• You can enroll in Medicare during specific times of the year.
  • Many people are automatically enrolled in Medicare if they’re already receiving retirement or disability benefits through Social Security or the Railroad Retirement Board.
  • Those who aren’t automatically enrolled will need to apply during an appropriate enrollment period.
  • You may be able to claim tax deductions for some of your out-of-pocket Medicare expenses, provided you meet certain income guidelines.

Medicare is a federal program that provides health insurance coverage to adults ages 65 and older, as well as people with certain health conditions or disabilities.

According to a 2017 article in the Journal of the American Geriatric Society, Medicare currently covers about 58 million individuals, and that number is expected to increase to 75 million by 2027.

Most people first become eligible for Medicare around the time they turn 65 years old. Many will be automatically enrolled, whereas others will need to sign up.

You can sign up during several different Medicare enrollment periods throughout the year.

Below, we’ll dive deeper into the different Medicare enrollment periods, how to apply for Medicare, and more of your Medicare questions.

You can enroll in Medicare only during certain times of the year. These time frames are called enrollment periods. When you’re enrolling in Medicare for the first time, you should be aware of two important enrollment periods:

  • Initial enrollment. This is when you’re first eligible for Medicare.
  • General enrollment. If you didn’t enroll in Medicare when you were first eligible, you can do so during this period, which lasts from January 1 through March 31.

In some circumstances, you can enroll in Medicare outside the standard enrollment periods. These times are called special enrollment periods.

An example of when this applies is when you didn’t enroll in Medicare when you were first eligible because you had coverage through an employer-provided health insurance plan. In this case, you could enroll in Medicare during a special enrollment period.

Medicare enrollment periods

The following list includes all the various Medicare enrollment periods you might need to know:

  • Initial enrollment period. This is a 7-month window around your 65th birthday when you can sign up for Medicare. It begins 3 months before your birth month, includes the month of your birthday, and extends 3 months after your birth month. During this period, you can enroll in all parts of Medicare without a penalty.
  • Open enrollment period (October 15–December 7). During this time, you can switch from original Medicare (parts A and B) to Part C (Medicare Advantage), or from Part C back to original Medicare. You can also switch Part C plans or add, remove, or change a Part D plan.
  • General enrollment period (January 1–March 31). You can enroll in Medicare during this time frame if you didn’t enroll during your initial enrollment period.
  • Special enrollment period. If you delayed Medicare enrollment for an approved reason, you can later enroll during a special enrollment period. You have 8 months from the end of your coverage or the end of your employment to sign up without penalty.
  • Medicare Advantage open enrollment (January 1–March 31). During this period, you can switch from one Medicare Advantage plan to another or go back to original Medicare. You can’t enroll in a Medicare Advantage plan if you currently have original Medicare.
  • Part D enrollment and Medicare add-ons (April 1–June 30). If you don’t have Medicare Part A but enrolled in Part B during the general enrollment period, you can sign up for a Part D prescription drug plan at this time.
  • Medigap enrollment. This 6-month period starts after the first day of the month that you apply for original Medicare or from your 65th birthday. If you miss this enrollment period, you may not be able to get a Medigap plan. If you do get one later, you may pay higher premiums for it.

If you’ve been receiving retirement benefits from the Social Security Administration (SSA) or Railroad Retirement Board (RRB) for at least 4 months before turning age 65, you’ll be automatically enrolled in original Medicare (parts A and B) and won’t need to apply.

Other times when you may be automatically enrolled in original Medicare include:

  • if you’re under 65 year old and have been receiving disability benefits from the SSA or RRB for 24 months
  • if you have amyotrophic lateral sclerosis and begin receiving disability benefits

If you aren’t automatically enrolled in Medicare you’ll need to apply during an enrollment period that applies to your situation. Examples of situations when you’d have to apply for Medicare include:

  • if you haven’t been receiving retirement benefits from the SSA or RRB in the 4 months prior to your 65th birthday
  • if you’ve been diagnosed with end stage renal disease

Enrolling in original Medicare

Original Medicare includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).

You can follow the steps below to enroll in original Medicare:

  1. Determine whether you’ve been automatically enrolled. If you haven’t, complete an application on the SSA website. You can also apply by calling the SSA directly (800-772-1213) or by visiting your local SSA office.
  2. Decide if you’d like to have Medicare Part B. This portion of original Medicare is optional, and some people may wish to delay getting it.
  3. Consider Medicare Advantage (Part C) plans offered in your area. Sometimes these plans may be more cost effective or offer additional benefits. If this is the case, you can choose to enroll in a Medicare Advantage plan at this time instead of original Medicare.
  4. If you’re sticking with original Medicare, decide if you’d like to enroll in a Part D (prescription drug) plan as an add-on. You can compare different Part D plans available in your area before choosing one.

If you enroll in original Medicare and would like to switch to a Medicare Advantage plan later, you can do so during Medicare’s open enrollment period. You can also add, remove, or switch a Part D plan at this time.

It’s also possible to switch from Medicare Advantage back to original Medicare. You can do this during the Medicare open enrollment period as well. If you do, you can also add a Part D plan as an add-on during this time frame.

Enrolling in Medicare Advantage

Medicare Advantage (Part C) plans are sold by private insurance companies. They provide the same coverage as original Medicare but may include additional benefits like:

When you’re first enrolling in Medicare, you can choose to purchase a Medicare Advantage plan instead of original Medicare. Compare different Medicare Advantage plans offered in your area before you select one.

Enrolling in Medicare Part D

Medicare Part D plans are also sold by private insurance companies and cover prescription drugs. They can be bundled with Medicare Advantage plans or sold as an add-on to original Medicare.

If you’re enrolling in a Medicare Advantage plan and want prescription drug coverage, know that you can’t purchase a separate Part D plan. Instead, you’ll need to select a plan that comes bundled with Part D coverage.

There are two different ways that you can enroll in a Part C or Part D plan:

  • Compare and purchase plans online using Medicare’s plan finder tool.
  • Contact a specific insurance company directly to learn about and purchase a plan.

Some parts of Medicare may have a late enrollment penalty. This is an additional cost applied to your premiums if you don’t enroll in Medicare when you’re first eligible.

Here’s a look at the late enrollment penalties for each part of Medicare:

  • Medicare Part A. If you pay premiums for Part A and don’t enroll when you’re first eligible, your premiums can go up by 10 percent. You’ll pay higher premiums for twice the number of years you were eligible for Part A but didn’t enroll.
  • Medicare Part B. If you don’t enroll in Part B when you’re first eligible, your premiums can increase by 10 percent for every 12-month period that you could’ve had Part B. You’ll pay this increased premium as long as you have Part B.
  • Medicare Part D. You pay a late enrollment penalty when you don’t have a Part D plan or other creditable prescription drug coverage for 63 or more days after you’re initially eligible for Medicare. The increase in the amount you pay is permanent and is based on how long you didn’t have coverage.
  • Medigap. Once the initial enrollment period and open enrollment period have passed, you may have a harder time enrolling in a Medigap plan. If you’d like a Medigap plan, you should apply as soon as you enroll in Medicare Part B. You can’t get a Medigap policy if you have Medicare Advantage.

It’s important to note that if you’re enrolling during a special enrollment period, you typically won’t have to pay late enrollment penalties. You can confirm this with Medicare when enrolling.

You may be able to claim tax deductions for Medicare premiums and other out-of-pocket expenses on your income tax return. However, you must meet certain guidelines to do so.

According to the IRS, you can deduct the total amount of medical or dental expenses that exceed 7.5 percent of your adjusted gross income (AGI).

Your AGI is your total income after taxes have been taken out. For example, an individual with an AGI of $40,000 would be able to deduct $3,000 worth of medical expenses on their tax return.

In order to claim a deduction for medical expenses, you must itemize your deductions using Schedule A (Form 1040 or 1040-SR), Itemized Deductions. The IRS provides detailed instructions on how to fill out this form here.

As you can see from the form, you’ll need to enter the total amount of your medical expenses for the applicable year. To calculate this information, it’s important to save documents such as your:

  • SSA-1099. This is a form sent by the SSA each January. It details the Social Security benefits that you received in the previous year. If you use Social Security to pay Medicare premiums, that payment information will be listed.
  • Medicare summary notices. This is a notice sent by Medicare every 3 months. It details both the amount that Medicare paid and the amount that you paid for services covered under Medicare parts A and B.
  • Insurance statements. If you have a Medicare Advantage or a Medicare Part D plan, you should receive insurance statements from the company that provides your plan.

Medicare premiums

There are some rules for claiming a deduction for the premiums associated with each part of Medicare. Let’s break this down further:

  • Medicare Part A. Most people don’t have to pay a premium for Part A. However, you can claim a deduction if you have to pay the Part A premium and you don’t receive Social Security benefits.
  • Medicare Part B. You may claim your Part B premiums as long as you meet the AGI guidelines discussed above.
  • Medicare Advantage (Part C). Like with Part B, you can claim your Medicare Advantage plan premiums as long as you meet AGI guidelines.
  • Medicare Part D. As with Part B and Part C, you may claim your Part D premiums provided you meet AGI guidelines.

Other out-of-pocket expenses

In addition to your Medicare premiums, you may be able to claim additional out-of-pocket medical costs. Some examples include:

If you’re self-employed

Tax deductions for medical expenses can be a little different if you’re self-employed. In this case, you may be eligible for a self-employed health insurance deduction.

You may take this deduction if you meet both of these conditions:

  • You’re self-employed.
  • You made a net profit in the applicable year.

This type of deduction allows you to deduct health insurance premiums before taxes. Doing this can make your AGI (and your taxable income) lower.

When using a self-employed health insurance deduction, you can also deduct the health insurance premiums you pay for your spouse and any dependents you claim on your tax return.

What if I still have more questions?

For additional help understanding Medicare enrollment and tax questions, you can use the following resources:

Healthline

You can enroll in Medicare only at specific times of the year. These are called enrollment periods.

Many people are automatically enrolled in original Medicare. This happens if you’ve already been getting retirement or disability benefits from the SSA or RRB. Others will have to apply for Medicare during one of the enrollment periods.

You have different options as far as your Medicare enrollment is concerned. For example, some people may choose to enroll in original Medicare, while others may select a Medicare Advantage plan provided by a private insurance company.

You can potentially claim tax deductions for some of your out-of-pocket Medicare expenses as long as they exceed 7.5 percent of your AGI. Save any documents related to your medical expenses so you have them on hand when filing your taxes.