Understanding Your Medicare Options

If you are approaching age 65, it is important to understand how and when to apply for Medicare to avoid delays or penalties.

Who’s Eligible?

Medicare is available to individuals age 65+. You can begin the application process three months before the month you turn 65. Your initial enrollment window spans seven months, including the three months before, the month of your 65th birthday, and the three months after.

Can I Keep My Current Providers?

You may be able to keep your providers if they participate in the Medicare program. Providers fall into three categories:

• Participating Providers: Accept Medicare and always take assignment (they accept the Medicare-approved amount as full payment).
• Non-Participating Providers: Accept Medicare but may not take assignment in every case. You may owe more out-of-pocket if they charge above Medicare-approved amounts.
• Opt-Out Providers: Do not accept Medicare and can charge any amount for services. They must follow specific billing rules and provide written agreements.

To confirm your provider’s status, contact them directly before applying.

How to Apply for Medicare

Before you apply, gather the following:

• Current health insurance
• Employment start/end dates for your current employer (if covered through a group health plan)
• Start/end dates for your group health insurance

If born outside the U.S., you will also need:

• Country of birth at the time you were born
• Permanent Resident Card number (if not a U.S. citizen)

Applying for Medicare

1. Visit gov/myaccount to create an account
2. Then go to gov/medicare
3. Scroll down and click the blue Sign up for Medicare button
4. Complete the online application and click Submit Now to send your application
5. Save or print your confirmation page and application number
6. You can log in to your account at any time to check your application status

What Happens After You Apply?

You will receive a letter in the mail with your enrollment determination and next steps. A representative from the Centers for Medicare & Medicaid Services (CMS) will help guide you through choosing a plan and verifying provider participation.