How to Enroll in Medicare

Step 1 — work out whether you need to act

If you're already receiving Social Security or Railroad Retirement benefits, you're enrolled in Parts A and B automatically and your card arrives about three months before your birthday month. You only need to decide on a plan.

If you're not yet drawing Social Security — increasingly common — nothing happens automatically and you must sign up yourself. If you're still working with employer coverage at a company with 20 or more employees, you may deliberately delay Part B; see Medicare.gov on working past 65.

Step 2 — sign up for Parts A and B

Three ways, all through Social Security rather than Medicare:

• Online at ssa.gov — quickest, roughly 10–20 minutes.
• By phone — 1-800-772-1213.
• In person at a Social Security office; appointments are advisable.

Have ready: your Social Security number, birth certificate or proof of citizenship or lawful presence, and — if you're delaying because of employer coverage — details of that plan and your employment dates. If you're enrolling after 65 using a Special Enrollment Period, you'll need forms CMS-40B and CMS-L564, the latter signed by your employer.

Step 3 — choose your path

This is the decision that matters most, and the one with a deadline that doesn't repeat.

Choosing Advantage first and Medigap later is possible but not guaranteed — after your 6-month window carriers can decline you. Understand that before you choose, not afterwards.

Step 4 — pick the specific plan

Whichever path, choose on the same four things, in this order:

1. Your doctors — are they in the network (Advantage), or does the provider accept Medicare (Original)?
2. Your prescriptions — is each drug on the formulary, at what tier, with what restrictions?
3. Your total annual cost — premium plus expected cost sharing, not the premium alone.
4. The out-of-pocket maximum — your worst case in a bad year.

You can browse every plan in your county on Medicare Plan Compare. We do not offer every plan available in your area. For a complete list of every plan in your county, use Medicare Plan Compare or call 1-800-MEDICARE.

Step 5 — enrol in the plan and confirm

Plan enrolment happens with the insurer or through a licensed agent, and it's free either way — agents are paid by the carriers, not by you. See Medicare.gov on joining a plan.

Confirm three things before you consider it done: you have a written confirmation or enrolment number, your effective date is what you expected, and your plan card arrives before that date. If anything is missing two weeks out, chase it.

The timeline that avoids every common mistake

Mistakes we see most often

• Assuming enrolment is automatic when Social Security hasn't been claimed.
• Treating COBRA or retiree coverage as active-employment coverage — it isn't, and the penalty is permanent.
• Contributing to an HSA too close to claiming Social Security, given Part A backdates up to six months.
• Skipping Part D because there are no prescriptions today, then paying 1% of the national base beneficiary premium for each month you went without creditable drug coverage for life.
• Choosing on premium alone and discovering the drug is on tier 4.

Not sure which of these fits you? A free 15-minute call with a licensed local advisor sorts it out — no pressure, and no cost to you. We do not offer every plan available in your area. For a complete list of every plan in your county, use Medicare Plan Compare or call 1-800-MEDICARE.

Enrolling if you are already past 65

Plenty of people reach us at 67 or 70, either because they worked past 65 or because they simply didn't realise. It's usually fixable.

• You had employer coverage from active employment — you have a Special Enrollment Period and no penalty. You'll need form CMS-L564 signed by the employer confirming the coverage dates, plus CMS-40B.
• You had retiree coverage or COBRA — these don't qualify. Expect the General Enrollment Period and a penalty, and enrol as soon as possible because the penalty grows with each full year.
• You have VA coverage only — VA doesn't create a Special Enrollment Period. Most veterans should enrol in Part B; see Medicare for veterans.
• You were told the wrong thing by an official source — equitable relief may be available. It's worth asking rather than accepting a lifetime penalty.

Whatever the situation, enrolling sooner costs less than enrolling later, because the penalty is calculated on full 12-month periods.

Getting your card and using it

Your red, white and blue Medicare card arrives by post once Parts A and B are active, showing your Medicare Beneficiary Identifier and the effective dates for each part. If you chose a Medicare Advantage plan you'll also get a plan card, and on Advantage you generally show the plan card at the doctor rather than the Medicare one. On Original Medicare with Medigap you show both the Medicare card and the supplement card, and a Part D card at the pharmacy.

Check three things the week it arrives: your name is spelled as Social Security has it, the effective dates match what you were told, and both Part A and Part B appear if you enrolled in both. Errors are far easier to correct before you need care than after a claim is denied.

If the card hasn't arrived two weeks before your start date, call Social Security rather than waiting. You can print a temporary card from your online account in the meantime, and providers can verify your eligibility electronically without the physical card.