How to Apply for Medicare in Washington State: A Step-by-Step Guide

Four months. If your Social Security checks started at least 4 months before you turn 65, you don't apply for Medicare at all. Social Security enrolls you in Part A and Part B and mails your card about 3 months before coverage starts. Everyone else in Washington has to ask for it, and the asking happens with Social Security, not with Medicare and not with the state.

That surprises people. Medicare is run by CMS, but the federal agency that takes your application is the Social Security Administration (or the Railroad Retirement Board if you or your spouse worked for a railroad). Washington's own agencies come in at a different step: the Office of the Insurance Commissioner runs SHIBA, the counseling program, and the Health Care Authority handles Apple Health and the Medicare Savings Programs for people with limited income.

This guide is the paperwork side: who has to apply, the three ways to do it, what Social Security asks for, the forms if you're coming off a job's health plan, and what happens after the card shows up. If you want the calendar math (which month to sign up so Part B starts on time), that's in our Initial Enrollment Period guide. I won't repeat it here.

Source: Medicare.gov, How do I sign up for Medicare?; CMS, 2026 Medicare Parts A & B premiums and deductibles.

Step 1: Find out whether you have to apply

Social Security's own FAQ puts it plainly: if you already get Social Security benefits, "We will automatically enroll you in Original Medicare (Part A and Part B) when you become eligible." Medicare.gov adds the timing condition: you have to have started those benefits at least 4 months before your 65th birthday. The same goes for Railroad Retirement Board benefits.

If you're under 65 and on Social Security disability, Medicare.gov says you're enrolled automatically after 24 months of disability benefits. People with ALS get Part A and Part B the month their disability benefits start. Medicare for people under 65 has its own wrinkles, and I'm keeping this post to the turning-65 route.

A lot of Washington residents don't fall into the automatic group anymore, simply because they're waiting past 65 to claim Social Security. If that's you, nothing will arrive in the mail. You have to act.

Source: Medicare.gov, How do I sign up for Medicare?; Social Security FAQ: How do I sign up for Medicare?; Railroad Retirement Board.

One thing about automatic enrollment: it includes Part B, and Part B has a premium. Federal rules (42 CFR 407.17) enroll you in Part B unless you decline it. If you're still covered by a job's health plan at a large employer, declining can make sense. Read the instructions that come with your card and talk it through before you send anything back. The rules on who pays first are in Medicare and employer coverage after 65.

Step 2: Pick how you'll apply

Social Security gives you three routes. All three lead to the same application.

Source: Social Security, Sign up for Medicare; Social Security publication 05-10043, Medicare (April 2026); Medicare.gov.

My honest take: apply online if you're comfortable with it. You get a confirmation, there's no hold music, and you can do it at 10 p.m. on a Sunday. Social Security's own FAQ says to sign up three months before your 65th birthday if you aren't taking benefits yet, and online is the simplest way to hit that date.

If you'd rather talk to a person, call and ask for an appointment instead of walking in cold. Whether you live in Spokane, Yakima or Everett, the office locator at SSA.gov/locator finds the one that serves your ZIP code. Helping a spouse or parent? The online application has an "Apply for someone else" option.

Step 3: Have this ready

The Medicare-only application is short. Social Security's sign-up page lists what you'll need:

• Your Social Security number.
• Where you were born: city, state and country.
• Start and end dates for any current group health plan, yours or your spouse's.
• For a Part B-only application online: a working email address and your Medicare number.

If Social Security asks you for a document, its Medicare publication says it "must be original or copies that are certified by the issuing agency." Don't mail a photocopy of your birth certificate and expect it to count. Wait for them to tell you what they need, then send the right version.

Write down the group health plan dates before you start. Those dates are what protect you from the Part B late penalty later, and getting them wrong is the most common way a simple application turns into a months-long fix.

Step 4: Part A only, or Part A and B

Online, Social Security lets you apply for both parts or for Part A only. Here's how I'd think about it.

Part A is premium-free for most people. CMS says about 99% of beneficiaries don't pay a Part A premium because they (or a spouse) worked at least 40 quarters. Taking it at 65 usually costs nothing. The exception is anyone contributing to a Health Savings Account: once you have Medicare, HSA contributions have to stop, and Part A can be backdated up to 6 months (never earlier than the month you turned 65). Medicare.gov suggests you and your employer consider stopping contributions at least 6 months before you apply for Medicare.

Part B costs $202.90 a month in 2026 at the standard rate, with a $283 yearly deductible. Higher-income people pay more; the standard premium applies to individual income up to $109,000 (joint $218,000) on the tax return Social Security uses. CMS hasn't published the 2027 figures yet.

The reason not to skip Part B casually is the penalty. Medicare.gov says your premium can go up 10% for each full 12-month period you could have had Part B and didn't, and you usually pay it for as long as you have Part B. The exception is if you had group health coverage from your own or your spouse's current job. COBRA and retiree coverage don't count.

Signed up on time$202.901 full year late (+10%)$223.202 full years late (+20%)$243.503 full years late (+30%)$263.80

Source: Medicare.gov, Avoid late enrollment penalties (its own example: 2 full years late = $243.50 in 2026); CMS 2026 premium fact sheet. Writer's arithmetic for the other rows.

Show the numbers

Item	Monthly premium
Signed up on time	$202.90
1 full year late (+10%)	$223.20
2 full years late (+20%)	$243.50
3 full years late (+30%)	$263.80

That penalty is permanent in practice. Two years late means about $40.60 more every month at 2026 rates, for as long as you have Part B. That's real money, and it's avoidable. If you miss your window with no employer coverage, the next regular chance is the General Enrollment Period, January 1 to March 31, with coverage starting the month after you sign up.

Coming off a job's health plan: CMS-40B and CMS-L564

Say you kept working past 65, took Part A only, and stayed on your employer's plan. Now you're retiring, or your spouse is, and you need Part B. You aren't applying for Medicare anymore; you already have it. You're adding Part B through a Special Enrollment Period.

Social Security's rule: if you've had group coverage from current employment since turning 65 and it ended within the last 8 months, you can enroll without a penalty, any time of year. You prove it with two forms, or online.

Source: CMS-40B; CMS-L564; Social Security, Sign up for Part B only; Social Security blog, Oct. 17, 2024.

A few details that matter more than they look:

Apply before the job coverage ends if you can. The CMS-40B lets someone still covered by a job's plan (or in the first full month without it) pick the start date: the first day of the month you enroll, or the first day of any of the next 3 months. That's how you line Part B up with the day the employer plan stops, with no gap.

The employer section is the slow part. Getting a signature from HR on the CMS-L564 can take time. If your employer is unable to complete Section B, fill it in yourself as best you can and send other proof of coverage, such as W-2s showing pre-tax medical contributions or pay stubs showing health premium deductions. Keep copies of what you send.

The 8-month clock runs from when coverage or employment ends, whichever is first. Taking COBRA doesn't pause it. COBRA is not coverage based on current employment, so don't plan around it as if it were.

For the coordination questions (who pays first at a 20-employee company, HSA timing, creditable drug coverage), see Medicare and employer coverage after 65.

Step 5: The card, and what to do with it

Medicare.gov says your welcome package with the Medicare card is mailed about 2 weeks after you sign up. If you were enrolled automatically, it's mailed about 3 months before coverage starts. Social Security describes it as a red, white and blue card that shows whether you have Part A, Part B or both. You can also print an official copy from your Medicare.gov account if the mailed one is slow or gets lost.

Check three things the day it arrives: your name matches Social Security's records, the parts you asked for are listed, and the start dates are right. If a date is wrong, call Social Security now. It's much easier to fix before the coverage starts than after a claim is denied.

Then treat the Medicare number like a credit card number. Medicare.gov's advice: don't give it to anyone who contacts you by phone, email or in person unless you reached out first. If someone calls asking for it, asking for money or threatening to cancel your benefits, hang up and call 1-800-MEDICARE (1-800-633-4227).

Source: Social Security FAQ; Medicare.gov, How do I sign up; Medicare.gov, Your Medicare card; Medicare.gov, Joining a plan; CMS, Choosing a Medigap Policy; HCA, Medicare Savings Program.

Step 6: The coverage Social Security doesn't handle

Social Security's job ends with Part A and Part B. Everything else is a separate decision, made with private plans that Medicare approves, and it has its own deadlines.

Drug coverage (Part D). Original Medicare doesn't cover most outpatient prescriptions. Your Part D initial window is the same 7 months as Part B. Medicare.gov warns that going 63 days or more in a row without Part D or other creditable drug coverage after that window can trigger a separate, lifelong penalty. You need Part A or Part B to join a drug plan. More on that in Part D in Washington.

Medicare Advantage or Medigap. These are two different paths. A Medicare Advantage plan replaces how you get your Part A and B benefits and needs both parts. A Medigap (Medicare Supplement) policy sits on top of Original Medicare and helps with deductibles and coinsurance. Medicare.gov is clear that you can have one or the other, not both.

The Medigap timing is the one people miss. Your federal 6-month Medigap Open Enrollment Period starts the first month you have Part B and are 65 or older, and it happens once. Insurers can't turn you down or charge more for health reasons during it. Washington adds its own protections under RCW 48.66.045: the OIC explains that once you have a Medigap plan B through N, you can switch to another plan B through N at any time without a health questionnaire. Our post on Washington Medigap rules covers the details, and Medicare Supplement insurance in Washington explains how we approach it.

To look at options, use the plan finder on Medicare.gov or call 1-800-MEDICARE. Comparing on your own costs nothing, and you'll want your prescription list and your doctors' names in front of you when you do.

Help in Washington: SHIBA and Washington Connection

If your income is limited, apply for a Medicare Savings Program at the same time you apply for Medicare. These are Apple Health (Medicaid) programs that pay the Part B premium and, at the lowest income tier, deductibles and coinsurance too. The Health Care Authority says you can apply online at washingtonconnection.org or on paper with form HCA 13-691, which you can also submit by phone at 1-877-501-2233 or in person at a DSHS Community Services Office.

Two Washington details worth knowing. First, HCA says there is no asset test for these programs, so savings in the bank don't disqualify you. Second, the income limits are higher than many people expect: as of April 1, 2026, the QMB limit for one person is $1,483 a month, and the QI-1 limit (which pays the Part B premium) is $1,855, per HCA's income chart. Qualifying also gets you Extra Help with drug costs automatically, according to Medicare.gov. The full breakdown is in our Medicare Savings Program in Washington guide.

Source: HCA program standards chart, effective 4/1/2026 (includes $20 disregard); HCA, Medicare Savings Program. Limits change each April 1.

The short list

1. About three months before you turn 65, check whether you're already on Social Security. If not, plan to apply.
2. Write down your Social Security number, birthplace and any group health plan dates.
3. Apply online at ssa.gov, or call 1-800-772-1213 for a phone, video or in-person appointment. Railroad workers call the RRB.
4. Decide Part A only vs. A and B based on your job coverage, not on the premium alone. Stop HSA contributions on time.
5. When the card arrives, check it, then make your Part D and Medicare Advantage or Medigap decisions inside your windows.
6. If money is tight, apply for a Medicare Savings Program through Washington Connection. Call SHIBA if any step stalls.

For a broader look at how Medicare works here, see our page on Medicare in Washington.

Questions about applying

Where do I apply for Medicare in Washington state?

With Social Security, not the state. Apply online at ssa.gov/medicare/sign-up, call 1-800-772-1213 (TTY 1-800-325-0778), or make an appointment at a local Social Security office. Railroad workers apply through the Railroad Retirement Board at 1-877-772-5772.

Am I signed up for Medicare automatically at 65?

Only if you start getting Social Security or Railroad Retirement Board benefits at least 4 months before you turn 65. Then you get Part A and Part B and your card is mailed about 3 months before coverage starts.

How long does it take to get a Medicare card after applying?

Medicare.gov says the welcome package with your Medicare card is mailed about 2 weeks after you sign up. You can also print an official card from your Medicare.gov account.

What forms do I need to sign up for Part B after employer coverage ends?

The CMS-40B (Request for Enrollment in Medicare Part B) and the CMS-L564, which your employer completes to confirm your group health coverage. Social Security also accepts Part B-only applications online with uploaded proof of coverage.

Who can help me apply for Medicare in Washington?

SHIBA, the Washington Office of the Insurance Commissioner's Medicare counseling program, at 800-562-6900, 8:30 a.m. to 4:30 p.m., Monday through Friday. Its volunteers give unbiased help at no charge.

Federal Medicare rules, Washington law and your own coverage documents control what applies to you. Confirm your situation with Social Security, 1-800-MEDICARE, SHIBA or a licensed agent, and talk to an attorney for legal questions.

Sources

1. Medicare.gov: How do I sign up for Medicare?
2. Medicare.gov: When does Medicare coverage start?
3. Medicare.gov: Your Medicare card
4. Medicare.gov: Joining a plan
5. Medicare.gov: Avoid late enrollment penalties
6. Medicare.gov: How Medigap works
7. Medicare.gov: Help with drug costs (Extra Help)
8. CMS: Choosing a Medigap Policy (2026)
9. CMS: 2026 Medicare Parts A & B premiums and deductibles
10. CMS-40B: Request for Enrollment in Medicare Part B (07/2025)
11. CMS-L564: Medicare Request for Employment Information (03/2025)
12. Social Security: Sign up for Medicare
13. Social Security: Sign up for Part B only
14. Social Security FAQ: How do I sign up for Medicare?
15. Social Security publication 05-10043: Medicare (April 2026)
16. Social Security blog: Sign up for Medicare Part B online, by fax, or by mail (Oct. 17, 2024)
17. eCFR: 42 CFR 407.17, Automatic enrollment
18. Railroad Retirement Board: Medicare
19. Washington OIC: Get Medicare help from SHIBA
20. Washington OIC: Medigap (Medicare Supplement) plan coverage and costs
21. RCW 48.66.045: Medicare supplement policy requirements
22. Washington HCA: Medicare Savings Program
23. Washington HCA: Application for Medicare Savings Programs (HCA 13-691)
24. Washington HCA: Program standards for income, effective April 1, 2026