You are eligible to apply for Medicare in the seven-month period that begins three months before your 65th birthday, including your birthday month, and ends three months after your birthday month. This is what is called your initial enrollment period. To learn more about when you can enroll click here.

Most people are eligible for Medicare when they turn 65. You may also be eligible if you have a disability, end-stage renal disease (ESRD), or Lou Ghrig’s disease (ALS). 
You can read more about who’s eligible for Medicare here.

You can enroll in Medicare Part A and/or Medicare Part B online at SocialSecurity.gov, over the phone by calling Social Security at 1-800-772-1213 (TTY users 1-800-325-0778) 8 am–7 pm Monday through Friday, or in person at your local Social Security office.

There are six enrollment periods for Medicare. They are:

1. Initial Enrollment Period (IEP) is the seven-month window when you can first sign up for Medicare Part A and/or Part B. For most, it’s when you turn 65/entitlement. The 7-month period includes the 3 months before you turn 65/entitlement, the month you turn 65/entitlement, and the 3 months after you turn 65/entitlement.
2. Initial Enrollment Period for Part D (Part D IEP) is the 3 months before, the month of, and 3 months after turning 65/entitlement (same as the Initial Enrollment for Part A and Part B). This is the time you can sign up for Medicare Part D, which covers prescription drugs when you’re first eligible. 
3. Annual Enrollment Period (AEP) is from October 15 to December 7, and during this time,you can change your Medicare Advantage (Part C) or Prescription Drug (Part D) plans for the next year.
4. Medicare Advantage Open Enrollment Period (MA OEP) from January 1 to March 31. If you already have a Medicare Advantage plan, you can switch to a different Medicare plan or return to Original Medicare.
5. Special Enrollment Period (SEP) is the time outside the other enrollment periods that you may make changes under certain circumstances. Moving outside your plan’s service area is just one example of how you can qualify for an SEP. 
6. Open Enrollment Period for Institutionalized Individuals (OEPI) is available to those staying in a long-term care facility (like a nursing home). You can enroll, switch, or drop coverage anytime during your stay in a long-term care facility, such as a nursing home. This period ends two months after you leave the facility.

To learn more about the enrollment periods, click here. 

Original Medicare is Part A (hospital insurance) and Part B (medical insurance). However, Original Medicare only covers 80% of your Part B expenses. You are responsible for the remaining 20%, which can add up.

Medicare Advantage (Part C) plans are offered through private companies, like Clover Health, which contract with Medicare and must have all the benefits of Original Medicare (Parts A and B). 

With many Medicare Advantage plans, you get a health plan, prescription drug coverage, and additional benefits, like dental, vision, hearing, fitness, and more, all with $0 or low monthly premiums. Plus, Medicare Advantage plans usually have lower out-of-pocket expenses.

Part A – Original Medicare hospital coverage 
Part B – Original Medicare medical coverage 
Part C – Medicare Advantage plans
Part D – Medicare Prescription Drug plans
Learn more about the four parts of Medicare. 

Understanding the world of insurance can sometimes be confusing, especially with all the unique words and phrases. It’s important to understand what these terms mean so you can make smart choices about your health coverage. Click here to read about Insurance terms made simple.

PPO stands for preferred provider organization and is a Medicare Advantage Plan that has a network of contracted providers. Member cost sharing will generally be higher when plan benefits are received from out-of-network providers. Any provider may be seen in an emergency situation.

HMO stands for health maintenance organization. HMO insurance usually limits coverage (except for emergencies) to care from providers who contract with the HMO and typically are required to obtain a referral from a primary care physician (PCP) to specialists, most likely in their network. Because of the limitations of the network covered, HMO insurance is typically a lower-cost plan.

When choosing a Medicare Advantage (Part C) plan, there are a few things you need to think about. 

1. Cost - See if the plan has a premium and if the cost fits your budget. Also, look at the copays, coinsurance, and deductibles for the benefits that are covered.
2. Network - Look at the plan’s network of doctors, specialists, hospitals, and pharmacies. Make sure the providers and locations you want to visit are in the network.
3. Prescription Drugs - Look at the plan’s formulary to see if the medications you take are covered by the plan and, if so, how much it would cost you to fill a prescription.
4. Extra Benefits Offered - Review all the benefits offered with the plan. Check out the extra benefits like dental, hearing, vision, OTC, gym memberships, and more. Those extras can help save you money and give you extra coverage to help you live healthier.

Learn more about how to choose a Medicare Advantage plan here.

Extra help is available to those who need assistance paying for prescription drugs. We're happy to help you learn more about what's available. Depending on your circumstances, the Medicare Low-Income Subsidy (LIS), State Pharmaceutical Assistance Programs (SPAP), discount programs, Medicaid, and state premium assistance programs can all help lower your costs. To learn what's available in your area and how to apply, contact Member Services at 1-888-778-1478 (TTY 711) 8 am–8 pm local time, 7 days a week.* You can also learn more about the extra help available here.