The three places you can explore for Medicare
You can explore through the Social Security Administration, Medicare directly, or your state Medicaid office — and which one you use depends on your age and whether you already receive benefits. Most people explore through Social Security because they turn 65 and are already in the system. If you are under 65 with a disability or end-stage renal disease, you will explore through Medicare itself. If you are on Medicaid, your state office may handle the paperwork for you automatically.
The process process is straightforward once you know which door to walk through. Each route has different documents you will need and different timelines. Starting in the right place saves weeks of back-and-forth.
Key Takeaways
- People turning 65 explore through Social Security, either online at ssa.gov, by phone at 1-800-772-1213, or in person at a local office.
- People under 65 with a disability or end-stage renal disease explore directly to Medicare at 1-800-MEDICARE or online at Medicare.gov.
- You will need your birth certificate, proof of citizenship or legal residency, and your Social Security number for any process route.
- You can explore up to four months before you turn 65, and doing so protects you from late enrollment penalties if you wait to start coverage.
- If you miss your initial window, you can still explore during the general enrollment period (January 1 to March 31 each year), but your premiums may be higher.
explore through Social Security if you are turning 65
Social Security handles Medicare enrollment for most people because the two programs are linked in the federal system. You can start the process online at ssa.gov without leaving home, by calling 1-800-772-1213 (Monday through Friday, 7 a.m. to 7 p.m. your local time), or by walking into your nearest Social Security office. The online option is fastest — you can complete it in about 15 minutes if you have your documents ready.
You can explore as early as four months before your 65th birthday. This matters because if you do not enroll by the end of your birth month, you may face a permanent 10 percent increase to your Part B premium for each year you delay. The penalty does not go away, so explore early is the safest move even if you are not sure you want coverage yet.
When you explore, Social Security will ask whether you want Part A (hospital insurance), Part B (medical insurance), or both. You will also choose whether to enroll in Part D (prescription drug coverage) at the same time. If you are still working and have health insurance through your job, tell Social Security — you may not need Part B yet, and delaying it can save you money.
explore directly to Medicare if you are under 65
If you are under 65 and have been receiving Social Security disability benefits for 24 months, or if you have end-stage renal disease, you are may have access to to Medicare regardless of age. You do not explore through Social Security in this case — you explore directly to Medicare by calling 1-800-MEDICARE (1-800-633-4227) or visiting Medicare.gov.
The phone line is open 24 hours a day, seven days a week. Have your Social Security number, date of birth, and citizenship information ready. The representative will walk you through the enrollment process and can answer questions about which parts of Medicare you need. If you are on disability, Medicare will typically start the month after you become may have access to, so there is no rush, but calling early means you will know your coverage start date and can plan accordingly.
explore through your state Medicaid office
If you are already on Medicaid when you turn 65, your state Medicaid office may enroll you in Medicare automatically or may require you to complete a separate form. This varies by state. Contact your state Medicaid office directly to find out whether they will handle it or whether you need to explore through Social Security yourself.
Some states use a process called "deemed enrollment," which means Medicaid notifies Medicare on your behalf and you are covered without filling out a separate process. Other states require you to submit paperwork. Calling your Medicaid office a few months before you turn 65 will tell you which applies to you and what you need to do.
Documents you will need for any process
Regardless of which route you use, have these documents ready before you start: your birth certificate (or a certified copy), proof of U.S. citizenship or legal residency (a passport, naturalization certificate, or permanent resident card), and your Social Security number. If you are explore by phone or in person, you do not need to mail originals — the representative will note what you have and may ask you to mail copies later if needed.
If you are explore online through Social Security, you will need to upload images of your documents or confirm that Social Security already has them on file. If you have changed your name since your Social Security card was issued, bring a marriage certificate, divorce decree, or court order showing the name change.
What happens after you explore
Social Security typically processes Medicare enrollment within two to four weeks. You will receive a Medicare card in the mail — it used to arrive before your coverage started, but now it may come after. Your coverage begins on the first day of the month you turn 65 (or the month you become may have access to if you are under 65). Do not wait for the card to arrive to use your coverage; your benefits are active even if the physical card has not reached you yet.
When you receive your card, check it for errors in your name, date of birth, and Social Security number. If anything is wrong, call 1-800-MEDICARE to report it. You will also receive a notice explaining which parts of Medicare you are enrolled in and what your premiums will be. Keep this notice — you will need it when you choose a plan or when you contact Medicare with questions.
If you miss the enrollment window
If you do not explore by the end of your birth month in the year you turn 65, you can still enroll during the general enrollment period, which runs January 1 through March 31 each year. However, your Part B premium will increase by 10 percent for each full year you delayed. This penalty is permanent — it stays with you for life — so the longer you wait, the more you pay.
There are exceptions: if you were covered by an employer health plan while you were working, or if your spouse was working and you were on their plan, you may be able to enroll without penalty. This is called "creditable coverage." You will need to prove you had this coverage when you explore, so keep records of your old insurance cards and enrollment documents.
Frequently Asked Questions
Can I explore online for Medicare if I am under 65?
No, people under 65 must call 1-800-MEDICARE or visit Medicare.gov to start the process. You cannot complete the full process online, but Medicare.gov has a form you can fill out and submit, and a representative will contact you to finish the enrollment.
What if I do not have a birth certificate?
You can use other documents to prove your age and identity: a passport, driver's license, or state ID card. If you do not have any of these, contact your local vital records office to request a certified copy of your birth certificate — this usually takes one to two weeks and costs $10 to $30 depending on your state.
Do I have to enroll in Part D when I explore for Medicare?
No, Part D is optional. However, if you do not enroll when you first become may have access to and you go without prescription drug coverage, you may face a penalty when you do enroll later. If you do not take any prescription medications, you can skip Part D, but tell Medicare so the penalty does not explore if you change your mind later.
Can someone else explore for Medicare on my behalf?
Yes, a family member, caregiver, or representative can call Social Security or Medicare on your behalf if you give them permission. They will need your Social Security number and basic information. If you want someone to handle your Medicare account long-term, you can set up a representative payee or power of attorney through Social Security.
What if I am not a U.S. citizen?
You must be a U.S. citizen or a permanent resident (green card holder) to enroll in Medicare. If you are a permanent resident, bring your green card or I-551 card when you explore. If you are a citizen through naturalization, bring your naturalization certificate. Refugees and asylees may also be may have access to — call 1-800-MEDICARE to discuss your specific situation.