Applying For & Enrolling In Medicare
Turing 65 or 2 years of SSDI
If you are turning 65 and collecting Social Security or on SSDI and are hitting your two-year enrollment date, then enrollment in Medicare Parts A&B will be automatic. Your Medicare card will be mailed to you, usually about three months before your first month in Medicare.
In a rare case, someone who is collecting Social Security and has workplace-based insurance they want to keep, receives their card indicating automatic enrollment in Medicare A&B. In that case usually the person will need to mail back the card “opting out of Medicare Part B” while they have workplace-based insurance. (This allows for enrollment later without a penalty. This is not an option if you have an induvial policy or are on Medicaid.) There is typically no reason for an SSDI recipient to opt out of Medicare Part B, unless he/she has workplace-based insurance through a spouse and it costs less than the Medicare Part B premium, but that is exceedingly rare.
Turning 65 and not collecting SS retirement benefits
Many people who are still working want to wait until at least age 66 to collect Social Security retirement benefits because before that you are limited to how much you can earn without penalty. In that case, the person needs to apply for Medicare before turning 65. The easiest way (during COVID-19 especially) is to register for a My Social Security account at SSA.gov (here https://www.ssa.gov/site/signin/en/). Once you have done that, you can use this link to
“apply Medicare only” (https://www.ssa.gov/benefits/medicare/), making sure to opt into Medicare Part B, unless you have good, affordable workplace-based health insurance.
NOTE: Setting up a My Social Security account on SSA.gov can be wonky and sometimes they do security “checks” with information that doesn’t match the actual person trying to setup the account. If that happens, your only option is to get in touch with your local Social Security office either in person or on the phone. (Many offices are closed during COVID-19.) The individual phone numbers for local offices are not easily available online and you may have to call 800-772-1213 to find the number for your local office.
Adding Medicare at age 65+ & you have workplace-based health insurance
If you are past your initial enrollment period and want to enroll in Medicare, there are two forms you need to download and print: CMS 40B and CMS L564. The person applying for Medicare fills out the 40B, indicating which month they want the coverage to start. The employer fills out the L564, indicating the person has been covered by workplace insurance. These can be taken in or faxed to the local office. If faxed in, it’s good to follow up with a phone call to make sure they’re received and will be made active as requested. NOTE: Some SSA offices are great and will accept these forms via fax from an insurance agent. Some are more stringent and want the originals to be mailed or faxed directly from the employer. To be safe, follow up to make sure everything is being processed correctly and in a timely manner.
Adding Medicare post-65 and without workplace-based insurance
If you don’t currently have workplace-based health insurance and you didn’t enroll in Medicare when first eligible at age 65, you will have to wait until the following January to apply. Your coverage will not be active until the following July! Furthermore, you will incur a 10% Part B penalty for each year that you went without every month for the rest of your life. This is not an ideal situation. This is not a typical scenario, however, if this describes your situation, it is advisable to reach out to an agent that can assist you with your enrollment.
We hope you find this information valuable and helpful. If you need assistance applying for and enrolling in Medicare, contact us today.