If you are under 65 and disabled, you were probably automatically enrolled in Medicare Part A and Part B after you received disability benefits from Social Security or certain disability benefits from the RRB for 24 months. When you were automatically enrolled, you received your red, white, and blue Medicare card in the mail 3 months before your 25th month of disability. If you didn’t want Part B, you followed the instructions that came with the card, and sent the card back. If you kept the card and your Part B coverage, you have been paying Part B premiums. Individuals of any age with ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease) automatically get Part A and Part B the month your disability benefits began. You can get also Medicare no matter how old you are if have End-Stage Renal Disease (ESRD) meaning your kidneys no longer work, you need regular dialysis, or you have had a kidney transplant. There are certain other conditions that must be met so contact the Social Security office at 1-800-772-1212 (TTY 1-800-423-0778) to determine if you qualify for Medicare based on ESRD.

Some beneficiaries under 65 have found that although Original Medicare covers many medical expenses, you may incur overwhelming out-of-pocket costs that are not covered. During the Annual Election Period, you should review your current coverage and make sure you know all of you options. For instance, you may choose to take advantage eof the AEP’s opportunity to choose to change, drop, or add a Prescription Drug Plan (PDP) to your Original Medicare.

To supplement Original Medicare coverage, many people choose to purchase a Medicare Supplement insurance plan, also known as a Medigap policy. Federal law does not require insurance companies to sell Medigap policies to beneficiaries under the age of 65, but some states require Medigap insurance companies to see their supplemental insurance to beneficiaries of any age. If you are under 65, you might not be able to buy the Medigap policy you want, or any Medigap policy, until you turn 65, but there are some states that require Medigap insurance companies to sell you a policy if you are under 65.  Research the options available in your state to make sure you know what choices you might have.

During AEP, you may receive a great deal of information regarding Medicare Advantage plans. Some Medicare beneficiaries under the age of 65 are enrolled in Medicare Advantage plans. For instance, if you have ESRD and you were enrolled in an MA plan when it developed, you may have been able to stay with that MA plan, or join another plan offered by the same company. If you have an employer or union health plan through a company that offers MA plans, you may be able to join one of their Medicare Advantage Plans. You may also join a Medicare Advantage Plan if you have had a successful kidney transplant. You might also be eligible to join a Special Needs Plan for people with ESRD in your area. If you have ESRD and are enrolled in a Medicare Advantage Plan, and the plan stops participating in Medicare or no longer provides coverage in your area, you have a one-time right to join another plan. You can go directly to another MA plan or go back to Original Medicare, but you can always use your one-time right to join a Medicare Advantage plan later.

During the Annual Enrollment Period, take the time to review your current coverage and explore your options. As a Medicare beneficiary, you deserve to have the coverage that best fits your needs.

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.

Medicare Part B helps cover medically-necessary services like doctors’ services, outpatient care, home health services, and other medical services.  Part B also covers some preventive services.  You can find out if you have Part B by looking at your Medicare card.

How Do You Get Medicare Part B?

• If you get benefits from Social Security or the Railroad Retirement Board (RRB), in most cases you will automatically get Part B starting the first day of the month you turn 65.  If your birthday is on the first day of the month, your Part B will start the first day of the prior month.
• If you are under 65 and disabled, you will automatically get Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. You will get your Medicare card in the mail about 3 months before your 65th birthday or your 25th month of disability.
• If you do not 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 have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you automatically get Part B the month your disability benefits begin.

When Can You Sign Up for Part B?

If you didn’t sign up for Part B when you first became eligible, you may be able to sign up during one of these times:

• General Enrollment Period—Between January 1–March 31 each year. Your coverage will begin on July 1. You may have to pay a late enrollment penalty.
• Special Enrollment Period—If you wait to sign up for Part B because you or your spouse is currently working, and you are covered by a group health plan based on that work, or if you are disabled and you or a family member is working, and you are covered by a group health plan based on that work. You can sign up for Part B anytime while you have group health plan coverage based on current employment or during the 8-month period that begins the month after the employment ends, or the group health plan coverage ends, whichever happens first. If you have COBRA coverage, you must enroll during the 8-month period that begins the month after the employment ends. This Special Enrollment Period doesn’t apply to people with End-Stage Renal Disease (ESRD).
• Special Enrollment Period for International Volunteers—If you waited to sign up for Part B because you had health insurance while volunteering outside of the U.S. for a tax exempt organization  for at least a year. You can sign up during the 6-month period that begins the first month that any one of the following happens:
  • You are no longer volunteering outside the U.S.
  • The sponsoring organization is no longer tax exempt.
  • You no longer have health insurance coverage outside the U.S.

If you have Medicare because of End-Stage Renal Disease (ESRD), you can sign up for Part B when you sign up for Part A.  If you delay signing up for Part B, you can only get it during the general enrollment period, and you may have to pay a late enrollment penalty.

If you live in Puerto Rico, and you want Part B, you will need to sign up for it.  Contact your local Social Security office for more information.

If you aren’t getting Social Security or RRB benefits, and you want to get Part B, you will need to sign up for Part B during your initial enrollment period (the 7-month period that begins 3 months before the month you turn age 65, includes the month you turn age 65, and ends 3 months after the month you turn age 65).

Important Note:

If you do not sign up for Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare.  Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it.  Usually, you don’t pay a late enrollment penalty if you sign up for Part B during a special enrollment period.

Learn More About Medicare

You can learn more about the Original Medicare Plan and the Medicare program by reading Medicare & You, the official government handbook about Medicare.  You will need the free Adobe® Reader® software to download the files.

Download Medicare & You