ENROLLMENT INTO MEDICARE PART A AND PART B:
In most cases, if a client is already getting benefits from Social Security or the Railroad Retirement Board (RRB), they will automatically get Part A and B starting the first day of the month they turn 65. If their birthday is not the first day of the month, Part A and Part B will start the first day of the prior month.
If a beneficiary is under 65 and disabled, they will automatically get Part A and B after they get disability benefits from Social Security or certain disability benefits from the Railroad Retiree Board for 24 months.
Beneficiaries will receive a red, white, and blue Medicare card in the mail 3 months before their 65th birthday or their 25th month of disability. If a beneficiary wants to opt-out of Part A and/or Part B they will need to follow the instructions that come with the card and send the card back to Social Security. If they keep the card, they are confirming their enrollment into Medicare Part A and B and will begin to pay a Part B premium.
If a beneficiary has ALS (Amyotrophic Lateral Sclerosis) they automatically get Part A and B the month their disability benefits begin.
If a beneficiary is on dialysis their Medicare will start the first day of the fourth month of their dialysis treatment.
If a beneficiary is getting a kidney transplant their Medicare coverage will begin the month they are admitted to a Medicare-certified hospital for a kidney transplant.
If a beneficiary is not collecting Social Security benefits or Railroad Retirement Board benefits, they must enroll themselves into Medicare. Beneficiaries can do so by:
- Going online to medicare.gov or ssa.gov and create an account to complete their Medicare application
- Go to their local Social Security office and apply for Medicare in-person
- Or, meet with a Sunnyside Medicare agent and we can help you with the enrollment process in our office.
MEDICARE PART A AND B ENROLLMENT PERIODS:
If a beneficiary is not automatically enrolled into Medicare Part A and/or B or opted out of any part of Medicare when they initially became eligible, they can enroll into Medicare during one of the following enrollment periods:
INITIAL ELECTION PERIOD (IEP):
Beneficiaries can sign up for Medicare Part A and B at any time during a 7-month Initial Election Period (IEP) that begins 3 months before the month they become eligible for Medicare and ends 3 months after the month they were eligible for Medicare. If a beneficiary waits until after the month of their Medicare eligibility to enroll their Medicare coverage will not be retroactive and will be delayed depending on when the application is received.
MEDICARE GENERAL ENROLLMENT PERIOD (GEP):
If a beneficiary did not take Medicare Part A and/or Part B when they were first eligible and do not have other creditable coverage in place, their next opportunity to enroll into Medicare might be during the GEP which runs from January 1st through March 31st of each year. If a beneficiary enrolls into Medicare during the GEP, their Medicare coverage will be effective July 1st of that year. Also, if they want additional coverage such as a Medicare Advantage plan, they must enroll in a Medicare Advantage plan with a July 1st effective date or will need to wait until another enrollment period becomes available. Beneficiaries enrolling in Medicare during this enrollment period will be subject to late enrollment penalties.
SPECIAL ELECTION PERIODS (SEP):
Once a beneficiaries Initial Enrollment Period ends, they may have a chance to enroll in Medicare during a special enrollment period. If a beneficiary is covered under a group health plan, they will have the opportunity to enroll in Medicare upon the termination of their group coverage. They have an 8-month period from the loss of the group coverage to enroll into Medicare penalty-free.