While most people receiving social security benefits are automatically enrolled in parts A and B of Medicare as soon as they become eligible, many others like myself still need to apply to enjoy the Medicare benefits. Here, I’ve written the 3 fastest steps to apply for Medicare online.
What is Medicare, and Who is Eligible?
Medicare is a federal program created to provide health care coverage for older adults and certain disabled people who qualify. It is divided into four major parts, labeled A to D – health insurance, medical insurance, Medicare Advantage plans, and prescription drug coverage, respectively.
Those benefiting from Medicare also have the option of enrolling in a Medicare Supplement plan known as Medigap to make up for any areas lacking in Part A and B.
You qualify for Medicare if you’re 65 years or older and a citizen of the U.S. plus either of the following:
- You’re receiving benefits from Social Security or railroad retirement, or are qualified for those but aren’t yet receiving them.
- You or your spouse is employed in or retired from the government and has not paid Social Security taxes, but has paid Medicare taxes while working.
You can also be eligible for receiving Medicare if you under age 65 as long as you’re qualified to receive disability benefits and have been for at least 24 months, or:
- You’re a beneficiary of disability pension from the Railroad Retirement Board, or
- You have Lou Gehrig’s disease, or
- You’re ill from irreversible kidney failure that needs dialysis or a kidney transplant, and you have paid Social Security taxes for an approved period.
You can also get Medicare if you do not qualify for it through your work record or that of your spouse, by buying into it at age 65 or older.
As soon as you become eligible, you may decide to get your health insurance from Original Medicare or a Medicare Advantage plan. The Original Medicare plan comprises of Part A and Part B and is the classic fee-for-service program the federal government offers to its citizens.
The Medical Advantage plan comprises Part C and offers extra coverage options that include vision, dental, and wellness care. Part C Medicare requires you to have both Part A and B before signing up.
To be sure of your eligibility, you can use this handy Medicare tool before beginning the application process I’ve outlined below.
Step 1: Where and When to Start Your Journey to Medicare
If you’re actively receiving Social Security benefits, you’ll be automatically enrolled in the Original Medicare plan once the month you turn sixty-five begins. But if you don’t qualify for automatic Medicare enrolment, you must apply to enjoy the Medicare benefits.
You may have to enroll for Medicare yourself if you:
- don’t receive benefits from Social Security,
- want Medicare immediately you’re eligible for it even if you’ve chosen to delay your Social Security benefits,
- were automatically signed up for only Part A, or
- decided to delay your Part B enrolment despite your eligibility.
Whichever the case may be, knowing the best time to apply for Medicare is very important in acquiring it. There are several times to enroll in Medicare, and the rules surrounding application and coverage kick off differ according to the enrollment period. Below are the different enrolment periods:
- Initial Enrolment Period: This is the initial time you get to sign up for Medicare’s different parts. You can apply in the month of your 65th birthday, three months before your 65th birthday, or three months following your 65th birthday. If you apply during the initial enrolment period, your coverage will begin no sooner than your 65th birthday month.
For instance, if your birthday is in August, then the Initial Enrolment Period begins May 1 and ends November 31. If you happen to miss this enrolment period, you still get another chance to enroll, but the delay could result in late penalties and a period without health coverage.
- Special Enrolment Period: Special Enrolment Periods may apply if you delay your enrolment, but only under certain circumstances. You get a Special Enrolment Period to apply for Part A and Part B of Medicare
- If a health plan still covers you through your employer or union, or your spouse’s employer, or
- Eight months after the end of your health insurance from a union or an employer.
For Part C and Part D, you get the Special Enrolment Period during 63 days after health coverage from an employer or union ends if you’re already signed up for Parts A and B.
- General Enrolment Period: You may miss both the Initial and Special enrolment periods. If you do, you could still enroll for Parts A and B during the General Enrolment Period, which usually happens between January and March every year. Coverage would then start at the beginning of July of the same year.
- Open Enrolment Period: This enrolment period, sometimes called the Annual Election Period of the Annual Coordinated Enrolment Period, runs from October 15 to December 7 every year. During this period,
- You can change to a Part C plan if you already have Parts A and B.
- You can switch back to Parts A and B if you have a Part C plan.
- You can join, stop, or change a Part D plan if you have enrolled or are in the process of enrolling for Parts A and B.
- You can change to a new Part C plan even if you already have part C.
If you apply during the Open Enrolment Period, you will start receiving your health coverage on January 1 of the next year.
Step 2: Understanding Medicare A and B
Medicare covers everything from hospital care to doctor visits to prescription drugs, and so the program is divided into four parts for the different kinds of health coverage. Medicare A and B are the basic plans and most important. Here’s what the two parts are all about:
- Part A: Part A is the most basic Medicare plan. Once your application is successful, you will automatically be signed up in Medicare A. This plan gives coverage for your stays in the hospital, home clinical care, and some skilled nursing care you may need after being hospitalized for an episode that requires rehabilitation, such as stroke or a broken hip.
For most people, you don’t have to pay anything for Part A Medicare as you have already made payments in the form of Medicare tax on your income. This doesn’t make this plan totally free, though, as you are charged a large deductible each time you get admitted to the hospital.
This deductible amount changes every year, but as of 2020, it’s $1,408. To cover this fee, you can pay a Supplemental Medigap plan. For those who haven’t work long enough to become eligible for Medicare, you can still acquire it by paying a Part A Premium.
- Part B: This part of Medicare covers outpatient services such as doctor visits, diagnostic screenings, medical equipment, and ambulance transportation. Part B is costlier than Part A, and so you may want to hold on applying for it if you already have health coverage through your job or spouse’s job.
However, if you don’t have any health insurance and delay your Part B enrollment, you’ll likely pay a higher premium throughout your time in the program. For 2020, the Medicare B premium amount is set at $144.60 monthly, and an annual deductible of $198.
You will have to cover twenty percent of the bills for every outpatient service you receive, while Medicare pays the rest. If you’re receiving Social Security benefits, the Medicare premium will be automatically subtracted from your monthly benefit.
Step 3: How to Submit an Application
Now that I’ve explained to you what Medicare is all about, including the eligibility requirements and enrolment periods, I’m going to let you know how you can submit an application and the necessary documents you need.
There are different ways you can submit a Medicare application – online, by phone, or in person. But I would personally recommend enrolling online because it’s the fastest and easiest way. To enroll online, you will need first to visit www.socialsecurity.gov and open an account if you don’t already have one.
I’d advise you to open a Social Security account before you’re ready to enroll in Medicare because most times, you’d be required to verify your identity, age, and citizenship with your original birth certificate, passport, and driver’s license. If you happen to have verification issues, it may take a while or a visit to the Social Security office to rectify it.
- Get ready: When you’re ready to begin your enrollment and have your My Social Security account all set up, you can then fill in your online application on the Social Security website here. There you will find the necessary information you’ll need to provide during the enrollment process.
Apart from the basic information about your age, place of birth, citizenship, marriage, and children, you may need to provide some extra information about your Social Security card, health insurance coverage, coverage, and Military history along with supporting documents.
Note that all documents you submit must be original. It’s always best to start gathering these documents before you’re ready to begin your application, in case you need to get new copies of any one of them.
- Apply and complete: The actual online application takes anywhere between 10 and 30 minutes, depending on your situation. You can save your application step by step and take little breaks as you complete it.
- Follow-up: Once you have completed and submitted your application, you may get a call from a representative to update you about your application or ask any extra questions. You can keep up with your application on your My Social Security account.
Applying for Medicare is a pretty straightforward process. Most of the complications lie in preparation and timing. Once you become eligible, don’t hesitate to begin your application to avoid getting penalized. This article should help you understand the different enrolment periods to help you decide on the best time for you.
Medicare A and B make up the Original Medicare plan and is what you can get when you first enroll. The other Medicare plans require you first to have the Original Medicare plans.
Before enrolling for Medicare, ensure you create your My Social Security account and gather all necessary information to help your application go faster.