Eligible for Medicare? Understanding When and How To Sign Up

Many people have misconceptions concerning Medicare eligibility, assuming it is only available to individuals with disabilities, or perhaps, only to those individuals over 65 years of age.  Some people think they will only receive Medicare benefits if they have retired from working, while others believe it is provided solely for low-income individuals. It is important to understand the facts about Medicare eligibility so that you can receive the Medicare health coverage you deserve as soon as you reach eligibility.

Medicare is the Federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). If you have End-Stage Renal Disease (ESRD), you should visit your local Social Security office, or call Social Security at 1-800-772-1213 to sign up for Part A and Part B. TTY users should call 1-800-325-0778.  If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you automatically get Part A and Part B the month your disability benefits begin.

Most people are automatically enrolled in Medicare when they reach 65 years of age, or have been receiving disability benefits from Social Security or the Railroad Retirement Board for 24 months. In most cases, if you are already getting benefits from Social Security or the Railroad Retirement Board (RRB), you will automatically get Medicare 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.  You will get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability. If you don’t want Part B, follow the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums.

If you are not getting Social Security or RRB benefits (for instance, because you are still working) and you want Part A or Part B, you will need to sign up (even if you’re eligible to get Part A premium-free).  If you are not eligible for premium-free Part A, you can buy Part A and Part B. You should contact Social Security 3 months before you turn 65. If you worked for a railroad, contact the RRB to sign up.

If you do not sign up for Part A and/or Part B when you were first eligible, you can sign up between January 1–March 31 each year, and your coverage will begin July 1. There are also Special Enrollment Periods granted for specific circumstances, for instance if you didn’t sign up initially because you or your spouse (or family member if you’re disabled) are working, and you’re covered by a group health plan through the employer or union based on that work.

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