Soon after seniors blow out the candles on their 64th birthday cake, it is time to start thinking about Medicare, a United States health insurance program designed for people who are 65 years or older. Individuals with certain disabilities or end-stage renal disease (permanent kidney failure that necessitates dialysis or a kidney transplant) may apply for Medicare at any age.
How Medicare is managed
The Centers for Medicare & Medicaid Services (CMS) manages the national Medicare program. Governing the enrollment process is a joint effort between CMS and the Social Security Administration (SSA). When you apply for Medicare benefits, the SSA is the entity that processes your application.
The “Your Social Security Statement,” which is a personalized report the SSA updates annually for U.S. workers, informs individuals if they have enough credits to qualify for Medicare when turning 65. These credits reflect income earned with the potential to accrue four credits per year. To check the earnings that were taken into account, review your earnings record each time a new statement is issued. This appears on the statement under the column entitled “Your Taxed Medicare Earnings.”
Medicare eligibility and enrollment
Even when you earn enough credits to qualify for Medicare benefits, automatic enrollment only applies if you:
- Are already a recipient of benefits from Social Security or the Railroad Retirement Board for 24 months.
- Are younger than 65 and have certain permanent disabilities.
- Have ALS (amyotrophic lateral sclerosis), which is commonly referred to as Lou Gehrig’s disease.
If you do not fall into one of the above scenarios, an application is required. To avoid the risk of a late enrollment penalty being imposed, you may want to sign up even if you are still working and have health insurance through an employer or union. In that case, you would reach out to the benefits administrator of your company or union to learn how the current coverage will work with Medicare.
Applying for Medicare as you approach age 65
Applying for Medicare is as easy as calling your local Social Security office or visiting ssa.gov/benefits/medicare to enroll online. The initial enrollment period is the seven-month window of time surrounding your 65th birthday. The timeline starts three months prior to the month you become 65, includes the birthday month and terminates three months following the birthday month. For example, if your birthday falls in November, the initial enrollment period would be August through February.
With the exception of individuals who turn 65 on the first of the month, the effective date of coverage would be the first date of your birthday month, which is November 1 in this example, assuming you sign up during the first three months of the initial enrollment period. Using the same illustration, if your birthday is November 1, coverage would begin the first day of the prior month, i.e. October 1.
To learn more about how Medicare works when you turn 65, browse medicare.gov, cms.gov and ssa.gov. These official government websites offer factual information on Medicare benefits and provide links to resources.