As of 2021, there were well over 35 million Medicare beneficiaries enrolled in Original Medicare (Part A & B), and the amount of enrollees continues to grow each year. The Initial Enrollment Period (IEP) is the earliest phase of enrollment. Individuals that reach the age of 65 are eligible for Original Medicare and are automatically enrolled if they are receiving Social Security checks through the Social Security Administration. Those under the age of 65 that have qualifying disabilities may also enroll in Medicare. Understanding Original Medicare’s information and insight can enable beneficiaries from making informed decisions based on the enrollment process.

How Do I Enroll in Medicare?

As mentioned, individuals that reach the age of 65 are eligible and automatically enrolled in Original Medicare through the Social Security Administration if they have been receiving Social Security checks.
There is no need to create your own Medicare account for original Medicare enrollment. However, the following includes the specific windows of opportunity to sign up for Original Medicare:

  • If you are within three months of turning 65 or older or have a qualifying condition/disability, you may enroll in Original Medicare by activating your Social Security benefits or those provided by the Railroad Retirement Board. You may start your Social Security payments on the web by applying at the Social Security website. Alternatively, you may also contact your local Social Security office or the national Social Security help line at 1-800-772-1213.
  • If you or your spouse are set to receive financial compensation in retirement after working for a railroad, you may start those benefits and subsequent Medicare Part A by reaching out to the Railroad Retirement Board at 1-877-772-5772.
  • Once the Social Security benefits are activated, Medicare Part A coverage may commence. Your decision pertaining to obtaining Medicare Part B coverage is made after applying for benefits. If you are approved for the benefits, you may receive an introductory package along with your own Medicare identification card.
  • When enrolling for Medicare you may need to provide your SSN, date of birth, original birth certificate, marriage status or certificate, legal residency documents and evidence of any employer.

What Are My Options if I’m Ineligible for Original Medicare?

If you find out you are not eligible for Medicare Part A unless you pay a premium each month, you may want to determine the following:

  • If it makes financial sense to buy Part A coverage.
  • It is necessary to sign up for Medicare Part B benefits to purchase Part A coverage.
  • If you have Medicare Part A and would like to add Medicare Part B, reach out to the Social Security office.
  • The office may have you complete the Application for Enrollment in Medicare Part B, also known as CMS-40B. Transmit this complete form to the closest Social Security office to your home.

When is the Original Medicare Enrollment Period?

The general enrollment period for Medicare begins on January 1st and extends to the last day of March. It is during this time that you can enroll in Original Medicare. Those who do not have Medicare Part A coverage yet enroll in Medicare Part B in the general enrollment period are eligible to enroll in drug plan coverage between April 1st and the last day of June. There are different circumstances for each beneficiary which may include:

  • If the applicant does not enroll in Medicare Part B during the initial enrollment period or special enrollment period, a penalty might be assessed when enrolling in Medicare Part A and Part B.
  • The initial enrollment period commences three months prior to the month at which an individual reaches age 65 and ends three months after he or she turns 65-years-old.
  • The special enrollment period is a window of opportunity to make alterations to both the Medicare Advantage and Prescription Drug coverages when specific events occur in one’s life. As an example, losing health coverage through one’s employer qualifies as a special event.

Medicare Enrollment Period Chart

The chart below provides the full scope of Medicare-related enrollment periods which includes Original Medicare and enrollment periods relating to Medicare Part C (Advantage), Medicare Part D (Prescription Drugs), etc.

Medicare Enrollment Period Chart

  • Initial Enrollment Period (IEP):
Beneficiaries can enroll in Original Medicare, Medicare Part D, and a Medicare Advantage plan for a 7-month period. The period covers the 65th birthday month, the previous 3 months, and the following 3 months. The period will start in the previous month for people with a birthday on the first day of the month.
  • Medicare Advantage -Initial Coverage Election Period (ICEP):
This period runs concurrently with the IEP and represents the 7-month period Medicare enrollees can join a Medicare Advantage plan. For individuals who are just qualifying into Medicare they can enroll in an Medicare Advantage plan during ICEP.
  • Initial Enrollment Period 2 (IEP2):
The government provides this enrollment period for people who could enroll in Medicare before turning 65 because of a qualifying illness or disability. It works the same as the IEP.
  • Special Enrollment Periods (SEP):
Some people have special circumstances that allow them to enroll in Medicare Part D or Medicare Advantage outside of the regular enrollment periods. The SEP generally lasts for 60 days after the qualifying event. People who don’t enroll in Part B because they have job-based health insurance also get an SEP after losing this coverage, which lasts eight months.
  • Medicare Part B Special Enrollment:
Medicare-eligible people who delayed Part B enrollment because of creditable coverage from a job may have up to eight months after that coverage ends to enroll in Part B.
  • General Enrollment Period (GEP):
Eligible people who missed their IEP can enroll in Medicare Part A and Part B from January 1 to March 31. These people can also enroll in Part D from April 1 to June 30.
  • Medicare Supplement (aka Medigap) Open Enrollment:
This is a one-time only 6-month enrollment period, typically occurring when a person ages into Medicare at 65 providing new beneficiaries with the Guaranteed Issue Rights to Medigap plans. For individuals receiving Medicare Part B before their 65th birthday their Medigap OEP starts the first day of the month they turn 65 as well. If there is an enrollment delay going past turning 65 then the Medigap OEP will automatically start the month of enrolling in Medicare Part B.
  • Fall Open Enrollment Period (AEP):
This can also be referred to an open enrollment period (OEP). It is purposed for dropping, changing or joining: Medicare Advantage and/or a Part D plan. This time period is between October 15th to December 7th. This period enables enrollees to make a greater number of changes vs the Medicare Advantage Open Enrollment Period (MAOEP). Changes take effect January 1st.
  • Medicare Advantage – Open Enrollment Period (MAOEP):
This limited Open Enrollment Period runs between January 1st to March 31st. Enrollees in MA plans can switch or drop Medicare Advantage to return to Original Medicare and enroll in a stand-alone Part D drug plan. This difference from AEP in the sense that you cannot make the following changes during this period: switch from Original Medicare to an MA plan, join a Medicare Part D (prescription plan) if on Original Medicare, or switch from one Part D plan to another if on Original Medicare.

Am I Eligible to Enroll in Original Medicare if I Lost My Job or Retiring?

If you are signing up for Medicare because of your departure from the workforce or losing coverage from your job, it is crucial to follow these steps:

  • Your employer may be required to complete the Request for Employment Information form, also referred to as CMS-L564. The completion of this form sets the stage for you to qualify for coverage in a special enrollment period.
  • If your employer cannot complete the form in its entirety, fill out as much of Section B on your own.
  • Do not sign the form. You’ll have to provide proof that health insurance was provided by your employer.
  • Such proof can be provided on the Social Security’s website in the menu titled, “Already Enrolled in Medicare”, or mailed or faxed to the closest Social Security office.