Second Chances at Signing Up for Medicare
If you missed earlier enrollment periods, you can get coverage at other specified times
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En español | Timing is everything for Medicare.
If you miss an enrollment deadline, you may have to wait to get coverage and pay a late penalty. But in some cases, you can avoid the penalty when you sign up for Medicare outside your initial enrollment period (IEP) that starts three months before the month you turn 65 and ends three months after if you qualify for a special enrollment period (SEP).
You also can sign up during a general enrollment period (GEP). But you still may have to pay a penalty.
How a special enrollment period works
If you or your spouse works and you have health insurance through either of your employers, you might decide to sign up for Medicare Part A, which covers hospitalization. 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, the equivalent of 10 years.
However, you might delay enrolling in Medicare Part B, which covers doctor and outpatient services and costs $164.90 a month for most people in 2023. High earners pay more.
When your job-based health insurance ends, because of retirement or another reason, you can sign up for Part B during a special enrollment period. Sign up before your coverage ends or within eight months of losing the insurance to avoid a late enrollment penalty.
Other coverage decisions. You’ll also need to make decisions about other types of coverage when you enroll in Medicare, including Part D prescription drug coverage and Medicare supplement insurance, better known as Medigap, to help pay Medicare’s deductibles and copayments.
Or you may decide to get a private Medicare Advantage plan that provides health and drug coverage. You must have Medicare Part A and Part B before you can enroll in Medigap or Medicare Advantage.
11 steps to enroll online in Part B
To enroll in Part B during a special enrollment period, visit the Social Security Administration Medicare page and click on Sign up for Part B only | Get started. Scroll down to submit an application | start application.
To complete the form, you’ll need your Medicare number, documentation of your spouse’s or your health insurance and an email address.
1. At the bottom of the opening page, check a box indicating that you understand the agency’s policies. Click Start application and you’ll be taken to the application page.
2. Scroll down and fill out the application for enrollment. Provide your Medicare number, then click Yes when you’re asked if you want to sign up for Part B. Type in your name, address and phone number. In the Remark field, mention the date you would like your Part B coverage to start.
3. In Section B, provide information about the employer you’re receiving health insurance from.
4. In Section C, provide information about your group health plan.
5. In Section D, you’ll need to provide evidence of your coverage. Complete Section A of form CMS-L564 and ask your employer to complete Section B. The employer can send the form directly to the SSA or send you a digital copy, which you’ll need to upload as part of your application process.
If your employer cannot provide evidence of your group health coverage, you’ll need to submit proof of your employment and health insurance coverage. The following documents are acceptable:
- Explanation of benefits statement from your health plan.
- Health insurance cards that show the date your policy began.
- Pay stubs that indicate your health insurance premiums were deducted.
- Receipts or statements that show your health insurance premiums were paid.
- Tax returns that show your health insurance premiums were paid.
- W-2s that show pretax medical contributions.
If you need to include these documents, upload them in the yellow spaces.
6. Once you’ve completed Section D, type in your name and click the blue Apply button.
7. Look for a screen with a black bar at the bottom, then click the blue Click to Sign button.
8. Now enter your email address and click the Click to Sign button.
9. Go to your email account and look for a message from Adobe Sign. Click on the link that says Confirm my email address.
10. You’ll be taken to a page that confirms your e-signing was verified. Look for a second email that confirms your submitted application.
11. The SSA will send you a letter informing you of your application’s status. If it’s denied, you can appeal the decision by following the instructions.
Other ways to sign up
If you don’t want to enroll online, print the form and mail it, fax it or bring it to a Social Security office. Alternatively, you can fill out Form CMS-40B and have the employer who provides your health insurance complete Form CMS-L564. The forms are numbered on the bottom left of the page. If the employer is unable to complete the form, you can submit the documents that show you had health insurance.
To find your local office, use the Social Security field office locator. If you want to mail your application, use certified mail for delivery confirmation.
New special enrollment periods. On Jan. 1, 2023, SSA introduced several new six-month special enrollment periods for exceptional conditions — such as being unable to sign up because of a natural disaster, misinformation from your employer or losing Medicaid coverage.
You need to submit a different form to enroll in Medicare in these situations. For more information, see Medicare’s exceptional conditions SEP instructions.
How to sign up during the general enrollment period
If you missed signing up for Medicare during your IEP and any eligible special enrollment periods, you’ll need to enroll during the annual general enrollment period (GEP), which runs Jan. 1 to March 31 each year. You may have to pay a late enrollment penalty.
If you sign up during this time, your coverage will begin the first of the month after you enroll.
To sign up for Part B, complete Form CMS-40B and send it to your local Social Security office or call for assistance. To find your local office, use the Social Security field office locator. The federal agency doesn’t have an option to enroll online during your GEP.
Special rules for Part A. If you’re eligible for premium-free Part A, you aren’t limited to a SEP or GEP. Contact the Social Security Administration at 800-772-1213 to sign up after your initial enrollment period.
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If neither you nor your spouse paid Medicare taxes for 40 quarters, you have to pay premiums for Part A and you can enroll only during a SEP or GEP if you missed your initial enrollment period. You may also have to pay a Part A late enrollment penalty. The SSA has no paper form available for enrollment in Part A during the GEP, so you must call.
Images: Social Security Administration (SSA.gov); Centers for Medicare & Medicaid Services
This story, originally published Jan. 28, 2022, was updated with new information.
Kimberly Lankford is a contributing writer who covers personal finance and Medicare. She previously wrote for Kiplinger’s Personal Finance magazine, and her articles have also appeared in U.S. News & World Report, The Washington Post and The Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers.