People who should enroll in Medicare when turning 65

If you’re turning 65 and have any of the scenarios below, you will need to enroll in Medicare to avoid a possible Late Enrollment Penalty in the future. Your enrollment will either occur automatically if you’re receiving Social Security benefits, or you will need to “enroll manually” with Social Security at ssa.gov/medicare/sign-up, or call (800) 772-1213, or contact your local Social Security office.

* Retiree plan

* Cobra insurance

* ACA plan (Affordable Care Act)

* Group insurance plan (Company has 19 or less employees)

* Tri-Care

* Unemployed/retired with no individual health insurance and not yet collecting social security retirement benefits.

Unfortunately, none of the above are considered “creditable coverage” by Medicare, therefore requiring you to enroll in Medicare when turning 65 – during your Initial Enrollment Period (IEP) to avoid a Medicare Late Enrollment Penalty.

* NOTE: If you have group health insurance from an employer with 20 or more employees, (or you are on your spouses group insurance of 20 or more employees) you most likely can “delay” your Medicare Part B enrollment.

** IMPORTANT ** If you work past 65 and contribute to an HSA (Health Savings Account), you can NOT be enrolled in Part A or Part B.

If you’re already drawing Social Security retirement income when turning 65, you will automatically be enrolled in Medicare. Medicare will send your Red, White and Blue card

approximately 100 days prior to your 65th birthday. Your Part A and Part B effective dates will be the 1st day of your 65th birth month. If your birthday falls on the 1st, your effective date will be the first of the previous month). (Example, if your Birthday is July 1st, your effective date will be June 1st.) Medicare will start deducting your Part B monthly premium. In 2023, the Standard Part B premium for most people is $164.90 per month. People with higher incomes will pay more for their Part B premium. Click here for more information on Income Related Monthly Adjustment Amount (IRMAA)

If you are NOT drawing Social Security yet, you will have to manually enroll in Medicare. Go to SSA.gov or call Social Security at
(800) 772-1213. Social Security Administration will send you a quarterly bill for the Part B premium.

Below are the three enrollment periods to manually enroll in Medicare if you don’t automatically get enrolled when turning 65.

1. IEP Initial Enrollment Period (7 month window around your 65th birth month)

2. SEP Special Enrollment Period (This is after you delayed your Part B because you had creditable coverage from your or your spouses employer group insurance)

3. GEP General Enrollment Period (This is if you missed your IEP and don’t have an SEP. Penalties may come with this late enrollment).

(For more information, see Enrollment periods)