When you first get Medicare
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 for Medicare 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
- Ends 3 months after the month you turn 65
If you aren’t automatically enrolled, you can sign up for free Part A (if you’re eligible) any time during or after your Initial Enrollment Period starts. Your coverage start date will depend on when you sign up. If you have to buy Part A and/or Part B, you can only sign up during a valid enrollment period.
If you wait until the month you turn 65 (or the 3 months after you turn 65) to enroll, your Part B coverage will be delayed. This could cause a gap in your coverage.
In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You'll have to pay this penalty for as long as you have Part B and could have a gap in your health coverage.
Between January 1–March 31 each year
You can sign up for Part A and/or Part B during the General Enrollment Period between January 1–March 31 each year if both of these apply:
- You didn't sign up when you were first eligible.
- You aren’t eligible for a Special Enrollment Period (see below).
You must pay premiums for Part A and/or Part B. Your coverage will start July 1. You may have to pay a higher premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B.
To sign up for Part B, complete an Application for Enrollment in Part B (CMS-40B). Get this form and instructions in Spanish. If you don't have Medicare or you want to sign up for Part A (some people have to pay a premium for Part A), contact Social Security.
Special circumstances (Special Enrollment Periods)
Once your Initial Enrollment Period ends, you may have the chance to sign up for Medicare during a Special Enrollment Period (SEP). If you're covered under a group health plan based on current employment, you have a SEP to sign up for Part A and/or Part B anytime as long as:
- You or your spouse (or family member if you're disabled) is working.
- You're covered by a group health plan through the employer or union based on that work.
You also have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):
- The month after the employment ends
- The month after group health plan insurance based on current employment ends
Usually, you don't pay a late enrollment penalty if you sign up during a SEP.
COBRA and retiree health plans aren't considered coverage based on current employment. You're not eligible for a Special Enrollment Period when that coverage ends. This Special Enrollment Period also doesn't apply to people who are eligible for Medicare based on having End-Stage Renal Disease (ESRD).
If you have a Health Savings Account (HSA) with a High Deductible Health Plan (HDHP) based on your or your spouse’s current employment, you may be eligible for an SEP. To avoid a tax penalty, you should stop contributing to your HSA at least 6 months before you apply for Medicare. You can withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses (like deductibles, premiums, coinsurance or copayments).
You may also qualify for a Special Enrollment Period for Part A and Part B if you're a volunteer, serving in a foreign country.