Enroll in Original Medicare

Getting Started

Original Medicare is the federal health insurance program for people 65 and older, as well as certain individuals with disabilities. It consists of two parts: Part A, which covers inpatient hospital care, and Part B, which covers doctor visits, outpatient services, and preventive care.

Part A is generally premium free, with some exceptions for those who have not paid nor have their spouse paid 40 quarters of Medicare taxes through an employer. Medicare beneficiaries pay a monthly premium for Part B, and with a standard amount set annually. If your income exceeds certain thresholds, you may pay more than the standard amount for your Part B. This is called IRMAA, or the Income Related Monthly Adjustment Amount.

Together, Parts A and B form the foundation of Medicare coverage — but they do not cover everything. Most people add a prescription drug plan and either a Medicare Supplement or Medicare Advantage plan to fill the gaps. To understand your coverage and your up-to-date cost sharing responsibility with Original Medicare, including current IRMAA thresholds, visit CMS.gov.

This guide is designed to help you complete your Part A and Part B enrollment on your own timeline. Once you're enrolled, we're ready to help you choose the right coverage for your situation.

On this page:

Medicare enrollment rules, deadlines, and forms are subject to change. Always verify current information at SSA.gov, CMS.gov, or by calling 1-800-MEDICARE (1-800-633-4227).

This guide is intended as general educational information and does not constitute enrollment or legal advice.

Section 1: Understanding Your Enrollment Window

When you enroll in Medicare depends on your situation. Getting the timing right matters — late enrollment in Part B triggers a permanent penalty added to your monthly premium for as long as you have Medicare.

Initial Enrollment Period (IEP)

Your IEP is a 7-month window surrounding your 65th birthday:

3 months before the month you turn 65
The month you turn 65
3 months after the month you turn 65

Timing matters within your IEP: Enrolling in the first 3 months means your coverage starts the first day of your birthday month. Enrolling after your birthday month delays your start date. Enroll as early as possible to avoid gaps in coverage.

Are You Already Receiving Social Security Benefits?

If yes — you will be automatically enrolled in both Part A and Part B. Your Medicare card will arrive by mail before your 65th birthday. You do not need to take any action. You can decline Part B if you have other qualifying coverage — see the employer coverage section.

If no — you need to actively enroll. This guide walks you through the process.

Special Enrollment Period (SEP)

If you or your spouse have creditable employer-sponsored health coverage when you turn 65, you may delay Part B enrollment without penalty. Creditable coverage means that Medicare has determined it as at least as good at what Medicare would provide. You can find out of your coverage is creditable by contacting your employer or the insurance carrier. When that coverage ends, you have an 8-month SEP to enroll in Part B without penalty. See Section 5 for full details.

General Enrollment Period — and the Late Penalty

If you miss your IEP and don't qualify for an SEP, you can enroll January 1 through March 31 each year, with coverage starting the first day of the month after you apply. You will incur a Part B penalty if you do not use your IEP and you do not have other, creditable coverage. The late enrollment penalty is permanent: 10% is added to your Part B premium for every 12-month period you were eligible but did not enroll. This penalty never goes away.

Part A Only Enrollment

In some situations you may want to enroll in Part A during your IEP, which is premium free for most people, but delay Part B, which has a monthly premium:

You are still working and have employer coverage that qualifies as primary — you can enroll in Part A while delaying Part B
Part A is usually premium-free if you or your spouse have worked and paid Medicare taxes for at least 10 years
If you pay a premium for Part A, your enrollment decisions are different — call us to discuss your specific situation

HSA Important Note: If you are currently contributing to a Health Savings Account (HSA), enrolling in Part A — even premium-free Part A — will affect your ability to contribute. See our blog post on HSAs and Medicare before making this decision.

Section 2: Enroll Online Part 1 — Setting Up Your SSA.gov Account

Before you can enroll in Medicare online, you need an account on SSA.gov. If you already have one, skip to Section 3.

Before You Begin — What You'll Need

SSA.gov requires identity verification through Login.gov or ID.me. This is a one-time process. Have the following ready before you start:

• A smartphone or tablet with a working camera —

you will be asked to photograph your government-issued ID and take a selfie for identity verification

• A valid government-issued photo ID — driver's license or passport

• Access to your email or phone for verification codes — keep your device nearby

• Your Social Security number

• A valid email address

If you already have a Login.gov or ID.me account, use that — do not create a new one.

If you do not have a smartphone or a device with a camera, phone or in-person enrollment may be a better option. See Section 4.

Creating Your SSA.gov Account — Step by Step

Go to SSA.gov — the official Social Security Administration website
Click "Sign In or Create an Account" on the homepage
Choose Login.gov or ID.me — if you have an existing account with either, use it. If not, select one and follow the prompts to create your account
Verify your identity — you will be asked to photograph your government-issued ID and take a selfie. Follow the on-screen instructions carefully. Ensure good lighting for both photos
Enter a verification code sent to your email or phone — have your device ready
Set up your username, password, and security preferences
Once your account is created, you will be returned to SSA.gov and can access your account

If you run into trouble with any part of this process, give us a call at 763-878-5994. We're happy to help.

What Your SSA.gov Account Gives You Access To

Your Social Security earnings history and benefit estimates
Your current benefit status and payment information if you are already receiving benefits
Online application for Medicare Parts A and B
Application status tracking
Ability to update direct deposit and other account information

Section 3: Enroll Online Part 2 — Step by Step

Online enrollment is the fastest path and is available once your SSA.gov account is set up. The application takes approximately 30 minutes. You can save and return to it if needed.

Information to Have Ready

Your Social Security number
Your date and place of birth
Your current address and phone number
Current or previous employer information if you have or had employer health coverage — name, address, and phone number
Current health insurance information — including any coverage through MNsure or an employer plan
Your Medicare number if you already have one and are applying for additional parts

Enrollment Steps

Log into your SSA.gov account
Select "Apply for Medicare" from your dashboard
Choose whether you are applying for Part A, Part B, or both
Complete the application — answer all questions carefully, especially those about current or recent employer coverage
Review your application before submitting
Submit and save your confirmation number — you will receive it on screen and by email

What Happens Next

SSA will review your application — typically 2 to 6 weeks
You will receive a letter confirming your enrollment and effective date
Your Medicare card will arrive by mail — keep it in a safe place
Your Medicare number is not your Social Security number — it is a unique identifier assigned to you

Section 4: Enroll In Person or By Phone

Phone and in-person enrollment are available, but plan for a significantly longer timeline than online enrollment.

Both phone and in-person enrollment require calling Social Security first to schedule an appointment. Walk-ins are generally not accepted at local offices.

• Hold times when calling to schedule are typically 2 hours or more

• Phone appointments are generally available 2 to 4 weeks out from when you call

• In-person appointments at your local SSA office are generally 4 to 6 weeks out

If you are approaching an enrollment deadline — IEP or SEP — factor this timeline in. The online process is significantly faster if you have a deadline to meet.

To Schedule — Call Social Security

Phone: 1-800-772-1213

Hours: Monday through Friday, 8am to 7pm local time

TTY: 1-800-325-0778

Have your documents and information ready before your appointment — the same information listed in Section 3 applies. For in-person appointments, bring originals or certified copies. Photocopies are generally not accepted.

Finding Your Local SSA Office

Use the SSA office locator at SSA.gov/locator to find the office nearest you.

Section 5: If You Have or Have Recently Lost Employer Coverage

This section covers two common scenarios. Read the one that applies to your situation.

Scenario A — You Are Still Working and Have Employer Coverage

You may delay Part B enrollment without penalty while you or your spouse are actively employed and covered by an employer group health plan.

Important distinctions:

• Coverage through a current employer qualifies — COBRA and retiree coverage do not

• The coverage must be creditable. Contact your employer or your carrier to find out if your coverage meets this requirement.

• When your employer coverage ends, you have an 8-month Special Enrollment Period to enroll in Part B

• You may enroll in Part A now while still under employer coverage — but review our HSA blog first

• If you are on your spouse's employer creditable plan and your spouse is still actively employed, you may delay Part B

Scenario B — You Have Recently Lost Employer Coverage

You qualify for a Special Enrollment Period (SEP). You have 8 months from the date your employer coverage ended to enroll in Part B without penalty.

The Two Forms You Will Need

Form CMS-40B — Application for Enrollment in Medicare Part B

Form CMS-L564 — Request for Employment Information

This form verifies that you had qualifying employer coverage. Your employer — or your spouse's employer — completes Section B of this form.

How to Submit

Download both forms above, or at CMS.gov or request them from your local SSA office
Complete your sections of each form
Give Section B of the CMS-L564 to your employer or your spouse's employer to complete
Submit both completed forms to your local SSA office — by mail or fax (Milestone Medicare can fax for you)

If Your Employer Is Unresponsive or No Longer in Business

You still have options. SSA will accept alternative documentation to verify your prior coverage. Bring as much of the following as you can:

W-2 forms showing employer-sponsored health coverage
Pay stubs showing health insurance premium deductions
Health insurance cards with employer name and coverage dates
Any official correspondence showing your coverage dates

SSA has discretion to accept reasonable alternative evidence. Call us if you need help navigating this — 763-878-5994.

If Your Coverage is Through a Spouse's Employer

You are covered under your spouse's employer plan and your spouse is still actively employed → you may delay Part B
Your spouse retires or loses their job → this triggers your SEP. You have 8 months from that date
You are on COBRA following your spouse's job loss → COBRA does not qualify as employer coverage for SEP purposes — enroll in Part B immediately

Section 6: After Applying for Original Medicare

It will usually take Social Security between 30 and 60 days to process your application for Medicare. Once you receive your Medicare card and enrollment confirmation letter:

Note your coverage effective date — this determines when you can enroll in a Medicare Advantage plan or Supplement policy
Original Medicare covers many healthcare services, but not everything — prescription drugs, dental, vision, hearing, and other gaps need to be addressed separately
You have options: Medicare Advantage (Part C), Medicare Supplement (Medigap) paired with a standalone Part D drug plan, or Original Medicare with a standalone Part D plan
Keep your Medicare card in a safe place — your Medicare number is sensitive personal information

Once your Medicare card arrives and your coverage is active, we're ready to help you compare plan options and get enrolled in the coverage that fits your situation — and our services are available at no cost to you! Call us at (763) 878-5994, email info@milestonemedicare.com, or fill out the form below.

Section 7:
Let Us Know!

Once you've completed your Part A and/or Part B enrollment, let us know. We'll reach out to set your enrollment appointment for about 30 days from the date you apply— right around the time your Medicare card arrives — to help you choose the plan that fits your situation. Note that submitting this form allows Milestone Medicare permission to contact you via Medicare's guidelines.