Call us toll-free at: 1-866-424-0903 (TRS 711)
  • Overview
  • When can I enroll?
  • When will my coverage begin?
  • What if I enroll late?
  • When can I change my current coverage?

Enrolling in Medicare

Now that you are thinking about the coverage that you want, let’s review when you can enroll in Medicare.

You may automatically become enrolled in Medicare Part A when you turn 65. This automatic enrollment typically happens if you are already receiving benefits from Social Security or the Railroad Retirement Board (RRB). If you are automatically enrolled, you will receive your Medicare card three months before your 65th birthday. You will need to elect enrollment into
Part B.

If you are not receiving Social Security or RRB benefits, then you won’t be automatically enrolled in Medicare, and you won’t be notified of your Medicare eligibility. You will have to contact the Social Security Administration to begin your enrollment in Medicare. You can first sign up for Medicare Parts A and B when you become 64 years and 9 months old. Medicare also refers to this time as your Initial Enrollment Period.

To enroll, you can contact the Social Security Administration:

  1. Online—ssa.gov
  2. Phone—1-800-772-1213 (TTY: 1-800-325-0778)
  3. In person—visit your local Social Security Office

To enroll in a Part C (Medicare Advantage), Part D (prescription drug plan) or Medicare Supplement (Medigap) Plan, you will have to contact a private health plan that offers the coverage you are interested in. To compare your options first, you can visit medicare.gov or speak with a counselor from The Serving the Health Needs of Everyone (SHINE) Program. Contact information for these programs is in the "Learn more" section of this site.

When can I enroll in Medicare?

Initial Enrollment Period (IEP)

  • Begins 3 months prior to the month of your 65th birthday
  • Includes the month of your 65th birthday
  • Ends 3 months after the month of your 65th birthday

Types of coverage you can sign up for:

  • Original Medicare (Part A and/or Part B)
  • Medicare Advantage Plans (Part C)
  • Medicare Prescription Drug Plans (Part D)
  • Medicare Supplement (Medigap) Insurance

Special Enrollment Period*

For those who have special circumstances including:

  • Lost health plan coverage provided by an employer/union group
  • Moved out of current plan service area
  • Current health plan no longer offers coverage in your area

Types of coverage you can sign up for:

  • Original Medicare (Part A and/or Part B)
  • Medicare Advantage Plans (Part C)
  • Medicare Prescription Drug Plans (Part D)
  • Medicare Supplement (Medigap) Insurance

General Enrollment Period

  • January 1 to March 31, every year
  • Only open to those who did not sign up during their IEP or who do not qualify for a Special Enrollment Period

Types of coverage you can sign up for:

  • Original Medicare (Part A and/or Part B)

* This is not a complete list of Special Enrollment Periods that are available.


Want to join a Medicare Supplement Plan?

The best time to join one of these plans is during the six month-time period that begins the month you turn 65 or older and are enrolled in Medicare Part B. However, most health insurance carriers allow you to join these types of plans any time during the year, as long as you are enrolled in Medicare Parts A and B.

Plan to work after 65?

If you or your spouse will continue to work after the age of 65 and you will receive coverage through an employer or union group, you may be eligible to join Medicare during a special enrollment period.

When will my coverage begin?

Whether you are working or retired, Medicare Part A coverage will typically begin on your 65th birthday. The start date of other Medicare coverage will be determined by the type of plan you choose and by the date you enroll.

If you sign up for Medicare during your Initial Enrollment Period

You enrolled…

Your coverage begins…

During the 3 months before your 65th birthday

The first day of your birthday month*

The month you turn 65

1 month after you sign up

1 month after you turn 65

2 months after you sign up

2 months after you turn 65

3 months after you sign up

3 months after you turn 65

3 months after you sign up

* If your birthday is on the first day of the month, your coverage starts the first day of the month prior to your birthday.
Example: If your birthday in on July 1, and you sign up for Medicare in March, April, or May, your coverage will begin on June 1.

If you sign up for Medicare outside of your Initial Enrollment Period

You signed up for Medicare during …

You are able to enroll in this type of coverage

Your coverage begins

Medicare’s Annual Enrollment Period

Anytime from October 15 to December 7

Part A
Part B
Part C
Part D
Medicare Supplement (Medigap)

January 1

Special Enrollment Period*

  • the time you are still covered by an employer or union group health plan—through you or your spouse
  • the 8 months following the month that the employer/union group coverage ends, or when the employment ends—whichever happens first**
  • 63 days after the loss of employer/union group healthcare coverage or when employment ends (whichever is first)***

Part A
Part B
Part C
Part D
Medicare Supplement (Medigap)

The first day of the month following your enrollment

General Enrollment Period

  • January
  • February
  • March

Part A
Part B

July 1

* This is not a complete list of Special Enrollment Periods that are available.
** You can only enroll in Part A and/or B during this time.
*** You can only enroll in Part C (Medicare Advantage) or Part D during this time
.


Enrolling in Part C or D?

If you join a Medicare Advantage (Part C) or a Medicare Prescription Drug (Part D) Plan before you turn 65, your coverage begins the first day of the month in which you turn 65. Otherwise, your coverage—in either plan—begins the first day of the month following your enrollment.

What happens if I enroll late?

In some cases, delaying enrollment can subject you to a penalty.

I enrolled late in …

Will I have to pay a penalty?

How much is the penalty?

How long will I have to pay the penalty?

Part A

Yes

10% of the current Part A premium

Twice the number of years you were eligible for Part A but did not pay.
Example: You enrolled in Part A three years after you became eligible, therefore, you will pay the penalty for six years.

Part B

Yes*

10% of the current Part B premium for each full 12-month period you wait to enroll

You will pay this penalty for as long as you have Part B coverage.

Part D

Yes**

1% of the average monthly prescription drug plan premium (1% of $33.13 in 2015 or 33 cents), multiplied by the number of months you were late enrolling, rounded to the nearest 10 cents.

You will pay this penalty for as long as you have Part D coverage

*  You won't pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period. For example, if you or your spouse has health insurance through current employment, then you may not need Part B right away. You would qualify to sign up during a Special Enrollnebt Period without penalty when the employment or the health insurance ends.
** Those who are eligible for Extra Help with the costs of Medicare Part D prescription drugs will not have to pay a late enrollment penalty.

Example: I’m enrolling in a Part D Plan, but I’m late. How much will I pay?

In 2015, the average monthly premium for a Part D Plan is $33.13. If you enrolled in a Part D Plan six months late, in 2015, the calculation would look like:

$0.33
(1% percent of the average monthly prescription drug plan premium)

Multiplied by

6
(the number of months you were late enrolling)

=

$1.98
This number must be rounded up or down to the nearest 10 cents, meaning that your monthly penalty would be $2.00.

Your monthly Part D Plan premium with the penalty included would be $35.13 ($33.13 + the $2.00 penalty). This cost may go up each year you’re enrolled in a Part D Plan.

Want to change your current Medicare coverage?

If you have Medicare coverage but want to switch the way you get Medicare, you can do so during the following times:

When you can switch your coverage What you can do

Annual Enrollment Period

October 15-December 7

  • Join Medicare Advantage Plan.
  • Switch to a different Medicare Advantage Plan.
  • Join a Medicare Supplement (Medigap) Plan.
  • Switch to a different Medicare Supplement (Medigap) Plan.
  • Join a Medicare Prescription Drug Plan (Part D).
  • Switch to a different Medicare Prescription Drug Plan (Part D).
  • Your coverage will begin on January 1 of the following year.

Medicare Advantage Disenrollment Period

January 1-February 14

  • Leave your current Medicare Advantage Plan to return to Original Medicare (Medicare Parts A and/or B) coverage, only.
  • Join a Medicare Supplement (Medigap) Plan.
  • Switch to a different Medicare Supplement (Medigap) Plan.
  • Enroll in a Medicare Prescription Drug Plan (Part D).
  • Change will be effective on the first day of the month following the receipt of your enrollment or disenrollment request.

Special Enrollment Period

If you are eligible for a Special Enrollment Period, you may also be able to switch the way you receive your coverage during that time. Please see the "When can I enroll?" tab for more information.

Fallon Health is an HMO/HMO-POS plan with a Medicare contract and a contract with the Massachusetts Medicaid program. Enrollment in Fallon Senior Plan and NaviCare depends on contract renewal.

NaviCare is a voluntary program in association with MassHealth/EOHHS and CMS.


H9001_F_2015_37_r2 07312015
H9001_N_2015_14_r4 07312015
The information on this page was last updated on 6/24/2015.