How Do I Apply for Medicare?

The national healthcare program subsidizes healthcare for people aged 65 years or older or younger people with disabilities or end-stage renal disease. People who have paid payroll taxes for at least ten years don’t pay Medicare Part A premiums. However, all patients pay premiums for Medicare Part B and Part D.

Furthermore, it’s essential to meet the Initial Enrollment period; otherwise, if you don’t qualify for the Special Enrollment Period, you will have to wait for the General Enrollment Period, which delays your coverage.

At The Modern Medicare Agency, we help make the process easier by explaining it all below:

How to Apply for Medicare Part A and Part B?

Anyone already receiving Social Security benefits enrolls in Medicare Part and Part B automatically when turning 65. Everyone else must enroll in Medicare Part A during the Initial Enrollment Period three months before and three months after the month they turn 65. It’s best to enroll for Medicare Part A even if still working, helping to keep out-of-pocket expenses for inpatient care to a minimum.

With Medicare Part B, beneficiaries pay a monthly premium. They can delay enrolling without penalties if they have health coverage at age 65 through an active employer, union, health insurance from a previous employer, or spousal coverage unless they lose creditable coverage before enrolling for Medicare Part B.

Initial Enrollment Period for Medicare

The initial enrollment period for enrolling in Medicare without facing a penalty starts three months before turning 65, giving you a seven-month window that includes the month you turn 65 and three months after.

What Happens if You Miss the Initial Enrollment Period?

Suppose you continue working after turning 65 and continue to have coverage from your current employer. Then you get a special enrollment period that lasts eight months after leaving your job, or your employer coverage ends. Whichever happens first. During this time, you can enroll in any of the Medicare parts without paying penalties.

People with Medicare can also take advantage of the special enrollment period that lasts two months if they meet the criteria of certain qualifying events.

However, suppose you missed your Initial Enrollment Period and don’t qualify for the Special Enrollment Period. Then, you can use the annual General Enrollment Period (GEP) between January 1 and March 31. Remember, when you used the GEP in previous years, your coverage began on July 1. As of 2023, the coverage takes effect the first of the month following enrollment. Additionally, you may pay a late enrollment penalty.

Where Can You Apply for Medicare?

There are several ways to apply for Medicare, and all applications pass through the Social Security Office in your area.

•       You can apply online by visiting SocialSecurity.gov
•       Call the SSA toll-free number at Call SSA at 800-772-1213 (or 800-325-0718 for TTY) between 8 am and 7 pm
•       Visit the local SSA office
•       You can also request information from your local SSA office by mail

Wherever you are applying from, you will need your Social Security card, birth certificate, I.D Card or driver’s license, proof of legal residency, or U.S. citizenship.

How Long Does Medicare Part A and Part B Enrollment Take?

Once submitting your Medicare  application, the services review the information for accuracy, so you must ensure that you give all the correct information with a contact number and address. These help Social Security to process your application quickly and to contact you if needed.

You will receive notification of the decision, and it takes just a few weeks to receive your Medicare Identification card. However, the earlier you submit your application, the better for you because waiting times can reach 90 days in some cases.

Medicare Primary Coverage

The primary coverage of Medicare Part A includes hospital stays and at-home care.

Medicare Part B primary coverage includes doctor visits, medical tests, X-rays, medical supplies, and long-term preventive care.

People who want more than part A and B cover, for example, dental, vision, and hearing examinations, should consider a Medicare Part C (Medicare Advantage Plan). Many include a Part D plan for prescription drug coverage. If you take regular medication, a Part D plan is vital.

Getting a Medicare Supplement Plan

You can get a Medicare Supplement (Medigap) plan from a private insurer anytime only if you have Medicare Part A and Part B. However, the best time to enroll for Medicare Supplement is during the Open Enrollment Period since there is no health underwriting, and you will face no denial for any pre-existing medical conditions.

Medicare Supplement Plans can help you fill in the coverage gaps of Original Medicare, like copayments, coinsurance, and deductibles. Therefore, a monthly premium paid to private insurance supplements your Medicare benefits.

Some Medigap policies will also cover you when traveling outside the U.S., with Medicare paying its share and the Supplement Plan paying its share. 

Remember that you cannot buy a Medigap policy if you already have Medicare Advantage Plan coverage, and these plans only cover one person. So if you and your spouse want coverage, you must each buy a different plan.

Medicare Supplement Plans don’t cover:

•       Long-term care like that in a nursing home
•       Vision services and eyeglasses
•       Dental services
•       Private-duty nursing

If you decide to try and enroll in a Medicare supplement after your initial enrollment period, many states allow medical underwriting, meaning you may be declined or charged a higher rate. Furthermore, if you have a pre-existing condition, you may be excluded for a while. 

Finally, as long as you pay your Medigap premium, its renewal is guaranteed, even if you have health problems.

Get Medicare Application Help

Our agents will guide you to understand all of your options, both Medicare supplement and Medicare Advantage, so you feel comfortable making the correct choice for you.