Medicare can start for many reasons even before turning 65 years of age. Certain medical conditions and disabilities qualify you for coverage. Make sure you plan in advance for your Medicare so that it begins at a time that makes sense for your situation.

When Does Medicare Start if You Are Turning 65?

Medicare can begin the FIRST DAY of your birthday month.  HOWEVER, if you were born on the first day of the month Medicare can begin the first day of the month BEFORE your birthday month.

If you are collecting Social Security benefits you should receive a letter from the Center for Medicare and Medicaid Services (CMS) 3 months before your birthday month stating you were automatically enrolled in Medicare Parts A and B.  If you would like to decline Medicare Part B, commonly because you plan to remain on employer coverage, you will have to follow CMS instructions listed in the letter.

If you are NOT collecting Social Security benefits you will only be auto enrolled in Medicare Part A but will have to apply for Medicare Part B.  

You can sign up for Medicare three months prior to your birth month, and up to three months after your birth month—essentially providing you seven months to enroll. If you want Medicare Parts A and B to start on your birthday month it is very important to apply in advance.  If you wait until the month of or months after you will have a lag time before your coverage can begin.

• If you sign up prior to your birth month, coverage starts on the first of your birth month.

• If you wait until your birth month to enroll, there will be a one-month lag before your benefits start.
• If you sign up one month after your birth month, there will be a two-month lag before your benefits start.
• If you sign up two or three months after your birth month, there will be a three-month lag before your benefits start.

The phone number for Social Security is 1-800-772-1213 and the website to look up your closest location is Social Security Office Finder. 

Can I delay Medicare?

The most popular reason someone will delay their Medicare coverage is because you or a spouse have employer coverage.   If this is the case you should speak with your HR department to ensure your coverage is credible coverage under CMS guidelines. It is important to know that COBRA is NOT considered credible coverage under the CMS guidelines.  

Medicare Part A has no monthly fee for most people and the only reason to delay that coverage is if your employer plan has restrictions that don’t allow you to be enrolled in Medicare Part A.  

If you have credible employer coverage you can delay Medicare Part B since there is a monthly fee for Medicare Part B which varies based on your income.

Two months prior to losing your employer coverage you can apply for Medicare Part B to start with no penalty.  Two forms will have to be completed, one by you and one by your employer and you will have to either bring the completed forms to your local Social Security office or mail it to the main office for SS in Baltimore MD.  

When Does Medicare Start for Certain Medical Conditions?

If you are disabled and have received Social Security benefits or Railroad Retirement disability payments for 24 months, you will automatically be enrolled in Medicare.

Those with Lou Gehrig’s disease, or ALS, can receive Medicare benefits the first month they receive Social Security or Railroad Retirement benefits.

Lastly, those with end-stage renal disease can receive Medicare regardless of their age starting on the first day of the fourth month of dialysis treatments. However, if they receive homecare, they are covered as early as the first month.

When Will Medicare Start if I Miss My Initial Enrollment Window and Do NOT Have Other Credible Health Insurance?

If you did not take advantage of the initial 7 month window to enroll in Medicare Part B or got disenrolled from Medicare you can apply during the General Enrollment Period.  This time frame is between January 1 and March 31st but your Medicare Part B will not start until July 1st. You will also receive a late enrollment penalty for not having any credible insurance coverage.

Contact New Jersey Medicare Brokers for more information about enrolling in the plan that is right for you.