How Medicare Benefits Are Activated

Last Updated : 09/16/20183 min read

You may qualify to be automatically enrolled for your Medicare benefits at age 65 if you meet certain requirements. For example, if you’re receiving Social Security or Railroad Retirement Board retirement benefits before you turn 65, you’ll be automatically enrolled in Medicare the first day of the month that you turn 65.

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If your 65th birthday falls on the first day of the month, your Medicare coverage will start the first day of the month prior to your 65th birthday. You should receive a welcome package from Medicare at least three months before your 65th birthday. You’ll also be automatically enrolled in Medicare in the 25th month of disability benefits from Social Security or the Railroad Retirement Board.

If you don’t qualify for automatic enrollment, you will be responsible for enrolling during the Initial Enrollment Period (IEP). The Initial Enrollment Period for Part B is the seven (7) month period that begins three months before the month you meet the eligibility requirements for Part B, and ends three months after the month of eligibility. Keep in mind that if you don’t qualify for a Special Enrollment Period and you don’t enroll in Medicare Part B when you’re first eligible, you may be subject to a late-enrollment penalty when you do enroll. You may have to pay this late-enrollment penalty for as long as you have Medicare Part B.

If you are not retiring at 65 and will continue to receive insurance from your employer, you may want to opt-out of Medicare Part B. You can do so by returning the check-marked postcard in your welcome packet to Medicare. Even if you delay enrollment in Medicare Part B, your Part A remains effective and you usually will not have a premium for Part A if you have worked at least 10 years (40 quarters) and paid Medicare taxes while working or if you qualify because of your spouse’s work history.

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When you are getting ready to retire, contact Medicare before your employer-sponsored coverage ends at 1-800-633-4227 (TTY 1-877-486-2048), 24 hours a day, seven days a week. Explain to the representatives that you are planning on retiring and give the date you will leave your employer insurance. The office will confirm the employment end date with you and enroll you in Medicare Part B for doctor and outpatient services.

Medicare will send you a Medicare Part B enrollment package with forms that must be signed by your previous insurance carrier. You will need to return the forms to the Medicare office as soon as possible. These documents verify your previous insurance coverage and give you a Special Enrollment Period to enroll in Medicare Part B. To avoid any late-enrollment penalty, you have to enroll in Medicare Part B within eight months of leaving employer-based coverage.

This article is intended to be a brief explanation of how your Medicare benefits are activated. If you have any other questions or would like to consider enrolling in a Medicare Advantage plan or a stand-alone Medicare Prescription Drug Plan, then I can help. To find out more about my background, click the “View profile” link below. You can also get in touch with me in other ways: use the links below to schedule a phone appointment or have me email you personalized information about Medicare options that might work well for you. To see plans in your area, click the Compare Plans button on this page.


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