Medicare Eligibility

Enrolling in Medicare Part A

If you aren’t receiving Social Security or Railroad Retirement Board (RRB) benefits (for instance, because you’re still working), you must sign up for Medicare Part A even if you’re eligible to get it premium-free. You should contact Social Security three months before you turn age 65. If you worked for a railroad, contact the RRB to sign up.

You can sign up for Medicare Part A during the following times:

1. Initial Enrollment Period – When you’re first eligible for Medicare. This is a seven-month period that begins three months before the month you turn age 65, includes the month you turn age 65, and ends three months after the month you turn age 65.
2. General Enrollment Period – Between January 1-March 31 each year. Your coverage will begin July 1. You may have to pay a higher premium for late enrollment.
3. Special Enrollment Period – When you or your spouse (or family member if you’re disabled) is currently working, and you’re covered by a group health plan through the employer or union.
4. Special Enrollment Period for International Volunteers – When you’re serving as a volunteer in a foreign country.

If you aren’t eligible for premium-free Medicare Part A, you may be able to buy it. However, if you don’t buy Medicare Part A when you’re first eligible, your monthly premium may go up 10%. You’ll have to pay the higher premium for twice the number of years you could have had Medicare Part A, but didn’t join. For example, if you were eligible for Medicare Part A, but didn’t join for two years, you’ll have to pay the higher premium for four years. You don’t have to pay a penalty if you’re eligible for a special enrollment period.

Some People are Automatically Enrolled in Medicare Part A

If you receive benefits from Social Security or the RRB, you automatically get Medicare Part A starting the first day of the month you turn age 65. If you’re under age 65 and disabled, you automatically get Medicare Part A after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. You’ll get your Medicare card in the mail three months before your 65th birthday or your 25th month of disability.

For more information on Medicare Part A, call Social Security, or visit socialsecurity.gov. If you receive benefits from the RRB, call 1 877 772 5772.

If you have end-stage renal disease (ESRD), different rules apply. Visit your local Social Security office, or call Social Security at 1 800 772 1213 to sign up for Medicare Part A. For more information, visit medicare.gov/Publications/Pubs/pdf/10128.pdf to view the booklet, “Medicare Coverage of Kidney Dialysis and Kidney Transplant Services.”

Signing Up for Medicare Part B

If you didn’t sign up for Medicare Part B when you first became eligible, you may be able to sign up during one of these times:

1. General Enrollment Period – Between January 1–March 31 each year. Your coverage will begin on July 1. You may have to pay a late enrollment penalty.
2. Special Enrollment Period – If you wait to sign up for Medicare Part B because you or your spouse is currently working, and you’re covered by a group health plan based on that work, or if you’re disabled and you or a family member is working, and you’re covered by a group health plan based on that work, you can sign up for Medicare Part B anytime while you have group health plan coverage based on current employment or during the eight-month period that begins the month after the employment ends, or the group health plan coverage ends, whichever happens first. If you have COBRA coverage, you must enroll during the eight month period that begins the month after the employment ends. This special enrollment period doesn’t apply to people with ESRD.
3. Special Enrollment Period for International Volunteers – If you waited to sign up for Medicare Part B because you had health insurance while volunteering outside of the U.S. for a tax exempt organization for at least a year, you can sign up during the six-month period that begins the first month that any one of the following happens:
   • You’re no longer volunteering outside the U.S.
   • The sponsoring organization is no longer tax exempt
   • You no longer have health insurance coverage outside the U.S.

Some People are Automatically Enrolled in Medicare Part B

If you receive benefits from Social Security or the RRB, in most cases, you’ll automatically get Medicare Part B starting the first day of the month you turn age 65. If your birthday is on the first day of the month, your Medicare Part B will start the first day of the prior month. If you’re under age 65 and disabled, you’ll automatically get Medicare Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. You’ll get your Medicare card in the mail about 3 months before your 65th birthday or your 25th month of disability.

If you don’t want Medicare Part B, follow the instructions that come with the card, and send the card back. If you keep the card, you keep Medicare Part B and will pay Medicare Part B premiums. If you have amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease), you automatically get Medicare Part B the month your disability benefits begin.

If you have Medicare because of end-stage renal disease, you can sign up for Medicare Part B when you sign up for Medicare Part A. If you delay signing up for Medicare Part B, you can get it only during the general enrollment period, and you may have to pay a late enrollment penalty.

If you live in Puerto Rico, and you want Medicare Part B, you’ll need to sign up for it. Contact your local Social Security office for more information.

If you aren’t receiving Social Security or RRB benefits, and you want to get Medicare Part B, you’ll need to sign up for Medicare Part B during your initial enrollment period, which is the seven-month period that begins three months before the month you turn age 65, includes the month you turn age 65, and ends three months after the month you turn age 65.

If you don’t sign up for Medicare Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium for Medicare Part B may go up 10% for each full 12-month period that you could have had Medicare Part B, but didn’t sign up for it. Usually, you don’t pay a late enrollment penalty if you sign up for Medicare Part B during a special enrollment period.