How to Help Someone Enroll in Medicare
Key Takeaways
- If your loved one is turning 65, they’ll need to enroll in Medicare during their Initial Enrollment Period (IEP)The Initial Enrollment Period (IEP) is the seven-month period around your 65th birthday when most people are eligible for the first time to enroll in Medicare. .
- For purposes of Medicare, you need legal authorization anytime you’re acting on behalf of a beneficiary. For example, you can’t enroll another person in Medicare, even your spouse, unless you have power of attorney, health-care proxy or other authorization to make such decisions for the beneficiary.
- Beneficiaries with Original Medicare can switch to Medicare Advantage during the Annual Enrollment Period from Oct. 15 to Dec. 7.
- If your loved one moves or loses their coverage, they may have a Special Enrollment PeriodA Special Enrollment Period is an opportunity outside of a standard enrollment period in which your specific circumstances allow you an opportunity to make changes to your Medicare-related coverage. to choose a plan.
Is Your Loved One Turning 65?
If you care for someone approaching 65, it’s time to start researching Medicare plans. Medicare is health insurance for all Americans aged 65 and older. Original Medicare (Parts A and B), Medicare Prescription Drug Plan (Part D), Medicare Supplement Insurance (Medigap) and Medicare Advantage are the four parts of Medicare.
Power of Attorney
For purposes of Medicare, you need legal authorization anytime you’re acting on behalf of a beneficiary. For example, you can’t enroll another person in Medicare, even your spouse, unless you have power of attorney, health-care proxy or other authorization to make such decisions for the beneficiary. You also can’t enroll him or her in a Medicare Advantage plan without such authorization.
Mark your calendar: Initial Enrollment Period
Your loved one’s first chance to sign up for Medicare at 65 is known as their Initial Enrollment Period (IEP). Missing the IEP can cause them to pay steep enrollment penalties that last for years. Starting three months before they turn 65, your loved one will have a seven-month window to enroll in Medicare.
As an example, say your loved one will turn 65 next June. Their IEP will open on March 1 and close on Sept. 30.
Missed Your IEP?
If someone misses their IEP, there are usually two options:
- Special Enrollment Period (SEP): If you qualify, you can enroll after your IEP without penalty.
- General Enrollment Period: This enrollment period runs from Jan. 1 to March 31 each year. These policies typically begin July 1.
New to Medicare: What else to know
As a primary caregiver, you have enough to think about without learning Medicare from scratch. Instead, check out our New to Medicare Guide. We’ve put together facts and tips to help you.
Find the Medicare Plan that works for you.
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Already Enrolled in Medicare?
If someone you care for has a Medicare plan, make sure it meets their needs. Here are a few examples to consider:
- Are they living with a new illness or injury since they last enrolled?
- Have their doctors changed?
- Would Medicare Advantage be a cost-effective option?
Want to Switch to Medicare Advantage?
You can change plans and coverage during the Open Enrollment Period each year from Oct. 15 to Dec. 7. Here are a few changes to consider during Open Enrollment:
- Change from Medicare Advantage back to Original Medicare
- Switch from Original Medicare to a Medicare Advantage Plan
- Change to a different Medicare Advantage Plan
- Join, change or drop a drug plan
My loved one has End Stage Renal Disease (ESRD) — is it true they can’t enroll in Medicare Advantage?
As of 2021, people living with ESRD are allowed to enroll in Medicare Advantage. Previously, only Original Medicare covered ESRD services. ESRD patients can now take advantage of the out-of-pocket maximums that come with many Medicare Advantage plans.
What if my loved one can’t afford Medicare?
If your loved one has limited resources, you may be able to enroll them in both Medicaid and Medicare together. Known as dual eligibility, the insurance covers services like:
- Hospitalizations
- Physician services
- Prescription drugs
- Skilled nursing facility care
- Home health visits
- Hospice care
- Long-term nursing facility services
- Home health services
How does Social Security pay for Medicare Services?
For those receiving Social Security benefits and enrolled in Medicare, Medicare premiums are usually automatically deducted from Social Security payments. Individuals enrolled in Medicare but are not receiving Social Security will receive monthly or quarterly bills for Medicare premiums.
Where do you enroll in Medicare?
Suppose you already get benefits from Social Security. In that case, you are automatically entitled to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) starting the first day of the month you turn age 65. Your Medicare card will arrive in the mail about three months before your 65th birthday.
If you are not getting Social Security benefits, you can apply for retirement benefits online. If you would like to file for Medicare only, you can apply by calling the Social Security Administration at 1-800-772-1213.
If you are not getting Social Security benefits, you can apply for retirement benefits online. If you would like to file for Medicare only, you can apply by calling the Social Security Administration at 1-800-772-1213.
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Sources
- Joining a health or drug plan. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.