Eligibility and Enrollment Periods

Who is Eligible:

To be eligible for Medicare, you must be a United States citizen or lawfully present in the United States.  You must also:

  • Be Age 65 of over, OR
  • Be under 65 with certain disabilities, OR
  • Have End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease).

When you can enroll in Medicare

Most individuals typically enroll in both Part A (Hospital Insurance) and Part B (Medical Insurance) during their initial eligibility period, which usually occurs around the age of 65. Delaying enrollment can come with potential drawbacks, such as experiencing a lapse in coverage or being subject to a penalty. It’s a good idea to learn about all enrollment windows so you can act when the time is best for you.  Nevertheless, there are instances where postponing enrollment could be a reasonable decision.

 

 

 

Initial Enrollment Period (IEP) – when you turn 65.

  • General Enrollment Period (GEP) – January 1 to March 31
  • Annual Enrollment Period (AEP) – October 15-December 7 every year
  • Special Enrollment Period (SEP) – after specific circumstances
  • If you or your spouse work past age 65

How to Enroll in Medicare

Most people are automatically enrolled in Original Medicare (Part A and Part B) once they’re eligible.  But not every is.

You’ll be automatically enrolled in Original Medicare if:

  • You’re receiving Social Security benefits or Railroad Retirement board benefits when you turn 65, OR
  • You’re eligible for Medicare because of a disability or qualifying condition.

 You must enroll yourself in Original Medicare if you’re not receiving Social Security when you become eligible for Medicare.  There are three ways you can enroll yourself in Original Medicare:

  1. Enroll Online through the Social Security Administration
  2. Call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778), Monday – Friday 8AM – 7PM
  3. Enroll in Person

When Should I Enroll? 

There is a seven-month period when you can first enroll in Medicare. It’s called the Initial Enrollment Period (IEP) and it happens three months before the month you turn age 65, the month of your 65th birthday and the three months after. If your birthday is on the 1st of the month, your coverage can begin on the first day of the previous month.

If you are disabled and under age 65, there is a seven-month period surrounding the 25th month you begin receiving Social Security Disability payments. Enrollment time frames are different for people who become eligible because of end-stage renal disease or Lou Gehrig’s Disease (ALS).

Continue to learn more and visit the Parts of Medicare page.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ready to Chat? Let's Connect
LET'S GET STARTED