The Ultimate Guide to Applying for Medicare 2025

Navigating how and when to apply for Medicare can be challenging, especially considering all the coverage conditions, requirements, and other fine print details. For example, did you know that Medicare does not cover regular dental care? And that Medicare Advantage dental insurance may only cover basic care? Sadly, it’s true – but you do have inexpensive options, like dental savings plans, that can help reduce the cost of dental care by an average of 50%*.

So, if you’re planning on enrolling for Medicare, don’t worry. We’re here to help you understand what you need to do to get on Medicare and how to make the most of your coverage.

When to Apply for Medicare

Generally, you should apply for Part A (hospital insurance) and Part B (medical insurance) Medicare as soon as you’re eligible. The enrollment period begins three months before your 65th birthday, including your birthday month, and extends three months after your birthday month, meaning you have seven months to apply for Medicare.

However, if you fail to sign up for Medicare during this seven-month window, you’ll have to wait to enroll and go months uncovered. You may also have to pay a monthly penalty for as long as you have Part B; the penalty increases the longer you wait to enroll.

If you’re still working and have health insurance via your employer, or if your spouse’s employer covers you, you might be able to delay enrolling in Medicare. However, you’ll need to follow the rules and sign up for Medicare within eight months of losing your coverage to dodge substantial penalties when you eventually enroll.

How to Apply for Medicare

You’ll automatically be enrolled in Part A and Part B if you receive Social Security benefits at least four months before you become eligible for Medicare. However, if you’re about to turn 65 or recently turned 65 and haven’t received Social Security benefits yet, here’s what you should do according to the Medicare website:

• Online – Signing up via Social Security is the easiest, fastest way to apply for Medicare and get the financial aid you need. You must create a Social Security account to sign up for Medicare or apply for benefits.
• Phone – Call Social Security at 1-800-772-1213. Teletypewriter (TTY) users may call 1-800-325-0778.
• Visit your local Social Security office – You can find your nearest location via the Social Security office locator.
• Call the Railroad Retirement Board – Call the Railroad Retirement Board at 1-877-772-5772 if you or your spouse worked for a railroad company.

About two weeks after you apply for Medicare, you’ll get a welcome package with your Medicare card and program details.

What are the requirements to qualify for Medicare?

If you’re 65 or older, you’re eligible for Medicare if you meet one of these requirements:

• You’re a United States citizen or a permanent legal resident who’s lived in the U.S. for at least five years.
• You’re getting Social Security or railroad retirement benefits or have worked long enough to receive them but have not yet secured them.

• You or your partner is or was a government employee and paid Medicare payroll taxes during you or your partner’s tenure.

If you’re under 65, you may still qualify for Medicare if:

• You’ve been eligible for Social Security disability for at least 24 months (doesn’t need to be consecutive).
• You’re eligible to collect a disability pension from the Railroad Retirement Board and meet specific criteria.
• You’ve been diagnosed with amyotrophic lateral sclerosis (ALS) — also known as Lou Gehrig’s disease. This automatically qualifies you to receive Medicare benefits.

• You have permanent kidney failure that requires routine dialysis or a kidney transplant. Also, depending on your age, you or your partner must have paid Social Security taxes for a certain period.

Do I have to sign up for Medicare when I am 65?

If you have employer-provided health insurance from a company with over 20 employees, you can sign up within 8 months after you or your spouse stop working/lose coverage. If your coverage is from a company with less than 20 employees, check your options here.

Most people don’t have to pay a premium for Part A (Hospital Insurance). So, you may want to sign up for Part A when you turn 65, even if you or your spouse are still working.

Do I need supplemental insurance with Medicare?

Medicare doesn’t cover all costs, so getting supplemental insurance can help fill those coverage gaps and give you peace of mind when dealing with unexpected medical expenses. If you were left with a substantial medical bill without supplement insurance, you could risk being in debt and having your credit score ruined.

Consider looking into a Medigap plan. Medigap is a health insurance policy sold by private insurance companies to help cover co-pays, deductibles, coinsurance, and other remaining costs you’re responsible for. Typically, you must have Medicare Part A and Part B to buy a Medigap plan. Additionally, you’ll likely have to pay the monthly Medicare Part B premium and a premium to the Medigap insurance company.

What do I need to know about Original Medicare vs. Medicare Advantage?

Medicare Advantage (MA plans) are government-approved health insurance plans provided by private companies as an alternative to Original Medicare. These plans cover everything Original Medicare does (except for hospice care) and often include prescription drug coverage (Part D), as well as dental, vision, hearing, disability services, and other benefits not available through Original Medicare.

There are important differences between Medicare and Medicare Advantage plans. Many people choose an MA plan to access additional benefits such as dental, but that may not be the best option for everyone, it’s important to consider the long-term ramifications.

Does Medicare cover dental?

Medicare does not cover regular dental care. Medicare Advantage plansoften do include dental insurance. But it may not fit your needs, so review coverage details carefully.

• MA plans with no or low premiums may only include basic dental procedures such as cleanings and checkups (preventive care).
• An MA plan may also restrict your dental benefits to dentists near your home, which can be a concern for people who split their time between two locations.
• If you’re out of the coverage area, you may only get $100 coverage for emergency care only. Anything else, you’d pay out of pocket.

A Medicare Advantage plan can help fill in the gaps, but you may also want to consider another option — a dental savings plan.

Dental savings plans for Medicare recipients

A trusted alternative to dental insurance, a dental savings plan can help you save on a wide range of services, including preventive treatments, restorative care, dentures, and implants. Unlike standard dental insurance, there are no annual spending limits, delays in accessing specific treatments, or paperwork hassles. Many dental savings plans also include savings on vision and hearing screenings, chiropractic care, prescription drugs, and more.

You can use a dental savings plan to save on the majority of dental procedures if you are an Original Medicare recipient. You cannot use your Medicare Advantage dental insurance and your dental savings plan for the same procedure, in accordance with insurance policy rules. However, a dental savings plan can help fill gaps and provide savings on procedures that are not covered by your Medicare Advantage plan. Dental savings plans may also be used to reduce your out-of-pocket dental care costs once you’ve reached the annual maximum on your Medicare Advantage dental insurance. Talk to your dentist to understand how to maximize care.

Dental savings plan members report saving an average of 50%* on their dental care at thousands of dentists and specialists across the nation. It’s a great way to save on routine dental care and protect yourself against unexpected expenses. Have questions or want to learn more about using a dental savings plan while on Medicare/MA? Call us at 1-833-735-0399 or use our calculator below for a quick look at how much you can save.

*Discount Health Program consumer and provider surveys indicate average savings of 50%. Savings may vary by provider, location, and plan.