead begins the the first day of the month after you sign up. You might also pay a monthly late enrollment penalty.
Step-by-Step Guide to Online Applications
The online application process through SSA.gov is pretty straightforward.
Create a My Social Security Account
Before applying for Medicare online, you’ll need to create a My Social Security account at www.ssa.gov/myaccount if you don’t already have one. This account allows you to access the Medicare application and connects it to your record.
All new users will create a credential through either Login.gov or ID.me. If you’re unable to create an account, you can still file a claim, and a representative will contact you to verify your identity.
Once logged in, there are two ways to access the Medicare application on ssa.gov:
- Click on the Medicare square on the homepage
- Use the menu button and select Medicare under the Benefits section
After reaching the Medicare page, scroll down and click on “Apply for Medicare Only”.
Start the Application
On the application page:
- Agree to the terms of service
- Select “Start a new application” (or “Return to saved application” if resuming a previous attempt)
- Confirm you’re applying for yourself
- Verify that you have a My Social Security account
- Sign in with your My Social Security credentials
Complete the Application Form
The application will ask for information including:
- Your name (as it appears on your Social Security record)
- Social Security number
- Date of birth
- Gender
- Contact information
- Current Medicare status
- Employment information and healthcare coverage details
If your employment and health insurance coverage have not ended by the date of your application, be sure to check the appropriate box. If they have ended, enter the end dates.
Review and Submit
Before submitting:
- Review the summary of your application for accuracy
- If enrolling outside your Initial Enrollment Period, add a note specifying when you want Part B to start (always the first of a month)
- Read and accept the electronic signature agreement
Click “Submit Now”
Keep Your Confirmation
After submission, you’ll receive:
- A confirmation page with the option to view and print your receipt
- An application number to check your application status
- A confirmation email from Social Security
It’s strongly recommended to print or save a PDF copy of your receipt, as this is your only opportunity to obtain this documentation.
After You Apply
The important piece of information for most people after applying is their Medicare number. If you applied for Part A only, during your IEP, your application is normally processed in as little as a week. If you are applying for Part B also, or if you are applying outside of your IEP, it can take as long as six weeks for your application to process.
Once processed, even if you have not received your Medicare card yet, you find your Medicare number on your Social Security account. This number can be used in place of a card for supplemental or drug coverage that you may want to enroll into.
Special Enrollment Considerations
Applying After Age 65
Not everyone needs to enroll in Medicare at 65. If you have other creditable coverage, delaying your Part B enrollment may be best for you.
While you will not have a penalty for late enrollment in this situation, enrolling after your IEP is a slightly different than if you were to enroll at 65 as you will need to specify when you want your Part B coverage to start in the note section of your application
Dual Eligibility (Medicare + Medicaid)
Starting January 1, 2025, individuals who qualify for both Medicare and full Medicaid benefits will have access to a new Special Enrollment Period that allows them to make certain changes to their Medicare coverage outside the regular open enrollment period.
Additional Coverage Options
After your enrollment in Original Medicare, you can consider additional coverage options.
Medicare Advantage (Part C)
The Medicare Advantage initial enrollment period (ICEP) runs at the same time as your IEP.
You can read more about Medicare Advantage here.
Medicare Part D
If you need a standalone Part D plan, you can enroll in one, without penalty, during your IEP. You can change this plan during the Annual Enrollment Period from October 15 through December 7 each year.
Missing the enrollment window for Part D can lead to some pretty nasty penalties, so make sure to take advantage of your window when you can.
Medigap Plans
If you chose to go with a Medigap plan, your enrollment window is called the Medigap Open Enrollment Period. This enrollment period is six months long and starts the first month you are first eligible for and enrolled in Medicare Part B.
While you can enroll in a Medigap plan outside of the enrollment period, you will need to go through underwriting first.
Takeaways
Applying for Medicare doesn’t have to be complicated. By understanding your eligibility, knowing when to apply, and following the step-by-step application process, you can successfully navigate Medicare enrollment. Whether you choose to apply online, by phone, or in person, being prepared with the necessary information will help ensure a smooth application experience. Remember that timing is crucial—applying at the right time will help avoid potential coverage gaps or penalties, and take advantage of the annual open enrollment period if you need to make changes to your existing coverage.
If you have questions or if you’re ready to start the process and need some help, feel free to reach out and we can chat.
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