Apply for Medicare: Tips and Tricks

Are you ready to apply for Medicare? Did that question make you groan? It might sound like a complicated task, but applying for Medicare isn’t as hard as it seems. We won’t sugarcoat things, Medicare is complicated - it’s almost like learning a whole new language. You need to learn the differences between plans, eligibility requirements, enrollment timelines, and more.

But applying for Medicare? It’s actually not too difficult. Today, we’re going to help you understand how to enroll in Medicare by reviewing a few common scenarios and then give you a detailed how-to guide to make your Medicare enrollment a breeze.

When to Apply for Medicare

Knowing when to apply for Medicare is the first thing we need to tackle. Most people “age into” Medicare when they turn 65. However, turning 65 doesn’t mean you have to enroll. Many people worry that if they don’t enroll right away, they’ll be penalized. This is true, but it depends on your situation.

We have many clients that choose to work past the age of 65. If you are one of those people (or you have a spouse in that category), you may be able to delay your Medicare enrollment without paying any pesky penalties. It all boils down to whether or not you have creditable coverage.

Creditable coverage means the insurance has at least as much coverage as Original Medicare (Parts A and B). Employers with 20 or more employees always have creditable coverage, but some smaller groups can too. Regardless of your employer size, you should check with the insurance carrier or your HR manager to find out if your plan is creditable.

Now that we’ve got that definition out of the way, let’s look at a couple of different scenarios.

You Have Creditable Coverage

If you have creditable coverage - whether through your employer or through a spouse’s employer - you may choose to delay Medicare as long as you’d like. You will not be penalized, and you’ll be eligible to enroll in Medicare when you (or your spouse) decide to terminate the group health plan.

However, don’t dismiss Medicare too quickly. Even if you have creditable coverage, you may want to consider enrolling in Medicare anyways.

Many people still choose to enroll in Part A since most beneficiaries receive premium-free Part A. As long as you worked and paid taxes for ten years, you won’t pay a premium for Part A. Many people choose to enroll and enjoy the extra coverage in case they need it. The only time we recommend people not enroll in Part A is if they have an HSA, a Health Savings Account. You can use an HSA while you’re enrolled in Medicare, but you cannot actively contribute to the account once you have Medicare. 

You should also compare premiums and coverage of your group health plan versus Medicare. If your employer doesn’t pay for the plan or if the coverage is not good, Medicare may be the better option. At the very least, you should ask your Medicare advisor to compare your employer’s plan with what you could get on Medicare. It may make more sense to enroll in Medicare, even though you don’t have to.

You Don’t Have Creditable Coverage

This scenario is less complicated. If you turn 65 and don’t have creditable coverage, you must enroll in Medicare immediately. If you don’t, you’ll pay penalties and may even have a gap in coverage.

The worst part is that you can have a penalty for not enrolling in both Part B and Part D. Those penalties are applied to your premium every month, and they stick with you for the rest of your life. They may not seem like much initially, but they will quickly add up over time.

How to Apply for Medicare

You are first eligible to enroll in Medicare during your Initial Enrollment Period (IEP), which is a 7-month window around your 65th birthday. You can enroll in Original Medicare and any supplemental coverage you’d like during this time. This could be a Medigap plan, Part D plan, Medicare Advantage plan, or combination.

Apply Online

If you are computer-savvy, we’d highly recommend you apply for Medicare online. This is by far the quickest and easiest way to apply, and your application will be processed quickly.

To apply for Medicare online, you’ll need a “my Social Security” account. Once you’ve created an account, the site will take you through the rest of the enrollment process. It should only take ten minutes to apply. Plus, if you want to begin taking Social Security benefits, you can submit that application at the same time.

The main hiccup some clients have when they try to enroll in Medicare online is when their information doesn’t match what Social Security has on file. In this case, you’ll have to call the Social Security Administration and get the information corrected.

Apply by Phone

Applying for Medicare over the phone is just as easy as applying online. Contact the Social Security office at 1-800-772-1213 (TTY 1-800-325-0778). Individuals who have Railroad Retirement Board should call 1-877-772-5772 instead.

You might be able to get a representative that day. However, if they are experiencing a high call volume, they’ll schedule a phone appointment for you within a few weeks.

The process is fairly straightforward. It takes longer than applying online because the representative has to mail forms to sign. After you complete the forms, you’ll need to mail them back to the office. If you’re on a tight timeline, this could delay your enrollment. You should only use this method if you have at least a month or two before you need your Medicare to be effective.

Apply in Person

If you’d prefer to apply for Medicare in person, you can find a local Social Security office and make an appointment. At the end of your appointment, the representative will give you a confirmation of your enrollment, which has the information you need to begin applying for other Medicare plans.

As you wait for your Medicare ID card to arrive, you can begin looking at other Medicare plans. An expert at Local Medicare Specialists can teach you about Medicare Advantage plans, Medigap plans, and Part D plans. We’ll help you compare your options and then help you enroll in the one that works best for you.