Happy senior wondering if he is automatically enrolled in Medicare

Am I Automatically Enrolled In Medicare?

As you approach Medicare, it’s normal to have many questions. One of the most common is “Am I automatically enrolled in Medicare?” You know Medicare will be good coverage for you, you just want to make sure you get it on time. So, will you be enrolled automatically? The short answer is “maybe.” Let’s review some of the basics of eligibility and enrollment, and then dive into a few of the details.

When Am I Automatically Enrolled In Medicare?

There are a few situations where you’ll be automatically enrolled in Medicare. We’ll review each of these in detail as we go:

  • You’re receiving retirement benefits from either Social Security or the Railroad Retirement Board when you turn 65
  • You’ve received Social Security or Railroad Retirement Board disability income for 24 consecutive months
  • You’re receiving Social Security disability income due to Amyotrophic Lateral Sclerosis (ALS, or Lou Gehrig’s disease)

In all of these cases, you’re already receiving benefits from Social Security or the Railroad Retirement Board. If that’s the case for you, then your enrollment in Medicare will be automatic.

Receiving Social Security Retirement When You Turn 65

Your enrollment in Medicare will be automatic if you’re taking Social Security before you turn 65. For example, if you take Social Security early, say at age 62, you will get Medicare at 65 without having to sign up. When you get Medicare because you turn 65, it’s called “aging in” and this is how most people get Medicare.
You don’t have to be 62 for this to be the case; you just have to be taking Social Security payments before your 65th birthday. Of course, timing can matter here. If you sign up for Social Security just one month before you turn 65, you might not be automatically enrolled in Medicare right at 65. But, as long as your Social Security benefits begin a month or two before you turn 65, you’ll automatically receive Medicare at 65.

Disability Payments For 24 Consecutive Months

If you become eligible for Medicare before age 65 because you’re receiving disability income from Social Security or the Railroad Retirement Board, you’ll enter Medicare automatically, too. In this case, you will become eligible for Medicare when you’ve received these disability payments for 24 consecutive months. You will enter Medicare automatically on the first day of the 25th month you’re on disability.

Disability Payments Due to ALS

The last way to automatically enroll in Medicare is when you’re receiving disability income from Social Security due to ALS. In this case, age is not a factor, so the diagnosis of ALS can allow you to get Medicare at a much younger age than 65.

Here’s the most important thing to keep in mind: when you’re diagnosed with ALS, you’ll need to sign up for Social Security disability. Your Medicare enrollment will be automatic-only if you’re receiving disability payments as a result of your diagnosis.

For ALS, you’ll be automatically enrolled in Medicare, Parts A, and B, the first month that you receive Social Security disability payments.

These are the times when your Medicare enrollment will be automatic. Now let’s review the situations where enrollment isn’t automatic, and you’ll have to actively apply.

Disability Due To ESRD

We’ll talk about disability due to End-Stage Renal Disease (ESRD) first. Even though this diagnosis can get you into Medicare before age 65, it’s not automatic. Instead, you’ll have to apply for your Medicare benefits. The general rule for ESRD is that you’re eligible for Medicare once you’ve been on dialysis for four months.
However, getting Medicare with this diagnosis can be more complicated than the general rule. We can’t cover all of the different possibilities, but you should know that you might be able to get Medicare earlier in either of these situations:

  • You complete a home dialysis course, and your doctor believes that you’ll be able to do your own dialysis treatments, or
  • You’re receiving a kidney transplant

Your Medicare coverage can also end up being retroactive if you don’t apply for benefits when you’re first eligible.

Aging Into Medicare

Another time that you won’t be automatically entered into Medicare is when you turn 65, but you’re not receiving Social Security benefits. You’ll have to manually apply for Medicare. You can do this during your Initial Election Period (IEP). Your IEP lasts for seven months and includes:

  • 3 months before the month you turn 65
  • The month you turn 65
  • 3 months after the month you turn 65

You can sign up for Part A and B at any time during this seven-month period. Your coverage will be effective on the first day of the month you turn 65 if you enroll before your 65th birth month.

If you enroll in the month of your birthday, or the three months after, your coverage will be delayed. For example, if you turn 65 in June and you sign up in September, your coverage will be effective December 1st. This may not matter if you will be covered by an employer plan, but if you’re expecting to retire or lose your group coverage, make sure to enroll in Medicare before your 65th birthday to ensure your coverage starts when you turn 65.

When Can I Enroll If I Work Past Age 65?

If you delay taking Part B at age 65 because you’re still covered by your employer or spouse’s employer plan, you’ll be able to use a Special Enrollment Period (SEP) to get Medicare when your coverage ends. This SEP lasts for eight months, and you can sign up for Medicare at any point during this window.

Senior couple asking are automatically enrolled in medicare
Are enrolled in Medicare?

How Do I Sign Up For Part B If I’m Not Automatically Enrolled?

When your enrollment isn’t automatic, you’ll need to sign up manually. How you do this varies a little bit based on whether or not you already have Part A. You may have signed up for Part A at age 65, even if you still had employer coverage. Part A is usually “premium-free” which means you don’t pay a premium for the coverage. Instead, you’ve paid in to Part A through payroll taxes all of your working life. Since this makes Part A “free,” many people sign up for Part A at age 65, even if they keep their employer coverage.

If this is you, then signing up for Part B will be very easy. You can complete CMS Form 40B, and submit it in one of several ways:

  • Fax
  • Online
  • Mail it to your Social Security Office

You’ll be asked to provide proof that you’ve been covered by an employer group plan.

If you didn’t sign up for Part A when you turned 65, your process will be a little different. To sign up for both Part A and B, do one of the following:

  • Call the Social Security Administration (1-800-772-1213)
  • Apply online at ssa.gov
  • Apply in-person at your local Social Security office

How Does My Medicare Enrollment Affect Medicare Supplement Or Medicare Advantage Coverage?

Regardless of how you enroll in Medicare, whether automatically, manually, or after delaying your Part B benefits, you’ll have the chance to choose a private Medicare Insurance plan. Since you must have Part B coverage in order to enroll in either Medicare Supplement or Medicare Advantage, your Part B enrollment will be the trigger that allows you to sign up for a private plan. Once you have your Part B start date, you can enroll in the private plan of your choice.

Prepare Now For Enrolling In Medicare

We started out asking the question, “Am I automatically enrolled in Medicare?” The answer is a firm “Maybe!” Either way, planning is important. If you’re going to automatically enroll in Medicare or delay taking Part B, now is the time to get ready. If you’d like to chat with a professional about your Medicare benefits and your options for coverage, schedule a free consultation now, or call.

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