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Newly Eligible For Medicare? What You Should Know About Initial Enrollment

By Zawn Villines
If you don't enroll in Medicare on time, you could end up paying a premium penalty for the rest of your life. Learn more about about initial Medicare enrollment.

If you're newly eligible for Medicare, the clock for enrollment begins ticking 3 months before your 65th birthday.

Delaying your enrollment could mean paying a late enrollment penalty for the rest of your life, so the time to enroll is now. If you're overwhelmed by the complexities of Medicare or know little about the program, here's what you need to know about initial Medicare enrollment.

Is Medicare Enrollment Automatic?

Some people do not have to enroll in Medicare because the government automatically enrolls them. This may be true for you if you get Social Security or Railroad Retirement Board benefits. If you are disabled and receive disability payments, you'll be automatically enrolled in Medicare during the 24th month of disability payments.

If you will not be receiving Social Security or Railroad Retirement Board benefits at least 4 months before your 65th birthday, you need to enroll in Medicare.

Even though enrollment is automatic for many people, it's still a good idea to compare your Medicare plan options. You can choose how to receive Medicare benefits when you first become eligible, as well as during open enrollment. Some beneficiaries enroll in Medicare Advantage, or choose to pay for a prescription drug plan through Medicare Part D.

When Can I Enroll in Medicare?

Your initial enrollment period extends from 3 months before the month you turn 65 through three months after that month. For example, if you turn 65 in May, your enrollment period would include February, March, April, May, June, July, and August—giving you 7 total months during which you may enroll.

When Does My Medicare Coverage Begin?

If you enroll in Medicare during one of the 3 months prior to your birth month, coverage begins the first day of your birth month. So a person born May 5 would begin coverage on May 1. If, however, your birthday is on the first day of the month, coverage begins the prior month. So, if your birthday is November 1, your coverage begins October 1.

Coverage begins later if you wait until you turn 65. You'll get coverage according to the following schedule:

  • If you sign up the month you turn 65, coverage begins 1 month later.
  • If you sign up 1 month after the month you turn 65, coverage begins 2 months later.
  • If you sign up 2 months after the month you turn 65, coverage begins 3 months later.
  • If you sign up 3 months after the month you turn 65, coverage begins 3 months later.

What is a Late Enrollment Penalty?

If you sign up for Medicare late, you may have to pay a late enrollment penalty. The penalties are as follows:  

  • Part A: Your monthly premium could increase by 10%, if you have a premium.
  • Part B: Your monthly premium could increase by 10% for every 12-month period during which you were eligible for Medicare but did not enroll.
  • Part D: If you do not enroll in prescription drug coverage within 3 months of enrolling in Parts A and B, you will pay a penalty if you enroll later. In general, you will need to pay the penalty for the entire duration of your Medicare drug coverage. The penalty is 1% of the national base beneficiary premium multiplied by the number of months you delayed enrollment or didn't have creditable coverage. The figure is then rounded to the nearest 10 cents. For example, in 2019, the national base beneficiary premium was $33.19. If you delayed enrollment for 6 months, you would pay a monthly penalty of $1.99 per month.