What Documents Do I Need to Apply for Medicare?

As you approach your 65th birthday, you’ll need to start thinking about enrolling in Medicare. You might wonder what the application process is like, and which documents you should start gathering. We're here to help with that!

For starters, those who are already receiving Social Security benefits may be automatically enrolled in Medicare. If not, you will need to apply during your Initial Enrollment Period which starts three months before your 65th birthday, includes the month of your birthday, and ends three months after. 

If you miss your Initial Enrollment Period, you will have to wait until the General Enrollment Period, which begins in January, to sign up for Medicare which could leave you with a gap in coverage and late enrollment penalties.

To make the enrollment process as smooth and easy as possible, you may want to have certain documents on hand.  

‍Signing Up for Medicare Online

The easiest way to sign up for Medicare is online through the Social Security Administration website. Here you can apply online for Medicare Part A & B, or just Part B if you already have Part A. You can also check if you qualify for any financial assistance.

To get started, you will need to create a secure my Social Security account and verify your identity with either a Login.gov or ID.me account. If you don't have either one of those accounts, you'll need to create one and provide some personal information to verify your identity such as:

• An email address
• A secure password
• An authentication method like a security key, federal government employee or military identification, SMS/text messages, or backup code
• Your financial history
• A valid photo ID (driver's license, passport, passport card, or state ID)
• Your Social Security Number

Once you have verified your identity and successfully created your my Social Security account, you can begin the online Medicare application which should take you no longer than 10 minutes.  

For that, you will need to provide the following information:  

• Your Social Security number
• The city, state, and country you were born
• The start and end dates for any current group health plans
• The start and end dates for any group health plans after age 65

Signing Up for Medicare In-Person

If you are unable to sign up for Medicare online, you can also sign up in person or by phone.  

If you sign up by calling the Social Security Administration, the agent helping you will let you know which documents (if any) you need to mail in after your call.  

And if you decide to apply in person at your local Social Security office, you may want to bring some specific documents with you to help verify your identity and eligibility for Medicare benefits and make the application process for Medicare smooth and efficient.

And when in doubt, you can always contact your local Social Security office in advance or a trusted Medicare broker for guidance on the specific documents you'll need to bring based on your individual circumstances.

Let's take a look at a few documents that you may want to have handy.

Birth certificate

To apply for Medicare benefits, you generally need to be 65 years old. However, there are exceptions if you have a qualifying condition or disability.

An original birth certificate or other documents that state your date of birth serves as proof of your age and verifies that you meet the age requirement.

Proof of U.S. citizenship or legal residency

Another requirement to receive Medicare benefits is that you are a U.S. citizen or permanent resident. Your U.S. passport is valid proof of citizenship, while a birth certificate shows that you were born in the United States.

If you are not a U.S. citizen but are a legal permanent resident, bring your green card or permanent resident card with you.

Your Social Security card

Your Social Security card serves as proof of your identification and is required when applying for various government programs, including Medicare.

This card contains your unique Social Security number, which is used to track your earnings and determine your eligibility for Medicare benefits.

Health insurance information

When applying for Medicare, you will also need to provide information about any current group health plans you have and plan to keep after your 65th birthday.

For example, if you are still covered by a group health plan through your employer or spouse's employer, Medicare may need to know the start and end dates of that coverage.

W-2 or tax statements

The Social Security Administration may need to see your W-2 or Schedule C and SE from last year to verify your Social Security earnings.

While Part A is usually free and the standard premium for Medicare Part B in 2023 is $164.90 per month, some individuals with higher incomes may need to pay more.

Having your tax information handy can help determine if you fall into this category and what your premiums will be.

Military information

Veterans may be eligible for certain benefits or have specific rules that apply to them when it comes to receiving Medicare.

So, if you served in the military, you may need to provide proof of that service. This can be done by submitting documents like your military ID card, discharge papers, or a letter from the Department of Veterans Affairs.

Additional Forms for Specific Situations

In addition to the standard documents required to verify your identity and eligibility for Medicare enrollment, there may be other forms you are required to submit, depending on your situation.  

Enrolling in Part B only because you are losing your employer-based coverage

If you already have Medicare Part A and you need to add Part B because you're losing your job-based health insurance, you can still apply online. Just visit the Social Security Administration website and follow the instructions to apply for Part B only.

Then, your employer will need to fill out form CMS-L564 confirming that you're losing your coverage and you'll need to mail or fax the form to your local Social Security office.

If your employer is unable to fill out the form, you can complete Section B of the form yourself, providing as much information as you can, and leave the form unsigned. In this case, you may need to provide further information about your employer-based health insurance.

Enrolling in Part A & Part B during a Special Enrollment Period

If you qualify for a Special Enrollment Period, you may be eligible to sign up for Part A & Part B outside of your Initial Enrollment Period without penalty. To do so, you will need to fill out form CMS-10797 and mail or fax it to your local Social Security office.

Enrolling in Part B outside of your enrollment period

If none of the above situations apply to you, and you already signed up for Part A Medicare and now want to add Part B Medicare, you'll have to wait until the General Enrollment Period which is from January 1 – March 31.

For that, you'll need to fill out form CMS-40B and mail or fax it to your local Social Security office.

What's Next?

Once you've applied for Medicare and you've submitted all the necessary paperwork, the next step is to wait for your Medicare welcome package to arrive in the mail. This package will include your Medicare card and your Medicare number, which you'll need for future reference. 

If you're interested in adding any additional coverage, such as a Medicare Advantage plan (Part C), or prescription drug coverage (Part D) now is the time to do it.

If you're not sure whether you should add any additional coverage or are confused about any of the documents you need to enroll, the experts at Sams Hockaday are available to lend a hand.  

We're here to help make the enrollment process a seamless one so schedule an appointment with us today and we can help you get started!