Medicare Benefits | SSA (2023)

Medicare is our nation's health insurance program for people age 65 and older. Certain people under the age of 65 may also qualify for Medicare, including people with disabilities and people with permanent kidney failure.

The program helps with medical expenses, but does not cover all medical expenses or the cost of most long-term care. You have choices about how you get Medicare coverage. If you choose original Medicare coverage (Part A and Part B), you can purchase supplemental Medicare coverage (Medigap) from a private insurance company.

The portions of Medicare

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

• Medicare Part A (hospital insurance) helps pay for hospitalization or limited time at a qualified care facility (after hospitalization). Part A also pays for some home nursing and palliative care.
• Medicare Part B (health insurance) helps pay for the services of doctors and other healthcare providers, home care, home medical care, durable medical equipment, and some preventive services.

Other parts of Medicare are managed by private insurers who follow the rules established by Medicare.

• Supplemental policies (Medigap) help pay Medicare co-payments, coinsurance, and deductibles.
• The Medicare Advantage plan (also known as Part C) includes all of the benefits and services covered by Part A and Part B (prescription drugs and additional benefits such as vision, hearing and dentistry) bundled into one plan.
• Medicare Part D (Medicare Prescription Drug Coverage) helps cover prescription drug costs.

Most people over the age of 65 are eligible for free Medicare Part A (hospital insurance) if they work long enough and pay Medicare taxes. You can enroll in Medicare Part B (health insurance) by paying a monthly premium. Some higher-income beneficiaries pay a higher monthly premium for Part B. For more information, seeMedicare Premiums: Rules for Higher-Income Beneficiaries.

Do I have to apply for part B (health insurance)?

Our online application allows you to enroll in both Part A and Part B of Medicare. Because you have to pay a premium for Part B, you can choose not to have this insurance.

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

If you accept automatic Medicare Part B enrollment or enroll during the first 3 months of your IEP, your coverage begins the month you first become eligible.If you enroll in the month you turn 65 or in the last 3 months of your IEP, your coverage will begin on the first day of the month following enrollment.

The table below shows when your Medicare Part B will take effect in 2023:

If you choose not to enroll in Medicare Part B but later choose to enroll later, your coverage may be deferred. You may have to pay a higher monthly premium as long as you have Part B. Your monthly premium increases by 10% for each 12-month period that you were eligible for Part B but did not claim. This does not apply if you sign up for a "Special registration period“ (SEP).

If you do not enroll in Medicare Part B during your IEP, you have one additional opportunity each year during the "General registration period"(GEP) from January 1st to March 31st. Your insurance cover begins on the first of the month following your registration. read our poststate health insuranceFor more information.

You may have a Health Savings Account (HSA) or health insurance based on your current employment. If so, you can check with your human resources office or insurance company about how enrollment in Medicare will affect you.

Special Registration Period (SEP)

Depending on the status of your spouse or spouse, you may have health coverage under a group health insurance plan.current job. If so, you may not need to apply for Medicare Part B at age 65. You can sign up for a"September’, which allows you to register for Part B during:

• Each month that you remain covered by the Group Health PlanjYour work or that of your spouse goes on.
• The 8-month period ends the month after you take out your group health insurance or underlying employment, whichever comes first.

How to apply online for Just Medicare

Will you be 65 or older within 3 months and still not ready to collect your monthly Social Security benefits? You can use our online application to apply for Medicare only and wait to apply for your retirement or spousal benefits later. It takes less than 10 minutes, there are no forms to sign and usually no paperwork is required.

Apply for Medicare only

Back to saved app|Check application status|Replace the Medicare card

To find out which documents and information you need to request, go to theOnline Medicare, Retirement, and Spouse Enrollment Checklist.

health cards

To protect your identity, your Medicare card has a unique Medicare number for you. If you haven't received your red, white, and blue Medicare card, you may need to correct something, such as: B. Your mailing address. You can update your mailing address by logging in or by creating your personal account.mi social insuranceInvoice. learn more aboutYour Medicare card.

Already enrolled in Medicare

If you have Medicare, you can get information and services online. find out howManage your benefits.

If you are enrolled in Medicare Part A and would like to enroll in Part B, fill out the formCMS-40B, Application for Medicare Enrollment – ​​Part B (Health Coverage). If you are applying for Medicare Part B for job loss or group health insurance, you must also fill out the formCMS-L564, Application for labor information.

You can use one of the following options to submit your application for registration during the special registration period:

1. Go to "Apply online for Medicare Part B during a special enrollment periodand completeCMS-40BjCMS-L564. Then upload your Group Health Plan or Large Group Health Plan proof.
2. Send yours by fax or postCMS-40B,CMS-L564, and secondary evidence forYour local social security office(see list of secondary evidence below).

Use:When filling out the formsCMS-40BjCMS-L564:

• Please state "I would like coverage of Part B (MM/YY) to begin" in the comments section of theCMS-40BOnline form or application.
• If possible, your employer should complete Section B.
• If your employer is unable to complete Section B, complete this part to the best of your ability on their behalf and submit one of the following forms of secondary evidence:
• Income tax form showing the health insurance premiums paid.
• W-2s reflecting pre-tax medical contributions.
• Payslips reflecting health insurance premium deductions.
• Health insurance cards with policy expiry date.
• Explanations of the services of the GHP or LGHP.
• Bank statements or receipts reflecting the payment of health insurance premiums.

You get Original Medicare (Part A and Part B) unless you choose otherwise. You may choose to add a Medication Plan (Part D) or take out a Medigap policy to help pay for expenses that Original Medicare does not cover. You can enroll in a Medicare Advantage Plan (Part C) and get all Medicare coverage in one plan. This coverage includes medication and additional services such as vision, hearing, dentistry and more.

Some people with limited income and resources may also be affectedextra helpto pay for Part D's drug costs.

What happens after the application?

The Centers for Medicare and Medicaid Services (CMS) administer Medicare. After signing up, you will receive aWelcome to MedicarePackage mailed with your Medicare card. You will also receive the Medicare & You Handbook with important information about your Medicare coverage options.

Enroll in Medicare in Puerto Rico

If you live in Puerto RicoYou will not automatically receive Medicare Part B. You must register during your IEP or you may pay a penalty. To register, call our toll-free number1-800-772-1213(TTY 1-800-325-0778). You can also contact your local social security office. You can find your local social security office through ourworkshop search.

related information

• Who should I contact, Social Security or Medicare?
• Apply for Medicare online even if you're not ready to retire
• Help fight Medicare fraud
• Get additional help with Medicare plan prescription drug costs
• More Medicare information
• Understand Medicare Parts C and D enrollment periods
• Choosing a Medigap Policy: A Guide to Health Insurance for People on Medicare
• Understand Medicare Advantage plans
• Mandatory Medicare coverage