A University of Alabama Law School Clinical Program funded in part by West Alabama Regional Commission

Medicare Eligibility and Enrollment:

Eligibility. If you are eligible for Old Age Retirement benefits through Social Security, you will become eligible for Medicare on your 65th birthday (even though your Full Retirement Age may be 66 or older.)

Those eligible for Social Security Disability benefits become Medicare-eligible 24 months after the date of disability determined by the SSA (the 25th month after disability.)

If you take Social Security benefits early, you will be enrolled in Medicare at age 65.

Automatic Enrollment and Seven-month Enrollment Window. You should hear from the SSA approximately three months before your 65th birthday (or before the month that marks two years after your date of disability) that you have been enrolled in Part A and Part B

You may decline Part B, but it is hard to imagine a reason to do so.

If you have not heard from the Social Security Administration by the month before your birthday contact SSA (1-800-772-1213) right away, or apply online (www.ssa.gov). You must apply in the seven -month period from three months before your birthday month, during that month, or three months after it.

If you fail to apply within that initial seven-month period of eligibility, it will delay the date Medicare takes effect. You will also have to apply for Part B at the next open eligibility period, and pay a higher Part B premium. (It will also delay enrolling in a Part D drug plan.)

Penalty. If you do not accept automatic enrollment or enroll yourself within the seven-month period surrounding your 65th birthday, you will pay a permanent penalty of 10% of the Part B premium for each year of delay.

Coverage Through an Employer After 65

Group health plans of employers with 20 or more employees are required by law to offer workers and their spouses who are age 65 (or older) the same health benefits that are provided to younger employees. If you are covered under an employer-provided plan, talk to the personnel office before signing up for Medicare. Be sure to do this well before your 65th birthday. You still need to enroll in Part A, but you may want to delay enrollment in Part B until retirement. You should confirm this in writing with Social Security, and keep a copy of the letter. Once retired, enroll promptly in Part B! You have a limited time to do so.

Other Medical Insurance Plans After 65

If you are covered under a Department of Defense program, your health benefits may change or end when you become eligible for Medicare. Contact the Department of Defense or a military health benefits advisor for information before you decide whether to enroll in Medicare medical insurance.

If you are covered under programs of Department of Veterans Affairs, Alabama Retirement Systems, Medicaid or another program, contact the people in those offices to help you decide whether you have an option about coverage, and if so, whether it is to your advantage to have Medicare medical insurance.

(For those under 65 who have no insurance, there are few answers at present. See "A Few Current Issues", Section # 10, paragraph 4.)

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