What are you supposed to do first, and when? That’s the question almost everybody asks, and you’ll find answer here.
Your seven month window
Your Initial Enrollment Period is the seven month stretch when you can first sign up for Medicare Part A and Part B. Medicare Part A is the hospital insurance. Medicare Part B is the medical insurance that covers doctor bills and office visits.
Medicare Part A is free for most people, but Medicare Part B has a monthly premium. If you have coverage from your or a spouse’s employer with 20+ employees, you may want to delay your Part B enrollment.
Your 7 month Initial Enrollment Period (IEP) for Medicare opens three months before the month you turn 65, includes your birthday month, and closes three months after it. If your 65th birthday is June 12, that’s March 1 through September 30.
Apply during the three months before your birthday month and Part A and Part B begin the first day of that month. Apply during your birthday month or later and coverage starts the first of the month after you apply, which is a gap you didn’t plan on.
The Lifetime Penalty To Avoid
Unless you have employer coverage (COBRA does not count) through your or a spouse’s employer with 20+ employees, if you miss your IEP, you may face a lifetime late enrollment penalty for Medicare Part’s B and D.
Applying is a Social Security task
You apply for Medicare Part’s A & B through the Social Security Administration, online at https://www.ssa.gov/benefits/medicare/
If you’re already drawing Social Security retirement benefits you’ll usually be enrolled automatically. If you’re not, nothing happens until you file.
Processing a completed application takes about four weeks and it can run longer, which is the reason to apply in the first month of your window rather than the last.
If you’re still working at 65
If your employer has 20 or more employees and you’re covered by its group plan, you can generally delay Part B without a penalty and pick it up later when that coverage ends. Most people still take Part A, since it’s usually premium free once you’ve paid in long enough. Under 20 employees the answer often flips, and delaying Part B can leave you with claims nobody pays.
A small employer’s plan in Maine is priced in the same risk pool as individual coverage, because the state merged those markets in 2023. That’s explained on Fully Insured Small Group.
Request a Medicare quote and send us your plan documents and your employee count and we’ll say plainly whether to take Part B now or wait.
The six months that matter most
When your Part B coverage starts, a six month Medigap open enrollment window starts with it. A Medicare Supplement, often called a Medigap plan, is a private policy that pays much of what Part A and Part B leave behind.
During those six months every Medicare Supplement carrier selling in Maine has to accept you. No health questions, no higher price for a diagnosis, no declines. As an example, if you have a June 12th birthday, that’s June 1 through November 30, 2027. Note that December 1st may fall outside the guarantee issue window for some carriers.
This is the best time in your life to buy a Supplement and it doesn’t come back. Maine does leave you more room afterward than most states do, including one guaranteed issue month a year per carrier for Plan A, covered on Maine’s Medicare Supplement switching rules.
Example: What to do when, using a June 12 birthday
- February. Gather your provider list and your prescriptions with doses. Confirm whether you’re keeping employer coverage.
- March 1. Your window opens. Apply at https://www.ssa.gov/benefits/medicare/ this month.
- April. Send us your Part A and Part B effective dates when your card arrives.
- April and May. We price Original Medicare with a Supplement and a Part D plan against the Medicare Advantage plans in your county, checked against your doctors and your medications.
- Early to Mid-May. Enrollment completed so everything starts June 1.
- June 1 through November 30. Your Medigap (Medicare Supplement) open enrollment window.
- September 30. Your Medicare Initial Enrollment Period closes.
Shift every date to match your own birthday. Request a Medicare quote, then have your doctors and your prescriptions ready for a twenty minute call with Maine Health Insurance Brokers.
BEST PRICE GUARANTEE
Maine Health Insurance Brokers. services are 100% FREE and there is no extra cost or mark-up. Whether you get your Medicare coverage through us, another agent/broker or directly from the insurer, you’ll pay the exact same monthly premium for the same plan.