Sign Up for Parts A & B

• Most People Get Parts A & B Automatically
• When Can You Sign Up for Parts A & B?
• When Will Your Coverage Start?
• When Can You Buy Medicare Supplement Insurance (Medigap)?
• Should You Get Part B?
• Costs for Part A
• Costs for Part B
• Ways to Pay Your Part A & B Premiums

Most People Get Parts A & B Automatically

Are you already getting benefits from Social Security or the Railroad Retirement Board (RRB)?	In most cases, you'll automatically get Part A and Part B starting the first day of the month you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.
Are you under 65 and disabled?	You automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months.
Do you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease)?	You automatically get Part A and Part B the month your disability benefits begin.
Do you live in Puerto Rico and get benefits from Social Security or the RRB?	You automatically get Part A. If you want Part B, you need to sign up for it.

If You Get Medicare Automatically

If you're automatically enrolled, you'll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.

You Might Need to Sign Up for Parts A & B

You need to sign up for Medicare Parts A and B if:

• You aren't getting Social Security or Railroad Retirement Board benefits (for instance, because you're still working)
• You qualify for Medicare because you have End-Stage Renal Disease (ESRD)

How to Sign Up for Medicare Parts A & B

• Apply online at Social Security
• Visit your local Social Security Office
• Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778)
• If you worked for a railroad, call the RRB at 1-877-772-5772

Don't Want Part B?

If you don't want Part B, follow the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums. Get help deciding whether you should keep Part B.

When Can You Sign Up for Parts A & B?

• When You're First Eligible
• Between January 1 - March 31 Each Year
• If You Qualify for a Special Enrollment Period
• If You're Volunteering Abroad

When You're First Eligible

When you're first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B.

For example, if you're eligible when you turn 65, you can sign up during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. Find out when you're eligible for Medicare.

Between January 1 - March 31 Each Year

If you didn't sign up for Part A and/or Part B when you were first eligible, you can sign up during the General Enrollment Period between January 1 - March 31 each year.

Your coverage will start July 1. You may have to pay a higher premium for late enrollment.

If You Qualify for a Special Enrollment Period

If you're covered under a group health plan based on current employment, you have a Special Enrollment Period to sign up for Part A and/or Part B any time as long as you or your spouse (or family member if you're disabled) is working, and you're covered by a group health plan through the employer or union based on that work.

You also have an 8-month Special Enrollment Period to sign up for Part A and/or Part B that starts the month after the employment ends or the group health plan insurance based on current employment ends, whichever happens first.

If You're Volunteering Abroad

You may also qualify for a Special Enrollment Period if you're a volunteer serving in a foreign country. Usually, you don't pay a late enrollment penalty if you sign up during a Special Enrollment Period.

When Will Your Coverage Start?

If you sign up for Part A and/or Part B during the first 3 months of your Initial Enrollment Period, your coverage starts the first day of your birthday month, unless your birthday is on the first day of the month.

If your birthday is on the first day of the month, your coverage starts the first day of the prior month.

When Will Your Medicare Coverage Start?
If you sign up for Part A/ B in this month:	Your coverage starts:
The month you turn 65	1 month after you sign up
1 month after you turn 65	2 months after you sign up
2 months after you turn 65	3 months after you sign up
3 months after you turn 65	3 months after you sign up
During the January 1-March 31 General Enrollment Period	July 1

When Can You Buy Medicare Supplement Insurance (Medigap)?

You can buy a Medicare Supplement Insurance (Medigap) policy, sold by private insurance companies, to help pay some of the health care costs Medicare doesn't cover. You have a 6-month Medigap open enrollment period to buy a Medigap policy.

Medigap Open Enrollment Period

This period starts the first month you're 65 and enrolled in Part B. During the Medigap Open Enrollment Period, you have a guaranteed right to buy any Medigap policy sold in your state regardless of your health status. Once this period starts, it can't be delayed or replaced.

Should You Get Part B?

• Do you have Employer or Union Coverage?
• Do you have TRICARE?
• Are you an active duty service member?

Do you have Employer or Union Coverage?

If you or your spouse (or family member if you're disabled) is still working and you have insurance through that employer (including the Federal Employee Health Benefits Program) or union, contact your employer or union benefits administrator to find out how your insurance works with Medicare. It may be to your advantage to delay Part B enrollment.

You can sign up for Part B any time you have current employer insurance. (COBRA and retiree insurance don't count as current employer insurance.)

When Employer/Union Coverage Ends

Once your employment ends, 3 things happen:

1. You have 8 months to sign up for Part B without a penalty. This period will run whether or not you choose COBRA. If you choose COBRA, don't wait until your COBRA ends to enroll in Part B. If you don't enroll in Part B during the 8 months, you may have to pay a penalty; you won't be able to enroll until the next General Enrollment Period; and you'll have to wait before your coverage begins.
2. You may be able to get COBRA coverage, which continues your health insurance through the employer's plan (in most cases for only 18 months) and probably at a higher cost to you.
3. If you already have COBRA coverage when you enroll in Medicare, your COBRA will probably end. If you become eligible for COBRA coverage after you're already enrolled in Medicare, you must be allowed to take the COBRA coverage. It will always be secondary to Medicare (unless you have ESRD).

Do you have TRICARE?

If you have Part A and TRICARE (insurance for active duty military or retirees and their families), you must have Part B to keep your TRICARE coverage.

Are you an active duty service member?

If you're an active duty service member, or the spouse or dependent child of an active duty service member, the following applies to you:

• You don't have to enroll in Part B to keep your TRICARE coverage while the service member is on active duty.
• Before the active-duty service member retires, you must enroll in Part B to keep TRICARE without a break in coverage.
• You can get Part B during a special enrollment period if you have Medicare because you're 65 or older, or you're disabled.
• You don't need to re-enroll in TRICARE each year. Your coverage will continue as long as you have Part B.

Costs for Part A

You usually don't pay a monthly premium for Part A coverage. This is sometimes called "premium-free Part A."

You can get premium-free Part A at 65 if:

• You already get retirement benefits from Social Security or the Railroad Retirement Board.
• You're eligible to get Social Security or Railroad benefits but haven't filed for them yet.
• You or your spouse had Medicare-covered government employment.

If you're under 65, you can get premium-free Part A if:

• You got Social Security or Railroad Retirement Board disability benefits for 24 months.
• You have End-Stage Renal Disease (ESRD) and meet certain requirements.

If you buy Part A, you'll pay up to $450 each month. Contact Social Security for more information about the Part A premium.

Who Can Buy Part A?

If you aren't eligible for premium-free Part A, you may be able to buy Part A if:

• You're 65 or older, and you have (or are enrolling in) Part B and meet the citizenship and residency requirements.
• You're under 65, disabled, and your premium-free Part A coverage ended because you returned to work. (If you're under 65 and disabled, you can continue to get premium-free Part A for up to 8 1/2 years after you return to work.)

In most cases, if you choose to buy Part A, you must also have Part B and pay monthly premiums for both.

Part A Late Enrollment Penalty

If you aren't eligible for premium-free Part A, and you don't buy it 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 Part A, but didn't sign up.

If you have limited income and resources, your state may help you pay for Part A and/or Part B.

Costs for Part B

Most people pay the Part B premium of $99.90 each month.

If your modified adjusted gross income as reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain amount, you may pay more.

Social Security will notify you if you have to pay more than the standard premium of $99.90 each month. The amount you pay can change each year depending on your income. If you have to pay a higher amount for your Part B premium and you disagree (for example, if your income goes down), use this form to contact Social Security.

Part B Late Enrollment Penalty

If you don't sign up for 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 Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it.

Usually, you don't pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period.

Medicare Part B Late Enrollment Penalty Calculator

Ways to Pay Your Part A & B Premiums

If you get Social Security, RRB, or Civil Service benefits, your Part B premium will get deducted from your benefit payment. If you don't get these benefit payments and you sign up for Part B, you'll get a bill.

If you buy Part A, you'll always get a bill for your premium. Mail your premium payments to:

Medicare Premium Collection Center
P.O. Box 790355
St. Louis, MO 63179-0355

If you get a bill from the RRB, mail your premium payments to:

RRB, Medicare Premium Payments
P.O. Box 9024
St. Louis, MO 63197-9024

If you have limited income and resources, your state may help you pay for Part A and/or Part B.

Related Links

• Medicare Eligibility Calculator
• "Understanding Medicare Enrollment Periods"
• "Medicare Premiums: Rules for Higher Income Beneficiaries"
• "Medicare and Other Health Benefits: Your Guide to Who Pays First"
• "Choosing a Medigap Policy"
• "Medicare Coverage of Kidney Dialysis and Kidney Transplant Services"