Original Medicare is an important health insurance benefit provided by the federal government, one that millions of Americans count on. Understanding how it works can help you make better plans for your retirement and golden years. Given the cost of individual health insurance, as well as the rising cost of employer coverage, it’s critical to understand when Medicare coverage will begin. If you’ve ever wondered, When does Medicare start? this easy guide will help you understand when your coverage will begin.
I’m Turning 65 – When Does Medicare Start For Me?
Most people enter Medicare because they turn 65. This is known as “aging in” to Medicare. Every day over 10,000 Americans turn 65, so the Medicare ranks are swelling. When you enter Medicare due to turning 65, you have a seven-month window during which you can enroll. This window is called your Initial Election Period (IEP). The seven months of this window include:
- The three months before the month you turn 65
- The month you turn 65
- The three months after the month you turn 65
You can enroll in Original Medicare, Parts A, and B, at any time during this window. In many cases, your enrollment will be automatic. This usually happens when you’re already receiving Social Security income in retirement. If you’re automatically enrolled, your coverage will begin on the first day of the month in which you turn 65.
If you’re not automatically enrolled, you’ll have to enroll manually. This is best done online through SSA.gov. When you enroll manually, your actual coverage start date depends on when you apply. If you apply before the month of your 65th birthday, your Part A and B coverage will begin on the first day of your 65th birth month.
If you apply during your 65th birth month, your coverage will begin on the first day of the month after you turn 65. If you apply after your 65th birth month, your effective date is delayed as follows:
- If you enroll the month after your 65th birthday, your coverage is effective two months after you sign up
- If you enroll the second or third month after your birth month, your coverage will be effective three months after the month in which you enroll
Note that if your coverage is delayed in this case, you are NOT subject to a late enrollment penalty. Your enrollment is still considered to be timely because you applied within your 7 months IEP.
When it comes to choosing private insurance to augment Original Medicare, you’ll find that you have just about the same amount of time. However, in order to enroll in private coverage like Medicare Supplement (Medigap), Medicare Advantage, or Medicare Drug Plans, you’ll need to have active Part A and B coverage.
Since this is the case, it’s much easier to plan ahead and get your private Medicare Insurance coverage in place in advance if you enroll during the three months before your 65th birthday. You may still have three months after your 65th birthday to enroll in these private plans, but you increase the risk of being without their protection from out-of-pocket costs if you wait that long.
- Since this is the case, it’s much easier to plan ahead and get your private Medicare Insurance coverage in place in advance if you enroll during the three months before your 65th birthday.
I’m On Disability – When Does Medicare Start For Me?
When you’re disabled, you may have the opportunity to enter Medicare before you turn 65 years old. In fact, you can become eligible for Medicare once you’ve received disability income from either Social Security or the Railroad Retirement Board for 24 consecutive months, regardless of your age. 24 months is the requirement for eligibility. You actually enter Medicare on the first day of the 25th month that you receive disability payments from the Government.
Just like when you enroll at age 65, you’ll also have an opportunity to add some private coverage when you gain eligibility due to disability. One difference, though, is that you probably won’t have the option to enroll in Medicare Supplement Insurance before you turn 65, even if you have Part A and B. Although there are some States that allow you to get this coverage, in most States your Medigap Open Enrollment Period won’t start until you are BOTH age 65 and active in Part B.
I Have ALS Or ESRD – When Does Medicare Start For Me?
It is also possible to enter Medicare before age 65 if you’re diagnosed with ALS (Lou Gehrig’s disease) or End-Stage Renal Disease (ESRD). The entry dates for these illnesses can vary depending on your exact circumstances, like whether you receive a kidney transplant, but in all cases, you must apply for Social Security Disability first. Your enrollment in Medicare will become automatic once you’re approved for disability.
I Delayed Taking Part B Because I Was Working – When Does Medicare Start For Me?
Of course, not everyone decides to take Medicare when they’re first eligible. Many people choose to continue working past age 65. This is especially true of people nearing Medicare age these days. Social Security Full Retirement Age (FRA) is now age 66 or 67. Many people don’t want to retire until they can get their full Social Security payment. If you have quality health insurance from your employer or spouse’s employer, you don’t need Part B at age 65. In fact, you can save money in this case since you won’t have to pay your Part B premium until you actually need it.
When this is the case, you’ll have a special opportunity to enroll in Medicare once your employer coverage ends after your retirement (or your spouse’s retirement). As long as your employer coverage met the minimum requirements, you’ll have an eight-month Special Enrollment Period (SEP) during which you can enroll in Medicare. You can enroll in Medicare Part B (and A if for some reason you haven’t enrolled in that yet) at any time during the eight-month window. Your Medicare coverage will be effective on the first day of the month after you enroll.
You will also have the ability to add private Medicare Insurance options during this eight-month window. For one thing, since you’ve delayed taking Part B past age 65, you’ll qualify for your Medigap Open Enrollment Period at this time. You’ll have six months from your Part B effective date to enroll in a Medigap plan if you’d like to. Alternatively, you can enroll in a Medicare Advantage plan during this time. Your Medigap, Medicare Advantage or Part D drug plan effective date will coincide with your Part B start date.
Entering Medicare is just the start of your Medicare journey. You’ll want to make sure you understand all of your options for private coverage so that you limit your out-of-pocket costs. Part of this process may involve researching Medicare plan provider networks and prescription drug coverage. Working with an independent, licensed insurance agent can help make this work easier. An independent agent can help you compare quotes from many different carriers and choose the plan that fits your unique needs. To schedule a free, no-obligation consultation with an independent agent, reach out to us today.