You’ll receive your Medicare card in your Welcome to Medicare package, but when it arrives depends on how you enroll in Medicare:
If you receive Social Security benefits at least four months before your 65th birthday, your enrollment in Medicare is automatic. You’ll receive your card in the mail three months before your Medicare coverage starts.
You can start using the card at the beginning of the month you turn 65 or the first day of the previous month if your birthday falls on the first. The start date for Part A and Part B will appear on the front of the card.
You’re enrolled automatically in parts A and B, except in Puerto Rico, where you’re enrolled automatically only in Part A.
Most people don’t pay premiums for Part A because they or their spouse had Medicare taxes deducted from their paychecks for at least 40 quarters of work, the equivalent of 10 years. But you will pay premiums for Part B.
Your Medicare Part B premiums, $174.70 a month in 2024, are typically deducted automatically from your Social Security benefits. High earners pay higher premiums.
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If you receive Social Security benefits and are enrolled in Medicare automatically, you must keep Part A coverage. You can decide whether you want to keep Part B.
If you don’t have health insurance from your own or your spouse’s current employer, you usually need to keep Part B. Otherwise, you may have coverage gaps and have to pay a late enrollment penalty if you sign up later.
If you or your spouse is still working and you have health insurance from a company with 20 or more employees, you may not need Part B or its premiums yet. If you don’t want to keep Part B, check the box on the back of the Medicare card that says, “I do NOT want Part B (Medical Insurance),” sign the back of the card and send it back to Medicare.
You’ll receive a new card in a few weeks noting that you’re enrolled in Part A only.
Jot down your Medicare number before you return the card in case you need to use your Part A benefits before the new card arrives. And don’t forget to sign up for Part B no later than eight months after losing employer coverage to avoid a late enrollment penalty.
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If you don’t receive Social Security benefits at 65, you’ll need to take steps to sign up for Medicare. When you complete the enrollment process, expect the card to arrive in the mail along with your Welcome to Medicare package about two weeks later. For people born in 1943 and later, the age to receive full Social Security benefits is 66 and older. Even though you can wait to sign up for Social Security, you should be ready to make Medicare decisions at 65.
Most people need to sign up for Medicare during their initial enrollment period, which begins three months before the month they turn 65 and continues until three months after their birthday month. You may be able to delay if you or your spouse is still working and you have coverage from that active employer, depending on the size of the company. It generally needs to be 20 employees or more.
Some people with employer coverage still sign up for premium-free Part A at 65. But if you have a high-deductible health plan and want to continue contributing to a health savings account, you should delay your Medicare sign-up.
If you enroll in Medicare:
If you didn’t sign up during your initial enrollment period because you had health insurance from an active employer, you can qualify for a special enrollment period that lasts for up to eight months after you or your spouse leaves the job and loses the coverage.
If you miss your initial enrollment period and don’t qualify for a special enrollment period, you’ll have to wait to sign up until the next general enrollment period, Jan. 1 to March 31 annually. Coverage will begin the month after you enroll. But be aware: Depending on your circumstances, you may face a late enrollment penalty.
