How to Enroll in Original Medicare: A Step-by-Step Guide

Enrolling in Original Medicare is an essential step for those approaching their 65th birthday or qualifying due to a disability. Understanding the process ensures you receive the coverage you need without unnecessary delays or penalties. In this guide, we’ll walk you through the enrollment process, key deadlines, and common mistakes to avoid. If you need assistance, JM Insurance Service is here to help.'

 

Step 1: Determine Your Eligibility

 

You are eligible for Original Medicare if you:

• Are 65 or older
• Are a U.S. citizen or permanent resident
• Have received Social Security Disability Insurance (SSDI) for at least 24 months (for those under 65)
• Have been diagnosed with End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s disease)

If you’re already receiving Social Security benefits, you will be automatically enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance) at 65. Otherwise, you’ll need to apply.

 

Step 2: Know Your Enrollment Periods

 

Timing is crucial when enrolling in Original Medicare. Here are the key enrollment periods to keep in mind.

 

Initial Enrollment Period (IEP)

Your IEP is a seven-month window that starts three months before your 65th birthday, includes your birth month, and lasts three months after. Enrolling in Original Medicare during this time ensures you won’t face late penalties or delays in coverage.

 

General Enrollment Period (GEP)

If you missed your IEP, you can enroll during the GEP from January 1 – March 31 each year. However, coverage won’t begin until July 1, and you may face late enrollment penalties.

 

Special Enrollment Period (SEP)

You may qualify for an SEP if you delayed Medicare enrollment because you had employer-sponsored coverage. You will have eight months after your employment or coverage ends to enroll in Medicare without penalties.

 

Step 3: Apply for Medicare

 

You can enroll in Original Medicare in several ways:

• Online: Visit www .ssa .gov /medicare and complete the application.
• By phone: Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
• In person: Visit your local Social Security office.

If you’re automatically enrolled, you will receive your red, white, and blue Medicare card in the mail about three months before your 65th birthday.

 

Step 4: Understand Medicare Costs

 

While Medicare Part A is typically premium-free if you’ve paid Medicare taxes for at least 10 years, Part B requires a monthly premium. In 2024, the standard Part B premium is $174.70 per month (income-based adjustments may apply).

 

Additionally, Medicare does not cover all medical expenses, so many people consider supplemental coverage such as Medicare Advantage (Part C), Medigap, or a Part D prescription drug plan.

 

Common Mistakes to Avoid

• Missing your enrollment window, which could result in lifelong late penalties.
• Assuming you are automatically enrolled. If you’re not receiving Social Security, you need to apply.
• Skipping Part B if you don’t have other coverage. Delaying Part B without qualifying employer coverage can lead to penalties.
• Not considering additional coverage. Original Medicare doesn’t cover everything, so exploring supplemental options is wise.

Need Help? Contact JM Insurance Service

 

Navigating Medicare enrollment can be overwhelming, but you don’t have to do it alone. JM Insurance Service is here to guide you through the process, answer your questions, and help you find the best coverage for your needs.