Are You Turning 65? Knowing Which Plan Is Right For You Depends on Your Circumstances

If you don’t sign up yourself, you may automatically get enrolled into Medicare

Depending on your circumstances, you can either be automatically enrolled into Medicare, or you’ll have to sign up yourself. Much of it will be determined by: your work history, your employment status, and if you are filing for social security or not. Original Medicare has two parts to enroll into, Part A and Part B. Each is managed somewhat separately, so we’ll address each separately.


Let’s start with Part A:

If you are retiring or disabled you can be almost certain you will be getting Medicare Part A automatically. There will be a few instances when this isn’t the case, but most who have worked and paid Medicare taxes for at least 10 years, have been disabled for 24 consecutive months, or who have ALS (Lou Gehrig’s Disease) will get Part A automatically. The only exceptions will be:

  1. If you haven’t worked at least 10 years (being paid “under the table” can cause this, too)

  2. You don’t have a “green card” (permanent residence card) for at least 5 years

  3. You don’t have citizenship, a qualifying visa, or lawful status

  4. You are under 65 and have been diagnosed with ESRD (End-Stage Renal Disease)

Even with these exceptions it’s likely that you may qualify for Medicare, but you would need to manually apply for Part A. To be certain if you qualify you will need to contact Social Security. They can inform you if you fit any of the exceptions above, and enroll you into Medicare.

Moving on to Part B:

You will be automatically enrolled into Medicare Part B if:

  1. You are retiring and apply for Social Security benefits

  2. You have been disabled for 24 consecutive months

  3. You have ALS (Lou Gehrig’s Disease)

If none of the above apply to you, then you will have to manually apply for Part B through social security. The most common examples of having to manually apply are: when someone is 65 but not yet filing for Social Security or when someone is under 65 and has been diagnosed with ESRD (End-Stage Renal Disease).

If you get health coverage from an employer, it may be an option to continue that coverage and delay adding Part B. Those with employer coverage may not be automatically enrolled into Medicare Part B (your employer will inform you if this applies to you) as long as their employer coverage remains active. If you will be keeping employer coverage when you retire, please refer to our class on “Medicare and Employer Coverage” for more information on these rules. Also, if you have coverage through the Veterans Affairs (VA), then you may not be automatically enrolled into Part B for much of the same reasons as having employer coverage. For information, please refer to our class on “Medicare and VA Coverage”.


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You can enroll in Medicare Part A and/or Medicare Part B in the following ways:

  1. Online at www.SocialSecurity.gov.

  2. By calling Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday, from 7AM to 7PM.

  3. In-person at your local Social Security office.

If you worked at a railroad, enroll in Medicare by contacting the Railroad Retirement Board (RRB) at 1-877-772-5772 (TTY users 1-312-751-4701). You can call Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.

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