Your Clients May Not Be Automatically Enrolled in Medicare

Will your clients be automatically enrolled in Medicare Parts A and B when they turn 65? It’s more complicated than they may realize, and it’s something to plan months ahead.

For years, the popular belief has been that individuals were automatically enrolled in Medicare upon reaching age 65. That’s not the full story, and further preparation by your clients may be needed. Keep them in the loop and let them know where they stand before retiring.

Listen to this article:

Automatic Enrollment

If your clients are already receiving their social security benefits, good news, they’ll automatically be enrolled in both Parts A and B. They’ll receive coverage the first day of their birth month, unless their birthday is on the first — in which case, coverage will start the first day of the prior month.

For those who elect to defer social security benefits past 65, Medicare enrollment won’t happen automatically. Here’s a refresher on when and how to help your clients enroll in Original Medicare when they become eligible.

For those who elect to defer social security benefits past 65, Medicare enrollment won’t happen automatically.

Before Turning 65

Those eligible for Medicare upon turning 65 have a seven-month Initial Enrollment Period (IEP), generally starting three months before the month they turn 65 and ending three months after their birthday month. If your client has a birthday on the first of a month, however, their IEP starts four months before they turn 65 and ends two months after their birthday month. The earlier your clients sign up for Parts A and B, the better.

Those who sign up for Part A and/or Part B within the first three months of their IEP will receive coverage depending on their birthday. For instance, if your client’s birthday is February 11, their coverage will start on February 1. The only exception is those with birthdays on the first day of a month. They receive coverage the month prior to their birthday. For example, if your client’s birthday is on February 1, their coverage will start January 1.

However, if your client waits to enroll until the month of their birthday through the last months of their IEP, their coverage will be delayed. Starting in 2023, they will receive coverage one month after they sign up.

Before Retiring

As your clients near 65 and learn about social security benefits, they’ll likely come across information regarding Medicare.

There are several factors to consider when approaching retirement age, and many of your clients may choose to retire after their IEP ends. In that case, you should help them sign up for Medicare Parts A and B before they turn 65. If your clients defer receiving retirement benefits, they can apply for Medicare alone by using the online retirement application.

Many of your clients may not retire until after their IEP ends. In that case, you should help them sign up for Medicare Parts A and B before they turn 65.

Medicare Parts A & B

If your 65-and-older clients have worked and paid Medicare taxes for the required amount of time, they may be eligible for free Medicare Part A (hospital insurance). This is great news, but they should still sign up for Part A in the three months before their birth month to avoid a delay in coverage.

Those eligible for Part A can pay a monthly premium to receive Part B (medical insurance), and should enroll in both at the same time to receive timely coverage. Waiting to sign up for Part B may result in a delay in coverage, as well as a higher premium.

There’s a lot to go over when signing clients up for Medicare. Help answer their questions, or give them some reading material to prepare with Medicare.gov’s “Enrolling in Medicare Part A & Part B” booklet.

Editor’s Note: This post was originally published in March 2018. It has been updated to include relevant information to the 2023 plan year.