How to enroll in Medicare

Medicare is a federal health insurance program for people 65 or older and younger people living with disabilities. This insurance offered by the government is called Original Medicare and consists of Parts A & B, covering hospital and medical expenses.

Medicare Advantage (Part C) is an alternative offered through private insurance companies. These plans combine the benefits of Original Medicare with extra coverage, and often include prescription drug coverage (Part D); Part C eliminates the need for a Medicare supplement (Medigap) policy. Every Medicare Advantage plan is regulated by the government to ensure you get everything Original Medicare offers.

Basic parts of Medicare insurance plans

• Part A: Hospitals, skilled nursing facilities, and hospice.
• Part B: Medical insurance for doctors’ services, outpatient care, medical supplies, and some preventive services.
• Part C: Medicare Advantage including Parts A, B, and usually D, plus managed care.
• Part D: Prescription drug coverage.

When can you sign up for Medicare?

Knowing when and how to enroll in Medicare can be confusing. Let’s simplify the process. The initial enrollment period to sign up for Medicare begins 3 months before you turn 65, includes your birthday month, and ends 3 months after the month you turn 65. You may be eligible for Medicare before you turn 65 if you’re living with a disability, end-stage renal disease (ESRD), or Lou Gehrig's disease (ALS).

You can sign up after 65 if you’ve been covered by an employer group health plan. This is considered a special enrollment period. Check with your employer’s benefits team to be sure you don’t incur any penalties.

Are you under 65?

You will receive Medicare Part A and Part B automatically when you turn 65 if you’ve been receiving Social Security disability or retirement benefits at least 4 months before turning 65.

Are you turning 65 or older?

Social Security benefits and Medicare go hand in hand. You will need to contact Social Security to sign up for Medicare Part A and Part B coverage if you plan on waiting to apply for Social Security until you’re 65 or older. 

You can start receiving Medicare benefits at age 65 even if you decide to wait to collect Social Security benefits to possibly receive a higher monthly payment. 

If you are still working and have health coverage through your employer, you may be able to delay enrolling in Medicare Part B. Talk with your employer’s benefits team to be sure. It is your choice to delay or refuse Medicare at age 65, but know that it can lead to potential lifelong penalties and coverage gaps if you decide to enroll later.

If you have questions about enrollment, you can contact Medicare 24 hours a day, 7 days a week, except on some federal holidays, at 1-800-MEDICARE or 1-800-633-4227 (TTY: 1-877-486-2048 if you are deaf or hard of hearing).

Steps to sign up for Medicare

When you are ready to sign up for Medicare you can follow these steps:

1. Gather the information you’ll need.
   • To enroll in person at your local Social Security Administration (SSA) office, bring your Social Security card, original birth certificate, and proof of legal U.S. citizenship (or permanent resident card if you are not a U.S. citizen). 
   • To enroll by phone or online, you’ll need your date and place of birth. You’ll also need a permanent resident card number if you are not a U.S. citizen. 
   • Have your current health insurance details, including your or your spouse’s current employment start and end dates.
   • For those married or divorced, you may need the name, date of birth, and SSN of your current or ex-spouse, along with the start/end dates of the marriage and the place of marriage (city, state, and country).
   • For those who served in our U.S. military service, you’ll need the type of duty, branch, and service dates.
   • Have your direct deposit (USA) account type/number and bank routing number. For direct deposit (non-USA), have your International Direct Deposit (IDD) bank country, bank name, code, and currency, account type/number and branch/transit number.
2. Contact the Social Security Administration:
   • In person. Schedule an appointment with your local office before visiting.
   • By phone. Call 1-800-772-1213 (TTY: 1-800-325-0778) from 8 a.m. to 7 p.m. local time, Monday through Friday.
   • Online: Visit ssa.gov/medicare. 
     • Create or sign in to your my Social Security account online to apply for benefits. 
     • Apply for retirement/Medicare online. Once you review and approve your earnings history, you can get started. The application process may take 10 to 30 minutes to complete. You can save the application as you go. Watch this short video about helpful hints for applying online.
3. Follow up on the status of your application online by signing in to my Social Security. A representative may contact you with questions about your application.

For more information about Medicare, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048.

Common Medicare enrollment questions

Q: Do I have to sign up for Social Security before signing up for Medicare?

A: You typically need to sign up for Social Security benefits before you can sign up for Medicare, as you apply for Medicare through the Social Security Administration. You can apply for Medicare even if you aren't ready to start receiving Social Security benefits yet, but you will need to do so through the Social Security Administration.

You can sign up for Medicare online through your my Social Security account, by calling the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778), or by visiting a local Social Security office.

Generally, you are eligible for Medicare when you turn 65, but you may be eligible earlier if you have a disability like end-stage renal disease (ESRD) or Lou Gehrig's disease (ALS).

Q: How do I sign up for a dual-eligible special needs plan (D-SNP)?

A: Since a D-SNP is considered a Medicare Advantage plan, you’ll need to go through the steps to enroll in Original Medicare, and then switch to a Medicare Advantage plan from a private insurer such as Sentara Medicare. 

As this is a dual-eligible plan, you’ll also need to be enrolled in Medicaid through the same Medicare insurance company.

Q: How do I sign up for a chronic condition special needs plan (C-SNP)?

A: Since a C-SNP is considered a Medicare Advantage plan, you’ll need to go through the steps to enroll in Original Medicare, and then switch to a Medicare Advantage plan from a private insurer such as Sentara Medicare. You will receive a form for your doctor to complete which verifies you have a qualifying chronic condition.

Q: Do you need to enroll in Original Medicare Part A and Part B before you can enroll in a Medicare Advantage plan?

A: Yes, you must be enrolled in both Medicare Part A (hospital coverage) and Part B (medical insurance) before you can enroll in a Medicare Advantage (Part C) plan.

Q: Is there a penalty for switching from Medicare Advantage to Original Medicare?

A: There is no penalty for switching from Medicare Advantage to Original Medicare or vice versa. You can switch between the two types of coverage as many times as you want as long as the switch occurs during an annual, open, or special election period.

Q: If you join a Medicare Advantage plan, do you still have to pay for Medicare Part A and Part B?

A: Even with a Medicare Advantage plan, you still need to pay for your Medicare Part B monthly premium; you must be enrolled in both Part A and Part B to qualify for a Medicare Advantage plan. There are various methods to pay, including Medicare Easy Pay, online bill pay, or by mail.

Q: How much does Medicare Part A (hospital insurance) cost?

A: If you’re like most people who have worked and paid Medicare taxes for at least 10 years, you will not pay a monthly premium for Part A. If you don’t qualify, you will pay a monthly premium plus a deductible for hospital stays.

Q: How much does Medicare Part B cost?

A: In 2025, the standard Medicare Part B premium is $185 per month.

Q: Does your Part B premium automatically get deducted from your Social Security check?

A: You can have your Medicare Part B premium automatically deducted from your Social Security check if you receive Social Security benefits. If you don't receive Social Security benefits, you’ll receive a bill from Medicare for your Part B premium.  

Your first Medicare bill is typically for three months because Medicare bills are usually sent out quarterly, meaning you pay for three months of coverage at a time. This is considered a standard billing cycle when you first sign up for Medicare and aren't receiving Social Security benefits yet. 

Q: Does Medicare Part A or Part B incur a late enrollment penalty?

A: You might be charged a penalty if you don't sign up for Part B when you're first eligible, usually when you turn 65. The penalty increases the longer you wait to enroll. 
The Medicare Part B late enrollment penalty is an additional 10% of your monthly Part B premium for each year you could have enrolled. You'll pay this penalty for as long as you have Part B.  

To learn more about Medicare enrollment, call a Sentara Medicare Licensed Plan Advisor at 1-877-550-3285 (TTY: 711) or visit sentaramedicare.com/DSNP