How to sign up, step by step
- Check your timing. Your Initial Enrollment Period runs from 3 months before the month you turn 65 to 3 months after. Signing up before your birthday month means coverage starts the first day of that month.
- Gather your information. Your Social Security number, birth date and place, and details of any current job-based coverage. Still working? See working past 65 before you decide on Part B.
- Apply. Online at ssa.gov/medicare/sign-up, by calling 1-800-772-1213 (TTY 1-800-325-0778), or at a Social Security office; find the nearest with Social Security's office locator.
- Watch for your card. Keep your Medicare card and any letters from Social Security together.
- Choose added coverage. Decide between Original Medicare with Medigap and Part D, or a Medicare Advantage plan, within your windows.
Who is enrolled automatically?
If you get Social Security or Railroad Retirement benefits at least 4 months before you turn 65, you're enrolled in Part A and Part B automatically. People under 65 are enrolled automatically after 24 months of Social Security disability benefits, and people with ALS the month those benefits start.
You are not enrolled automatically if you haven't started Social Security, for example because you plan to claim at your full retirement age or later. Most North Carolina teachers and state and local employees pay into Social Security (about 93% of the state's public workers, according to the Congressional Research Service), so the usual rules apply to them: claim early and you're enrolled automatically, wait and you sign up yourself.
State Health Plan retirees
If you'll have retiree coverage from the State Health Plan, sign up for both Part A and Part B on time. The Plan says Parts A and B must be in effect to enroll in its group Medicare Advantage Base Plan or Enhanced Plan, and if they aren't, you're placed on the 70/30 Plan. See State Health Plan retirees and Medicare.
After you sign up
North Carolina has no Medigap birthday rule, so your 6-month Medigap open enrollment, starting when you're 65 and in Part B, is your one guaranteed chance at 65 or older to buy any policy without health questions. To compare options, see plans for your ZIP code, or you can request a call from a licensed insurance agent to review plans from the companies they work with. More in the turning 65 in North Carolina guide.
Related questions
When should I sign up if I'm turning 65 in North Carolina?
Your 7-month window, month by month.
Do I need Part B if I'm still working at 65?
The 20-employee rule.
What if I miss my enrollment period?
Penalties and your next chance.
Sources
- Social Security — Sign up for Medicare
- Medicare.gov — Sign up for Medicare
- Medicare.gov — When does Medicare coverage start?
- State Health Plan — Retiree presentation (Medicare Parts A and B must be in effect)
- Congressional Research Service — Social Security Coverage of State and Local Government Employees (R46961)
- NC Medicaid — How to apply
More questions in this guide
- Can I get Medicare before 65 in North Carolina?
- Do I need Medicare Part B if I'm still working at 65 in North Carolina?
- What are the Medicare deadlines in North Carolina for 2027?
- What happens if I miss my Medicare enrollment period in North Carolina?
- When should I sign up for Medicare if I'm turning 65 in North Carolina?
Part of the guide: Medicare enrollment periods in North Carolina · All questions
Frequently asked questions
Is there a North Carolina state office for Medicare sign-up?
No. Medicare is federal, and Social Security handles enrollment. North Carolina agencies handle related programs: NC Medicaid and the Medicare Savings Programs (called MQB in North Carolina) through ePASS or your county Department of Social Services.
How long does it take to get my Medicare card?
If you're enrolled automatically, your card arrives about 3 months before your coverage starts. If you apply, Social Security mails your card after it processes your application, so apply early in your Initial Enrollment Period.
Do I sign up for Medicare Advantage or Part D through Social Security too?
No. After you have Part A and Part B, you join a Medicare Advantage or Part D plan through Medicare.gov, 1-800-MEDICARE or the plan itself. Medigap is bought directly from an insurance company.
Medicare in your North Carolina county
Plans, local agents and help, county by county: Wake · Mecklenburg · Guilford · Forsyth · Durham · Cumberland · Buncombe · Union · Johnston · Cabarrus · New Hanover · Gaston · Onslow · Iredell · Alamance · Pitt · Davidson · Brunswick · Catawba · Rowan · All 100 counties →
