Medicare Eligibility and Enrollment Guide

Barbara Davis

Generally, you qualify for Medicare if you are 65 years or older and a citizen or permanent legal resident Who Is Eligible for Medicare?

Most people become eligible for Medicare when they turn 65. In addition, individuals under 65 may qualify if they have a qualifying disability or medical condition. Eligibility rules differ based on your age, work history, and health status.

Automatic Enrollment

Some people are enrolled in Original Medicare automatically. You may be automatically enrolled in Medicare Part A and Part B if any of the following apply:

  • You are turning 65 and are already receiving Social Security or Railroad Retirement Board (RRB) benefits.
  • You are under 65, disabled, and have been receiving Social Security or RRB benefits for at least 24 months.

If you qualify, your red-white-and-blue Medicare card will arrive about three months before your 65th birthday.

If You Are Not Automatically Enrolled

You can sign up during one of three enrollment periods. These include:

  • Initial Enrollment Period (IEP) – Your first chance to enroll, lasting seven months. It begins three months before the month you turn 65, includes your birthday month, and ends three months afterward.
    Example: If your 65th birthday is June 5, your IEP runs from March 1 through September 30.
  • Special Enrollment Period (SEP) – If you delayed Medicare because you had employer coverage, you can enroll:
    • Any time you are still covered by your employer’s group health plan.
    • During the eight months after your employment or group coverage ends (whichever happens first).
    Note: COBRA and retiree health plans do not count as active employer group coverage.
  • General Enrollment Period (GEP) – Runs from January 1 to March 31 each year. If you missed your IEP and don’t qualify for an SEP, you can enroll then. Coverage starts July 1, and you may face higher Part B premiums for late enrollment.

How to Apply for Medicare

Applications are processed through the Social Security Administration (SSA). Before applying, have the following ready:

  • Date and place of birth
  • Medicaid number and start/end dates (if applicable)
  • Current health insurance details

After submitting your application, the SSA may request additional information. You will receive a decision letter by mail. If you enroll manually, expect your Medicare card to arrive within 30 days.

Why Consider a Medicare Supplement (Medigap) Plan?

Original Medicare covers many costs but leaves you responsible for deductibles, coinsurance, and copayments. A Medicare Supplement Insurance (Medigap) plan can help cover these gaps, giving you more predictable health care expenses.

Compare Medigap plans today or speak with a licensed agent to find coverage available in your area.