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Medicare Eligibility

When can I enroll in Medicare?

Short Answer

Generally, you can enroll in Medicare if you are a U.S. citizen or lawfully present in the United States and turning 65. If you are turning 65 and will be eligible, you have seven months to enroll in Medicare Parts A and B. Your Medicare enrollment timeline includes:

  • Three months before the month of your 65th birthday.
  • The month of your 65th birthday.
  • Three months after the month of your 65th birthday.

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Who is eligible for Medicare?

Medicare is a federal health insurance program. In order to qualify for Medicare, you must be a U.S. citizen or lawfully present in the United States. You must also:

  • Be age 65 or older, or
  • Be under age 65 with certain disabilities, or
  • Have permanent kidney failure requiring dialysis.

Are you turning 65 or retiring soon?

If you are turning 65 or retiring soon, there is something important you should do: Enroll in Original Medicare Parts A and B. Your age and retirement date determine whether you are eligible for a Medicare plan. These factors may affect when you can enroll in Medicare.

It’s important to understand the basics of Original Medicare before you choose how to get your Medicare coverage. UPMC for Life can help you understand when to enroll in Medicare and help you understand your health coverage options.

When can I enroll in UPMC for Life?

UPMC for Life is a Medicare Advantage plan. To enroll in a Medicare Advantage plan, you must be enrolled in Original Medicare Parts A and B. If you are over 65 and planning to retire soon, you have seven months to enroll in Medicare Parts A and B. This time frame usually starts the month after your employment ends.

If you currently get your health care benefits through your employer, make sure to talk to your employer. Your employer can help you understand what you need to do before you retire.

What if I am already enrolled in a Medicare plan and need to change my coverage?

If you are already enrolled in Medicare, there are only certain times of the year when you can change your Medicare Advantage coverage. View the different enrollment period options to find out which ones apply to you.

Medicare Advantage Enrollment Timeline

Annual Election Period:
Oct. 15 – Dec. 7

You can add or drop Part D prescription drug coverage during this time. You can also change to a Medicare Advantage plan, change to Original Medicare, or change your current Medicare Advantage plan. Your coverage will be effective Jan. 1.

Open Enrollment Period:
Jan. 1 – March 31

You can make ONE change to your current Medicare coverage. You can add or drop Part D prescription drug coverage or change to a Medicare Advantage plan or change to Original Medicare. Your coverage will be effective the first of the next month.

Lock-in Period:
April 1 – Oct. 14
Dec. 8 – Dec. 31

You cannot make a plan change after March 31 unless you qualify for a Special Election Period (SEP) or have Medical Assistance coverage.

Learn more about when to enroll

Why choose UPMC for Life?

UPMC for Life is a Medicare Advantage plan that’s been around for 21 years. We are more than 200,000 members strong and growing!

We offer affordable medical and prescription benefits in one easy-to-use plan. We’re committed to providing you with the high-quality health care and coverage you need so you can live your best life.

Here are just a few benefits you get with a UPMC for Life plan:

  • Part D prescription drug coverage with $0 copays for preferred generic drugs.
  • New! The UPMC for Life Flex Spend Card gives you an additional yearly allowance to buy over-the-counter (OTC) products and pay for dental, vision, and hearing services (on most plans).
  • New! A dental allowance for many dental services as well as coverage for dentures (on most plans). Plus, oral exams, cleanings, and x-rays.
  • A hearing aid exam, a hearing aid fitting, and a discount on the cost of hearing aids.
  • A routine vision exam and an allowance for contact lenses and frames, now including all lens types, like progressive and transitional.
  • Free unlimited gym memberships, one free personal training session each year at participating fitness facilities, the option to work out at home with in-home fitness kits, and online fitness classes.
  • In-network coverage when you travel to Arizona, Florida, Georgia, North Carolina, South Carolina, and Tennessee (on HMO plans).
  • Benefits and programs that can help you live healthy and stay independent, such as home safety products, in-home safety assessments, Tools for Caregivers, support for serious illness, post-discharge meals, and more.
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Next Steps

When to Enroll

Understanding the right time to enroll in Medicare is important. Find out when to enroll.

The Four Parts of Medicare

The four parts of Medicare cover various services. Learn about each of the four parts of Medicare.

Medicare Part A

Medicare Part A covers inpatient and hospital coverage. Learn more about Part A.

This information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/Noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.

This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).

UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., UPMC Health Benefits Inc., and UPMC Health Coverage Inc.

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UPMC for Life Members
Call us toll-free: 1-877-539-3080
TTY: 711

Oct. 1 – March 31:
Seven days a week from 8 a.m. to 8 p.m.

April 1 – Sept. 30:
Monday through Friday from 8 a.m. to 8 p.m., Saturday from 8 a.m. to 3 p.m.

UPMC for Life Prospective Members
Call us toll-free: 1-866-400-5077
TTY: 711

Jan. 1 – Sept. 30:
Seven days a week from 8 a.m. to 8 p.m.

Oct. 1 – Dec. 31:
Seven days a week from 7 a.m. to 9 p.m.

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Last Updated: 10/01/2022