Medicare Part A Enrollment: How to Enroll

Are You Automatically Enrolled in Medicare Part A When You Turn 65?

You must be receiving Social Security benefits or Railroad Board benefits for at least four months prior to your 65th birthday in order to be automatically enrolled in Medicare Part A when you turn 65. Otherwise, you will have to apply for benefits.

From the beginning of the Medicare program in 1965 until the dawn of the 21st century, the timelines for Social Security and Medicare were in step with each other. You were able to receive full Social Security retirement benefits at age 65, and your Medicare Part A and/or B monthly premiums were deducted from your Social Security check.

Beginning in 2000, however, the Social Security Amendments of 1983 took effect and began a gradual process of pushing back the standard age for full Social Security benefits. Citing increased life expectancy and improvement in the health of older adults, the legislation started a 22-year clock pushing the standard age for receiving full Social Security benefits to age 67 beginning with people born in 1960.

With the changes adding up to many people waiting until after age 65 to draw Social Security, automatic enrollment has become less common. Automatic enrollment triggered by Social Security (or Railroad Board) payments now happens only if you begin receiving payments at least four months before you turn 65.

Here’s why — and why not being automatically enrolled may actually be a blessing.

The standard age for Medicare eligibility remains 65, and the time frame for first enrolling in Medicare is your seven-month Initial Enrollment Period, which includes the three full months before you turn 65, the month you turn 65 and the three months after you turn 65.

For you to be able to start Medicare coverage on the first day of your birth month, you must apply during the three months before your birth month. Automatic enrollment follows that timeline, so if you are automatically enrolled you receive a “Welcome to Medicare” kit about three months before you turn 65. In order for that timeline to work, you have to be receiving Social Security before the time arrives for your packet to go out in the mail.

While it can make things easier for you if you’re automatically enrolled, it could actually complicate things. Here’s why. Those who are automatically enrolled are enrolled in both Part A and Part B. While nearly everyone takes advantage of Part A at age 65 because it provides hospital insurance with no monthly premium if you have worked at least 10 years. People with employer insurance may opt out of Part B enrollment at age 65 because it provides similar medical insurance with a monthly premium.

So if you are automatically enrolled in Original Medicare — Parts A and B — you may want to decline Part B, depending on your needs. If you aren’t automatically enrolled, then you only have to go through the enrollment process for the part (or parts) of Medicare you want.