Health Insurance

If you already get Social Security benefits, you do not need to sign up for Medicare. The Social Security Administration will automatically enroll you in Original Medicare (Part A and Part B) when you become eligible. The Social Security Administration will mail you the information a few months before you become eligible.

Because you must pay a premium for Part B coverage, you can turn it down. However, if you decide to sign up for Part B later, your coverage can be delayed and you may have to pay a late enrollment penalty for as long as you have Part B coverage. Residents of Puerto Rico or foreign countries will NOT automatically receive Part B. They must elect this benefit.

If you do not get Social Security benefits and are not ready to apply for them yet, you should sign up for Medicare three months before your 65th birthday. The easiest way to apply for Medicare is by using our online application or you can make an appointment by calling  1-800-772-1213 (TTY 1-800-325-0778), 8:00 a.m. – 7:00 p.m., Monday through Friday.

If you have Medicare Part A, but you did not enroll in Medicare Part B during your Initial Enrollment Period (IEP), you may sign up during the General Enrollment Period (GEP), or you may qualify for a Special Enrollment Period (SEP).

The annual GEP runs from January 1 to March 31, with coverage starting the month after you enroll. You may have to pay a late enrollment penalty for not signing up when you were first eligible.

Those with group health plan coverage through an employer or spouse may qualify for an SEP.  If you qualify for an SEP, you can apply online at Apply for Medicare Part B Online during a Special Enrollment Period.

You can also fax or mail your completed Application for Enrollment in Medicare – Part B (CMS-40B) and the Request for Employment Information (CMS-L564) enrollment forms and evidence of employment to your local Social Security office. If you have questions, please contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Note: When completing the forms CMS-40B and CMS-L564:

• State “I want Part B coverage to begin (MM/YY)” in the remarks section of the CMS-40B form or online application.
• If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employer’s signature.
• Also submit one of the following forms of secondary evidence:
  • Income tax returns that show health insurance premiums paid.
  • W-2s reflecting pre-tax medical contributions.
  • Pay stubs that reflect health insurance premium deductions.
  • Health insurance cards with a policy effective date.
  • Explanations of benefits paid by the GHP or LGHP.
  • Statements or receipts that reflect payment of health insurance premiums.

In most cases, if you do not sign up for Medicare when you are first eligible, you may have to pay a higher monthly premium.

More information on Medicare late enrollment penalties:

• Part A Late Enrollment Penalty (Medicare.gov)
• Part B Late Enrollment Penalty (Medicare.gov)
• Part D Late Enrollment Penalty (Medicare.gov)

• Signing up for Medicare Part B may provide you with additional service and location options.
• If you do not sign up for Part B when you are first eligible:
  • You may have to wait to sign up, which will delay your coverage, and;
  • you may also have to pay a late enrollment penalty for as long as you have Medicare Part B.
• For Social Security Questions- most of the questions were copied for the social security maven site so please rephrase where you can

Timing your first benefit payment

You can time your first benefit payment to avoid a gap in income. Your first check will not arrive until the month after the one you pick in your application. You can apply any time up to four months before the month you pick.

For example, you want your first check in April. Follow this timing:

• Apply in November, December, January, February, or March
• Pick March in the application
• Get the first check in April