Posted on May 23, 2022 by Austin Lang
Posted on May 23, 2022 by Austin Lang
Waiting for your health insurance to come into effect is never much fun. This lingering period of anxiety where every random ache or throat tickle feels like it could be a potential hospital visit. The issue doesn’t go away with Medicare, but the unusual enrollment rules can throw people off. When applying for Medicare, timing is everything. Here’s everything you need to know about your Medicare application status, including how to sign up for Medicare, check your status, and know when your insurance finally comes into effect.
The best time to apply for Medicare is as soon as you are eligible. This will most likely be your 65th birthday, though you can qualify for Medicare earlier if you have certain health conditions.
You can apply for Medicare up to three months before your 65th birthday, the entire month of your 65th birthday, and up to three months after. These seven months are known as your Initial Enrollment Period (IEP). If you want your coverage as soon as possible, you’ll want to apply during the three months before your 65th birthday. This will allow you to benefit from your Medicare coverage on the first day of your birthday month. It doesn’t matter where your birthday falls in the month; even if you were born on June 30th, for example, you’d begin coverage on June 1st.
If you were to apply during your birthday month, your Medicare would come into effect on the first day of the following month. After this month, the wait can unfortunately increase. For instance, if you apply the month after you turn 65, your coverage will begin two months after enrollment. If you apply during the final two months of your IEP, you’ll need to wait three full months. But what if you apply later than your IEP?
Missing your IEP will cost you — literally. You’ll have a financial penalty added to your premiums, which increases the longer you wait to apply. This penalty never goes away until your application has been submitted, so getting your application in as soon as you can is critical.
If you’ve missed your IEP or are just switching to a Medicare Advantage plan, you can enroll for coverage during the General Enrollment Period (GEP). This takes place from January 1st to March 31st of each year, with coverage beginning July 1st.
You may be eligible for a special enrollment period if you meet specific criteria. Medicare offers this convenient tool to help you check your eligibility.
There is an exception to the enrollment period rule if you qualify for premium-free Medicare Part A (which most taxpayers do). You can delay your enrollment with no penalty, and your benefits will apply retroactively for up to six months, but not before your initial eligibility. Be aware that the penalty for late enrollment does apply if you pay a premium for Part A coverage.
If you collect Social Security Disability Insurance (SSDI), have Amyotrophic Lateral Sclerosis (also known as ALS/Lou Gehrig’s Disease), or End-Stage Renal Disease (ESRD), you can qualify for Medicare enrollment works a bit differently as well. Luckily, there are special rules for applying to Medicare in these situations.
If you collect SSDI, there is a 24-month waiting period before you qualify for Medicare, beginning when you first collect disability insurance. People receiving SSDI are automatically enrolled in Original Medicare. However, you will need to manually enroll in supplemental plans like Medicare Advantage, Medigap, or Medicare Part D. These 24 months do not need to be consecutive, but do need to be the result of the same condition and must have occurred within a reasonable timeframe.
If you have ALS, there is no waiting period. You can begin Medicare immediately upon collecting SSDI. You should get your Medicare application approval within a few weeks of applying.
If you have ESRD, coverage begins on the first day of the fourth month of your dialysis treatments or the first day of at-home dialysis, should you require it. Coverage lasts for up to a year after you cease dialysis treatments or up to three years after a kidney transplant. If you’re getting a kidney transplant, coverage begins upon admittance to the hospital (up to two months before your transplant). You can also apply for retroactive coverage up to 12 months after initial eligibility.
If you want to enroll in Medicare, you’ll first need to apply through the Social Security Administration or Railroad Retirement Board, whichever is responsible for your benefits. If you’re already receiving benefits, you’ll be enrolled automatically. Otherwise, head to their website to submit your Medicare application online. You can also enroll over the phone or at your local Social Security or Railroad Retirement Board office. This will secure your enrollment in Original Medicare, the government-funded branch of the program.
It takes about three weeks for a Medicare application to be approved. You’ll receive a Medicare card with your effective start date. If your application is denied, you’ll receive a letter informing you why you are not currently eligible and information regarding any further action you can take.
At MedicareInsurance.com, our licensed insurance agents can help you explore your coverage options for things Original Medicare doesn’t cover. We can help you compare coverage options from multiple insurers, and give you insight into the Medicare Advantage plan that’s best for you. Once your initial enrollment is secured, don’t hesitate to call our licensed insurance agents and Medicare Advantage experts at (800) 950-0608 to explore your additional options.
Austin is dedicated to breaking down complex topics, like Medicare, in a way that's easy to understand. He graduated with an M.A. from Florida Atlantic University in 2018.