ENROLLING IN A MEDICARE PLAN

How Do I Enroll in Medicare?

If you already get benefits from the Social Security Administration (SSA) or the Railroad Retirement Board, you do not need to do anything to enroll.

  • You are automatically entitled to Part A and Part B starting the first day of the month that you turn 65.
  • Your Medicare card will be mailed to you about 3 months before your 65th birthday. If you wait until you are 65, or sign up during the last three months of your initial enrollment period, your Medicare Part B start date will be delayed.

If you are not receiving Social Security, Railroad or disability benefits you will need to submit an application to the SSA. Visit your local Social Security office or call the SSA at 1-800-772-1213 to sign up. The SSA can answer any questions about your application.

When Can I Enroll in Medicare?

Initial Enrollment Period (IEP): When you first become eligible for Medicare
The IEP is a seven month period to enroll without penalty when you first become eligible for Medicare. You can enroll up to 3 months before your 65th birthday but no later than 3 months after the month of your birthday.

General Enrollment Period (GEP): If you refused Medicare during your IEP
The GEP is January 1- March 31 of every year. If you do not enroll during the initial enrollment period, but choose to enroll later during the GEP, you may face a penalty for each year that you were unenrolled. You pay this penalty for as long as you are covered by Medicare. You can also make an adjustment to your Medicare plan during the GEP after you enroll.

Special Enrollment Period (SEP): Any time while you have a separate group plan or shortly after you lose your coverage
The SEP is a period to enroll without penalty if you initially refused Medicare because you were covered by other insurance when you first became eligible. The SEP extends to any time while you have group coverage, 8 months after you lose your coverage or when you (or your spouse) stop working.

When Can I Make Adjustments to my Current Plan?

You can make adjustments to your current plan or change plans without incurring a penalty during the Fall Open Enrollment Period (also known as the Annual Coordinated Election Period, or ACEP). Fall Open Enrollment is October 15 - December 7 of every year. Enrollments and changes made during this period will become effective January 1.

You can also make an adjustment to your Medicare plan during the GEP after you enroll.

How Do I Know What Plan to Choose?

As with any insurance plan, you will want to do your research ahead of time and compare plans.

Contact us with insurance questions, success stories, suggestions, or requests to volunteer.


HELPFUL MEDICARE RESOURCES

Medicare.gov is the official U.S. Government site for people with Medicare.

Medicare & You 2015 is the official Medicare handbook.

Social Security Administration houses the Medicare application and can help you through the application process.

State Health Insurance Assistance Programs are state programs that offer one-on-one counseling and assistance to people with Medicare and their families.

Medicare Rights Center works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.

Caring Voice Coalition has programs to help patients with insurance reimbursement, financial assistance, patient support services, public advocacy and some legal assistance.

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The information provided on the PHA website is provided for general information only. It is not intended as legal, medical or other professional advice, and should not be relied upon as a substitute for consultations with qualified professionals who are familiar with your individual needs.

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The National Organization for Rare Disorders (NORD) awarded PHA the Abbey S. Meyers Leadership Award in 2012 for outstanding service to PHA members in advocacy, education and other key areas.