What Should I Do If I am Late to Enroll in Medicare?

Tamera Jackson by Tamera Jackson | Licensed since 2007
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This article was updated on: 10/06/2018

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Enrolling in Medicare late won’t compromise your eligibility for Medicare. It’s not a one-chance-or-lose all scenario. However, if you are late to enroll in Medicare, you could face late-enrollment penalties. You could avoid these late-enrollment penalties if you qualify for a special enrollment period.

What does it mean to be late to Medicare?

To be “late to Medicare” means you missed your initial enrollment period to enroll in Medicare. There are two ways to qualify for Medicare: when you turn age (65) and through a disability, such as end-stage renal disease or Lou Gehrig’s disease. If you qualify by age, you have a 7-month initial enrollment period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

If you qualify for Medicare through disability, you will generally have a 24 month waiting period. You can enroll in Medicare two years of becoming eligible for Social Security Disability Insurance (SSDI) or Railroad Retirement Board (RRB) disability benefits. Your initial enrollment period is 3 months before your 25th month of getting disability benefits, includes the 25th month of getting disability benefits, and ends 3 months after your 25th month of getting disability benefits.

Why might I be late to Medicare?

You may be enrolling in Medicare after your initial enrollment period because:

  • You are busy and don’t have time to enroll in Medicare
  • You can’t make up your mind between Original Medicare and Medicare Advantage
  • You were working and had employer-sponsored health coverage
  • Your spouse was working and had employer-sponsored health coverage that extended to you

If you missed your initial enrollment period because you were busy or couldn’t make up your mind, you probably will have to pay a late-enrollment penalty. However, if you delayed enrolling in Medicare because you were covered by an employer, you could qualify for a special enrollment period (SEP). If you are covered by an employer, you can apply to Medicare before your employment ends. If you have both Medicare and employer coverage for a time period, then the employer coverage will usually be secondary coverage. You may have to provide proof to Medicare that you have coverage from an employer.

If you receive coverage through a spouse, you want to apply for Medicare before your spouse’s employment ends. Retiree health coverage is not considered credible coverage and you may have to pay a late-enrollment penalty. You may want to know if your spouse will be covered under your Medicare.

What is a late enrollment penalty?

Medicare Part A, Medicare Part B, and Medicare Part D may all charge late-enrollment penalties if you enroll after the period you’re first eligible. Learn more about Medicare late-enrollment penalties.

Do you have more questions about Enrolling in Medicare?

I can help you compare costs and coverage, as well as Medicare plan types, available in your area. To get started:

  • Feel free to let me know if you’d like to discuss anything with me by phone or email; the links for requesting those are below as well.
  • Click on the Compare Plans buttons on this page.

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