When Is It Too Late to Enroll in Medicare?

Medicare for older Americans
By Christopher Coble, Esq. on April 03, 2019 2:43 PM

The modern American health care system can seem like a mess. Many of us have health insurance through our employers, with different coverage options, deductibles, and copays. Many others are on Obamacare, with its own enrollment period, possible penalties if you're not covered, and legal challenges to the Affordable Care Act. Medicaid covers low-income people who don't have the financial means to afford health care on the private market.

And then there is Medicare, which applies to everyone aged 65 or older who has paid into the system, usually through payroll or self-employment taxes. But do you automatically get Medicare once you turn 65? And if you need to enroll, can you miss your window if you wait too long?

Automatic Enrollment

There are some people who will be enrolled into Medicare automatically. If you have already received Social Security benefits before you turn 65 or are receiving disability benefits, you may be automatically enrolled in Medicare, in which case you'll get a Medicare card in the mail three months before your 65th birthday or your 25th month of disability. If you're not enrolled automatically, you need to apply online.

Most people have a 7-month initial Medicare enrollment period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. And there are different parts of Medicare:

  • Part A (Hospital Insurance): covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Part B (Medical Insurance): covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Enrollment Penalties and Gaps

Medicare.gov recommends enrolling in Part A when you turn 65, even if you already have health insurance from an employer, because you've probably paid Medicare taxes while you worked so you won't pay a monthly premium for Part A. Also, if you don't enroll when you're first eligible, you may have to pay a Part B late enrollment penalty. You may have a gap in your health insurance coverage if you decide you want Part B later.

If you've been denied health insurance coverage or a specific claim, or have more Medicare questions, contact a local health care attorney.

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