Medicare Benefits | SSA (2024)

Medicare is our country's health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare too, including those with disabilities and those who have permanent kidney failure.

The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care. You have choices for how you get Medicare coverage. If you choose to have Original Medicare (Part A and Part B) coverage, you can buy a Medicare Supplement Insurance (Medigap) policy from a private insurance company.

The Parts of Medicare

Social Security enrolls you in Original Medicare (Part A and Part B).

  • Medicare Part A (hospital insurance) helps pay for inpatient care in a hospital or limited time at a skilled nursing facility (following a hospital stay). Part A also pays for some home health care and hospice care.
  • Medicare Part B (medical insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.

Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.

  • Supplemental (Medigap) policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
  • Medicare Advantage Plan (also known as Part C) includes all benefits and services covered under Part A and Part B — prescription drugs and additional benefits such as vision, hearing, and dental — bundled together in 1 plan.
  • Medicare Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs.

Most people age 65 or older are eligible for free Medicare Part A (hospital insurance) if they have worked and paid Medicare taxes long enough. You can sign up for Medicare Part B (medical insurance) by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read Medicare Premiums: Rules For Higher-Income Beneficiaries.

Should I Sign Up For Part B (Medical Insurance)?

With our online application, you can sign up for Medicare Part A and Part B. Because you must pay a premium for Part B coverage, you can opt out of that coverage.

If you’re eligible at age 65, your Initial Enrollment Period (IEP) begins 3 months before your 65th birthday, includes the month you turn age 65, and ends 3 months after that birthday.

If you accept the automatic enrollment in Medicare Part B or if you sign up during the first 3 months of your IEP, your coverage will start the month you’re first eligible. If you sign up during the month you turn 65 or during the last 3 months of your IEP, your coverage starts the 1st day of the month after you sign up.

The following chart shows when your Medicare Part B becomes effective in 2023:

If you enroll in this month of your IEP Your Part B Medicare coverage starts
1 to 3 months before you reach age 65 The month you turn age 65.
The month you reach age 65, or 1 to 3 months after you reach age 65 The 1st day of the month after you sign up.

If you choose not to sign up for Medicare Part B but then decide to do so later, your coverage could be delayed. You may have to pay a higher monthly premium for as long as you have Part B. Your monthly premium will go up 10% for each 12-month period you were eligible for Part B but didn’t sign up for it. This does not apply if you qualify for a "Special Enrollment Period" (SEP).

If you don’t sign up for Medicare Part B during your IEP, you have another chance each year to sign up during the “General Enrollment Period” (GEP) from January 1 through March 31. Your coverage starts the 1st day of the month after you sign up. Read our publication Medicare for more information.

You may have a Health Savings Account (HSA) or health insurance based on current employment. If so, you may want to ask your personnel office or insurance company how signing up for Medicare will affect you.

Special Enrollment Period (SEP)

You may have medical insurance coverage under a group health plan based on your or your spouse's current employment. In this case you may not need to apply for Medicare Part B at age 65. You may qualify for an "SEP” that will let you sign up for Part B during:

  • Any month you remain covered under the group health plan and you or your spouse's employment continues.
  • The 8-month period that begins with the month after your group health plan coverage or the employment it is based on ends, whichever comes first.

How to Apply Online for Just Medicare

Are you within 3 months of turning age 65 or older and not ready to start your monthly Social Security benefits yet? You can use our online application to sign up just for Medicare and wait to apply for your retirement or spouses benefits later. It takes less than 10 minutes, and there are no forms to sign and usually no documentation is required.

Apply for Medicare Only

Return to Saved Application | Check Application Status | Replace Medicare Card

To find out what documents and information you need to apply, go to the Checklist for Online Medicare, Retirement, and Spouses Applications.

Medicare Cards

To help protect your identity, your Medicare card has a Medicare number that’s unique to you. If you did not receive your red, white, and blue Medicare card, there may be something that needs to be corrected, like your mailing address. You can update your mailing address by signing in to or creating your personal my Social Security account. Learn more about your Medicare card.

Already Enrolled in Medicare

If you have Medicare, you can get information and services online. Find out how to manage your benefits.

If you are enrolled in Medicare Part A and you want to sign up for Part B, please complete form CMS-40B, Application for Enrollment in Medicare – Part B (medical insurance). If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.

You can use 1 of the following options to submit your enrollment request under the Special Enrollment Period:

  1. Go to “Apply Online for Medicare Part B During a Special Enrollment Period” and complete CMS-40B and CMS-L564. Then upload your evidence of Group Health Plan or Large Group Health Plan.
  2. Fax or mail your CMS-40B, CMS-L564, and secondary evidence to your local Social Security office (see list of secondary evidence below).

Note: When completing the forms CMS-40B and CMS-L564:

  • State “I want Part B coverage to begin (MM/YY)” in the remarks section of the CMS-40B form or online application.
  • If possible, your employer should complete Section B.
  • If your employer is unable to complete Section B, please complete that portion as best as you can on their behalf and submit 1 of the following forms of secondary evidence:
    • Income tax form that shows health insurance premiums paid.
    • W-2s reflecting pre-tax medical contributions.
    • Pay stubs that reflect health insurance premium deductions.
    • Health insurance cards with a policy effective date.
    • Explanations of benefits paid by the GHP or LGHP.
    • Statements or receipts that reflect payment of health insurance premiums.

You’ll have Original Medicare (Part A and Part B) unless you make another choice. You can decide to add a drug plan (Part D) or buy a Medigap policy to help pay for costs that Original Medicare doesn’t cover. You can choose to join a Medicare Advantage Plan (Part C) and get all your Medicare coverage bundled together in 1 plan. This coverage includes drugs and extra benefits like vision, hearing, dental, and more.

Some people with limited resources and income may also be able to get Extra Help to pay for Part D drug costs.

What Happens After I Apply?

The Centers for Medicare & Medicaid Services (CMS) manages Medicare. After you are enrolled, they will send you a Welcome to Medicare packet in the mail with your Medicare card. You will also receive the Medicare & You handbook, with important information about your Medicare coverage choices.

Medicare Enrollment in Puerto Rico

If you live in Puerto Rico you will not receive Medicare Part B automatically. You will need to sign up for it during your IEP, or you may pay a penalty. To sign up, please call our toll-free number at 1-800-772-1213 (TTY 1-800-325-0778). You also may contact your local Social Security office. You can find your local Social Security office by using our Office Locator.

If you do not live in the U.S. or 1 of its territories you can also contact the Federal Benefits Unit that provides service to your country of residence.

Related Information

Medicare Benefits | SSA (1)

Medicare

Website: www.medicare.gov

Toll-free number:
1-800-MEDICARE
(1-800-633-4227)

TTY number: 1-877-486-2048

Medicare Benefits | SSA (2024)

FAQs

How do I get answers to Medicare? ›

Live chat with us, and find local organizations that can help answer your Medicare questions. You can also: Call us at 1-800-MEDICARE (1-800-633-4227). Help from Medicare is available 24 hours a day, 7 days a week, except some federal holidays.

Which people qualify for Medicare benefits responses? ›

What is Medicare? Medicare is a federal health insurance program for people age 65 or older. People younger than age 65 with certain disabilities, permanent kidney failure, or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig's disease), may also be eligible for Medicare.

How do I qualify for the $16728 Social Security bonus? ›

Have you heard about the Social Security $16,728 yearly bonus? There's really no “bonus” that retirees can collect. The Social Security Administration (SSA) uses a specific formula based on your lifetime earnings to determine your benefit amount.

Who is eligible for the Social Security bonus? ›

There is no specific “bonus” retirees can collect from the Social Security Administration. For example, you're not eligible to get a $5,000 bonus check on top of your regular benefits just because you worked in a specific career. Social Security doesn't randomly award money to people.

How do you qualify for $144 back from Medicare? ›

To qualify for the giveback, you must:
  1. Be enrolled in Medicare Parts A and B.
  2. Pay your own premiums (if a state or local program is covering your premiums, you're not eligible).
  3. Live in a service area of a plan that offers a Part B giveback.

Can AARP help with Medicare questions? ›

AARP's Medicare Question and Answer Tool offers practical and comprehensive information to help you navigate the program according to your own situation.

Is Medicare free at age 65 for seniors? ›

If you qualify for premium-free Part A: Your Part A coverage starts the month you turn 65. (If your birthday is on the first of the month, coverage starts the month before you turn 65.)

Can you be denied Medicare benefits? ›

Medicare can deny coverage if a person has exhausted their benefits or if they do not cover the item or service. When Medicare denies coverage, they will send a denial letter. A person can appeal the decision, and the denial letter usually includes details on how to file an appeal.

Which three groups of people are eligible for Medicare benefits? ›

Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig's disease).

At what age is Social Security no longer taxed? ›

Social Security tax FAQs

Social Security income can be taxable no matter how old you are. It all depends on whether your total combined income exceeds a certain level set for your filing status. You may have heard that Social Security income is not taxed after age 70; this is false.

When my husband dies, do I get his Social Security and mine? ›

In many cases, a surviving spouse can begin receiving 1 benefit at a reduced rate and allow the other benefit amount to increase. If you will also receive a pension based on work not covered by Social Security, such as government or foreign work, your Social Security benefits as a survivor may be affected.

What is the $1800 Social Security payment? ›

The $1800 payment is provided as part of the Social Security Paycheck, which includes benefits such as retirement, post-retirement, child care, disability, care allowance, attendance allowance, and survival.

Who is eligible for $134 day April 2024? ›

You should meet qualify through the $134/Day April Eligibility 2024 to get the Social Security Benefits from SSA. Being an American citizen and permanent resident is vital. You have to be at least 64 years old. You can't make more than $75,000 a year.

What is the Social Security 5 year rule? ›

• If you become disabled before your full retirement age, you might qualify for Social Security disability benefits. You must have worked and paid Social Security taxes in five of the last 10 years.

Can I get a tax refund if my only income is Social Security? ›

You would not be required to file a tax return. But you might want to file a return, because even though you are not required to pay taxes on your Social Security, you may be able to get a refund of any money withheld from your paycheck for taxes.

How to solve problems with Medicare? ›

Contact the MBO. If you have been unable to resolve your concern with your plan or 1-800-Medicare, ask a 1-800-MEDICARE representative to submit your complaint or inquiry to the MBO. The MBO will help to ensure that your inquiry is resolved appropriately.

What is the best resource to understand Medicare? ›

Centers for Medicare & Medicaid Services (CMS) provides information about Medicare coverage, Medicare health plans, Medicare quality initiatives and free publications. The Medicare Helpline: 1-800-MEDICARE (1-800-633-4227) TTY: 1-877-486-2048. Find your state Medical Assistance Office.

How do I get through to Medicare? ›

How to access
  1. Call 132 011.
  2. Visit the Medicare website.
  3. Email Medicare.
  4. Download the Express Plus app.

How long does it take to get a response from Medicare? ›

You can apply for Medicare online, by phone, or at a local Social Security office. Medicare applications typically take between 30 to 60 days to receive approval. The status of your application can be viewed online. You can also call or ask in person.

Top Articles
Latest Posts
Article information

Author: Msgr. Benton Quitzon

Last Updated:

Views: 5351

Rating: 4.2 / 5 (63 voted)

Reviews: 94% of readers found this page helpful

Author information

Name: Msgr. Benton Quitzon

Birthday: 2001-08-13

Address: 96487 Kris Cliff, Teresiafurt, WI 95201

Phone: +9418513585781

Job: Senior Designer

Hobby: Calligraphy, Rowing, Vacation, Geocaching, Web surfing, Electronics, Electronics

Introduction: My name is Msgr. Benton Quitzon, I am a comfortable, charming, thankful, happy, adventurous, handsome, precious person who loves writing and wants to share my knowledge and understanding with you.