Do you need to enroll in Medicare?

That's a question many people ask. Here's a brief description of how the Medicare enrollment process works.

You do not have to apply for Medicare if:

• You are already getting Social Security or Railroad Retirement benefit payments when you turn 65.
• You have been receiving disability benefits under Social Security or Railroad Retirement for 24 months. (Note: If you are under age 65 and have Lou Gehrig's disease (ALS), you get your Medicare benefits the first month you get disability benefits from Social Security or the Railroad Retirement Board.)

In these situations, you will automatically receive a Medicare card in the mail, showing benefits for both Part A (hospital care) and Part B (medical care).

You may have to apply if:

• You have not applied for Social Security or Railroad Retirement benefits.
• You were employed by the government.
• You have kidney disease.

How and when to apply

You should apply for Medicare 3 months prior to turning 65. As soon as you become eligible for Medicare benefits, contact the Social Security Office to learn how to enroll.

For most people, Part A is free -- there is no premium. The initial enrollment period for Part B and premium Part A (if you must purchase it) runs for seven months. This period begins three months before you turn age 65 and runs through three months after your birth month.

Even though you have seven months to enroll, if you do not sign up for Medicare during the first three months of your initial enrollment period, your coverage will not start until one to three months after you enroll.

In addition, if you do not enroll during your initial seven-month enrollment period, you will have to wait until the next "general enrollment period." The general enrollment period occurs each year from Jan. 1 through March 31. If you enroll at this time, your coverage will not begin until the following July 1.

Late enrollment and late enrollment penalties

It is extremely important that you enroll in Medicare during your initial enrollment period. If you do not, you will be subject to late charges or a premium surcharge.

The Part B premium goes up 10 percent for each 12-month period you were eligible but did not enroll. The increase in the Part A premium (if you have to pay a premium) is 10 percent no matter how late you enroll.

In certain situations you can delay your Medicare enrollment without penalty.

First, if you have been covered under an HMO, you can sign up for premium Part A at any time while in the HMO and up to eight months after the HMO coverage has ended. The premium surcharge, if any, may be waived.

Second, if you are 65 but you have group health coverage through your job or your spouse's job, you will not be penalized for delaying your enrollment. You may enroll in Part B or premium Part A at any time you are covered under another group health plan. However, you may also choose to wait and enroll during a special eight-month period. This special period would start with the month you or your spouse stops working or when you are no longer covered by the employer plan, whichever comes first.

If you do not enroll during this special enrollment period, you will have to wait until the next general enrollment period. Contact Social Security as soon as employment ends or if your employer health plan changes or ends so that you get the information necessary to enroll in Part B.

Also, note that the special enrollment period rules do not apply to you if you stop working or lose employer group health coverage during your initial enrollment period.

Questions?

If you have any questions in regard to eligibility or enrollment in the Medicare program, please contact the Social Security office at (800) 772-1213.