Preparing for Medicare Advantage Plan enrollment when you’re new to Medicare

 

Enrolling in Medicare for the first time can feel overwhelming. It helps to break things into manageable pieces. First, understand if you’re eligible to enroll. Then, based on your eligibility, find your enrollment window. Finally, explore frequently asked questions about first time Medicare enrollment before digging deeper into more specific resources.  

 

What is Original Medicare?  

Offered by the federal government, it includes Part A (hospital insurance) and Part B (medical insurance) benefits. Original Medicare helps cover hospital and doctor visits. 

 

What is Medicare Advantage?  

Medicare Advantage plans combine all the benefits of Original Medicare Parts A and B, and may include your Part D Prescription Drug coverage built right in. Plus, some plans may include additional benefits. Medicare Advantage is offered by private insurance companies and is an alternative to Original Medicare as a way to receive parts A & B benefits.

 

Are you eligible for Medicare?  

You may be eligible for Medicare if you are a US citizen or permanent legal resident for the last five years. You must also be one of the following:  

• You are age 65 or older 
• You have received Social Security Disability Insurance (SSDI) benefits for at least 24 months 
• You have Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig’s disease)
• You have End‑Stage Renal Disease (ESRD), meaning permanent kidney failure requiring dialysis or a transplant

 

Finding your Medicare enrollment window 

Those who are about to turn 65, or just turned 65, are eligible for the Initial Enrollment Period, which lasts for seven months. Your window starts three months before your 65th birthday, the month of your birthday, and three months after. If you were born on the 1st of the month, the enrollment period begins four months before your 65th birthday and ends two months after your birthday month.

During your initial enrollment period, you can choose to receive your Medicare coverage through Original Medicare Parts A and B, or a Medicare Advantage company with a private insurance company.

Find out if you qualify for a Special Enrollment Period

 

Enrolling in Original Medicare for the first time 

If you’re currently receiving Social Security benefits at least four months before age 65, then you most likely are already enrolled in Original Medicare Parts A and B. You should get your Original Medicare card and details in the mail three months before your coverage starts.  

If you’re not automatically enrolled in Original Medicare Parts A and B, then you can request coverage from the Social Security Administration either online, by phone, or in-person.  

Then, if you want, you can enroll in a Medicare Advantage plan through a private insurance company. You can do this any time within your Initial Enrollment Period.