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    How to Sign Up

    What you have to do to sign up for Medicare depends on how you qualify and whether you want Original Medicare or a Medicare Advantage plan.

    Original Medicare is automatic for some people, but not others, while anybody who wants Medicare Advantage has to sign up. And, even if you get Original Medicare automatically, you still need to sign up for a Part D plan.

    You should also think about applying for a Medicare Savings Program and the Low Income Subsidy (LIS) — many people lose out on this help because they never bother to apply.

    If you need help, call your local Iowa SHIIP and SMP counselor or Medicare at 1-800-772-1213 or 1-800-325-0778 (TTY).

    Signing Up for Original Medicare

    Some people automatically start getting Original Medicare coverage without having to sign up. This includes anybody who:

    If you are in one of these situations, you get a notice in the mail three to four months before your Medicare is supposed to start. The notice will tell you:

    If you do not automatically start getting Medicare benefits, you can sign up for Original Medicare Parts A and B:

    Learn more about signing up for Original Medicare.

    Declining Part B

    If you decline Part B coverage:

    • You can usually only sign up again between January 1 and March 31 of each year, which is called the General Enrollment Period. Your Medicare Part B coverage starts the month after you sign up.
    • If you lose employer-sponsored coverage, you can sign up for Part B outside of the general enrollment period. You have eight months to sign up, starting with the month when the job ends (or when you lose your coverage). If you sign up during those eight months, you don’t have to pay monthly penalties.
      • Note: If you also decline Part D and then you lose your employer-sponsored coverage, you only have two months to sign up for Part D without paying monthly penalties.

    Signing Up for Private Plans: Part D, Medigap, and Medicare Advantage

    If you have government-run Original Medicare, you have the options of also getting a privately managed Part D prescription drug policy and, if you are 65 or older, a privately run Medigap policy (Medicare Supplement Insurance).

    Or, you may decide that you want a privately run Medicare Advantage plan that includes all the benefits you need. Note: Most Medicare Advantage plans include prescription drug coverage, but some allow you to sign up for a separate Part D plan instead.

    For all of these types of privately managed Medicare benefits, the signup process is basically the same:

    1. You decide which types of plans you want to sign up for.
    2. You research the private plans you are looking at:
    3. You sign up:
      • On Medicare.gov
      • By calling Medicare at 1-800-633-4227 or 1-877-486-2048 (TTY)
      • By calling your local Iowa SHIIP and SMP counselor
      • By completing a paper application with the plan, or
      • By contacting the plan directly.

    When to Sign Up for Part D or Medicare Advantage Plans

    When you should sign up for a Part D or Medicare Advantage plan (or switch from Medicare Advantage back to Original Medicare) depends on your situation:

    1. You can sign up, switch, or drop plans at any time if you:
    2. If your Medicare coverage is just starting, you can sign up anytime during the three months before and after your Medicare coverage starts. This is called the initial enrollment period.
    3. You can add, drop, or switch plans every October 15 - December 7. This is called the annual election period. Any changes you make start on January 1 of the following year.
    4. If you're already in a Medicare Advantage plan, there is another open enrollment period from January 1 to March 31. You can switch plans or go back to Original Medicare with a separate Part D plan.
    When to sign up for Medigap (Medicare Supplement Insurance)

    Medigap enrollment works differently than other private Medicare plans. There is a six-month open enrollment period that starts the day you turn 65 and enroll in Medicare Part B. If you don't sign up during this open enrollment period, they are allowed to deny you coverage or charge you more based on pre-existing conditions.

    In Iowa, if you are under age 65 and qualify for Medicare because you have a disability, you do not get an open enrollment period and you are not eligible for most Medigap policies. There may be some Medigap policies available to you, but the premiums are very expensive and you can be denied coverage based on pre-existing conditions.

    If you do get a Medigap policy before you are 65, you will become eligible for an open enrollment period when you turn 65 and you can buy a new Medigap policy with a lower premium.

    Learn more about Medigap enrollment or call your local Iowa SHIIP and SMP counselor to get live help.

    Applying for Help to Pay for Medicare

    Regardless of whether you have Original Medicare or Medicare Advantage, you can apply for help to pay for your Medicare coverage:

    Note: If you have Medicaid coverage as well as Medicare, you may already be getting help from an MSP and the LIS automatically.

    Learn more about MSPs and the LIS. If you want to talk with someone about them, call your local Iowa SHIIP and SMP counselor.

    Learn more

    Getting Past the Myths

    Get the facts about how benefits support work.

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    There are more ways to qualify for Medicaid if you have a disability.