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What Documents Do I Need When Applying for Medicare?

Since healthcare is a matter of concern today, Americans are generally excited to start their Medicare benefits, which are often a better value than other health insurance options. Enrollment can be stressful because people fear they’ll miss their enrollment or make a mistake. If you’d like to know what it’s like to apply for Medicare, this is the guide for you. Read on to find out what documents you need when applying for Medicare.

Key takeaways:

What documents do I need to apply for Medicare Part A?

The documents you need to enroll in Medicare can depend on the circumstances of your enrollment. Specifically, how and when you enter Medicare can be unique to each person, and the required documents may differ in each case. It helps to understand that there are two main paths to entering Medicare for the first time:

  • Aging into Medicare at age 65 or beyond.
  • Entering Medicare early (before 65) due to disability or qualifying illness.
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The Medicare documents required in each of these enrollment paths can be different. Since most people enter Medicare at 65 or later, we’ll start with that scenario.

How to apply for Medicare Part A

You have three options when it comes to applying for Medicare Part A. You can enroll:

  • In person at a Social Security office.
  • Over the phone by calling 1-800-MEDICARE.
  • Online through the Social Security Administration’s website (ssa.gov).

Applying online is the fastest and simplest method available, and most people take advantage of this. When you apply online, you simply complete your Medicare application form on their website. You won’t have to deal with paper forms.

An insider trick to applying for Medicare online is that your Medicare number will likely show up on your online "mySocialSecurity" account after a few weeks, long before you'll likely receive your Medicare card in the mail.

Steps to apply for Medicare Part A at age 65 or later

How you apply for and enter Medicare at age 65 or later will depend on your decision about Social Security. The documentation required for Medicare in the United States also potentially changes based on your Social Security status.

If you have elected to start your Social Security retirement benefits at or before age 65, your Medicare enrollment process will be streamlined. The documents you need to apply for Medicare Part A will be minimal. Your enrollment will likely be automatic. That’s because you will have already gone through the process of verifying your age and eligibility for Social Security. Once you’re approved for Social Security, and assuming that you did this before age 65, you’ll no longer need any documents for Medicare. You’ll simply receive your Medicare card in the mail.

But what if you don’t take Social Security before age 65? Since the Social Security Full Retirement Age (FRA) is now age 66 and eight months or later, many people will claim Medicare before they claim Social Security. In this case, you will have to apply for Medicare actively.

Steps to apply for Medicare Part A before age 65

Some people become eligible for Medicare before turning age 65. This can happen for three reasons:

  • You’ve received Social Security disability income for 24 consecutive months.
  • You’ve been diagnosed with End Stage Renal Disease (ESRD).
  • You’ve been diagnosed with ALS (Lou Gehrig’s disease).

In the case of disability for 24 consecutive months, your enrollment into Part A will be automatic. You won’t need to apply, and there are unlikely to be any Medicare documents required.

Enrollment into Medicare due to a diagnosis of ESRD or ALS requires you to apply for Social Security disability income first. Once you have your disability income in place, your Medicare enrollment will again be automatic.

What documents do I need to apply for Medicare Part B?

As you might imagine, the process for applying for Part B is just like that for Part A. You will often apply for both Medicare Parts A and B at the same time. This will always be the case if you enter Medicare early (because of ESRD, ALS, or 24 consecutive months of disability).

However, things can change if you delay your entry into Medicare. You might do this if you plan to continue working beyond 65 and can keep your employer's health insurance coverage. Or, if your spouse is still working, you can stay on their coverage. In most cases, you can do this without facing any kind of late enrollment penalty. You’ll likely be required to take Part A at 65, even if you plan to stick with your employer coverage. In that case, you’ll have to apply for Part A using one of the methods described above.

You’ll have to enroll in Part B when your employer coverage ends. In this case, because you’ve delayed your enrollment past age 65, you won’t be able to apply online. Instead, you’ll have to use CMS Form 40B. When applying for Part B in this way, you'll need at least one other Medicare document. You must complete and submit CMS Form L564, employment verification, and employer coverage information. This form proves that your plan has covered you since you were 65 and will allow you to enter Part B without any kind of enrollment penalty.

What documents do I need to apply for Medicare online?

You’ve probably noticed we haven’t mentioned any documents you’d typically think of, like a birth certificate or driver’s license. That’s because, for many Americans, those documents for Medicare aren’t required. However, there may be times when further or more detailed documentation may be required. These documents may include:

  • Birth certificate
  • Immigration records
  • Passport
  • Driver’s license
  • Social Security card
  • Military health insurance benefits documentation

These documents would be used to establish both your overall eligibility for Medicare (it is only available to U.S. citizens or permanent legal residents), as well as your age for benefits.

In some cases, you might need even more information like tax returns and pay stubs. You would use these other documents to help determine the amount of your Part B premium if you meet certain high-income thresholds.

What documents do I need for private Medicare insurance plans?

Medicare Parts A and B are known as Original Medicare. They form the basic benefit that all Americans eventually qualify for. However, because Original Medicare has a number of gaps (services not covered, or amounts you’ll have to pay out of pocket) many people choose to add a private Medicare Insurance option. The three main kinds of private Medicare insurance include:

  • Part D prescription drug plans
  • Medicare Supplement Plans (MediGap plans)
  • Part C Medicare Advantage plans

Each of these plans has its eligibility requirements. However, the thing to understand is that you’ll still need to enroll in Medicare first for each of these options.

Medicare Part D eligibility

Part D has the easiest eligibility rules. You need to have one Part of Medicare in place, either Part A or Part B. You don’t need both. Also, there are no age requirements. If you have one Part, you can get a Part D drug plan.

Medicare supplement plan eligibility

To enroll in a Medicare Supplement Plan, you must have Part A and B in place. In addition to this, you may need to be at least 65 years old. The Medicare Supplement eligibility age is set at the state level, so the minimum age varies by state. However, all states permit you to get Medicare Supplement Insurance at age 65 or later. If you get Medicare before age 65, your choices may be limited, depending on which state you reside in.

Part C Medicare Advantage plan eligibility

Medicare Advantage Plans require you to be enrolled in Parts A and B. However, unlike Medicare Supplement plans, there are no age restrictions. This means you can enter a Medicare Advantage plan at any age, as long as you have both Part A and B active.

It’s important to note that all you need to prove your eligibility for these private plans is your red, white, and blue Medicare card. You don’t need a Medicare letter of eligibility.

In this guide, we’ve answered the documents needed to apply for Medicare online. We’ve reviewed options for several scenarios. It’s helpful to remember that, in many cases, you won’t need any particular documents when applying for Medicare. However, there are a few scenarios where you will be asked to prove your age, eligibility, or proof of prior health insurance enrollment. Once you have your basic Original Medicare coverage, you can use your Medicare card to get your private Medicare Insurance plan.

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