Enrollment Windows Are Limited
If you’re thinking about delaying your enrollment in Medicare, keep in mind that there are enrollment windows that apply. After your initial enrollment window ends, you can only sign up for Medicare Part A and B during the general annual enrollment period from January 1March 31, with coverage effective July 1.
And you can sign up for Part D during the annual enrollment period from October 15December 7, with coverage effective January 1 of the coming year.
So if you delay your enrollment, you could be paying higher premiums when you eventually do enroll, and you’ll have to wait until an open enrollment period in order to have access to coverage. If you’re only enrolled in Part A, for example, and you get diagnosed with a serious illness in April, you’ll have to wait until the following January to have Part D coverage, and until the following Julymore than a year in the futureto have Part B coverage.
Keep all of this in mind when you’re deciding whether to enroll in the parts of Medicare that have premiums.
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No, your Original Medicare benefits will not change when you turn 65. All of the Part A and Part B coverage you have had for the last decade will stay as is.
What may change, however, are your options for private Medicare insurance, such as Medicare Advantage plans, standalone Medicare Part D prescription drug plans or Medicare Supplement plans.
Only 10 states require insurance companies to sell Medigap plans to beneficiaries under 65 in 2020 .
Note: Medicare Advantage plans and Medicare Supplement plans arent the same thing. They work in very different ways, and you cannot have both types of coverage at the same time.
Do You Have To Take Medicare If You Have Other Insurance
You do not have to take Medicare if you have other insurance, and youâre actually exempt from penalties. That means that if you want to switch to Medicare after youâre 65, you donât have to pay a penalty for waiting.
The most common example is an individual who waits to retire. He or she has group coverage through their employer, so they donât need Medicare. As soon as they retire, theyâre free to sign up for Medicare without paying any of the penalties.
As long as you have some kind of health insurance coverage â even if youâre over age 65 â you canât be penalized when you do decide to make the switch to Medicare.
If youâd like a Medicare specialist to help you one-on-one, schedule a free Medicare planner with one of our licensed agents. Call our team at 833-801-7999.
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If The Employer Has Fewer Than 20 Employees
The laws that prohibit large insurers from requiring Medicare-eligible employees to drop the employer plan and sign up for Medicare do not apply to companies and organizations that employ fewer than 20 people. In this situation, the employer decides.
If the employer does require you to enroll in Medicare, then Medicare automatically becomes primary and the employer plan provides secondary coverage. In other words, Medicare settles your medical bills first, and the group plan only pays for services that it covers but Medicare doesnt. Therefore, if you fail to sign up for Medicare when required, you will essentially be left with no coverage.
Its therefore extremely important to ask the employer whether you are required to sign up for Medicare when you turn 65 or receive Medicare on the basis of disability. If so, find out exactly how the employer plan will fit in with Medicare. If not, ask for that decision in writing.
Note that in this situation, signing up for Medicare Part B when you also have employer insurance will not jeopardize your chances of buying Medigap supplemental insurance after the employment ends. When Medicare is primary to the employer plan, you have the right to buy Medigap with full federal protections if you do so within 63 days of the employer coverage ending.
The Basics On Signing Up
Medicare enrollment in Part A and Part B is automatic if you have claimed Social Security benefits before your 65th birthday your Medicare card will arrive in the mail and coverage begins the first day of the month in which you turn 65. There is no premium charged for Part A in most cases, and you may be able to turn down Part B at that point without incurring late-enrollment penalties if you are still working and receive your primary insurance through work.
If you have not yet applied for Social Security, signing up for Medicare requires proactive steps to avoid problems.
Medicare offers an Initial Enrollment Period around your 65th birthday. If you miss that window, you will be subject to a late enrollment surcharge equal to 10 percent of the standard Part B premium for each 12 months of delay a penalty that continues forever. That can really add up. In 2017, 1.3 percent of Part B enrollees paid penalties , according to the Congressional Research Service. On average, their total premiums were 31 percent higher than what they would have been.
Medicares prescription drug program comes with a much less onerous late enrollment penalty, equal to 1 percent of the national base beneficiary premium for each month of delay. In 2019, the base monthly premium is $33.19, so a seven-month delay would tack $2.32 onto your plans premium.
Late enrollment also exposes you to significant gaps while waiting for Medicare coverage.
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Do You Have To Get Medicare If You Are Still Working
Whether you are working or not when you turn age 65, youll still be eligible for Medicare coverage. It is not mandatory to sign up for Medicare. In fact, you may prefer the healthcare coverage offered by your employer. However, if you defer or decline Medicare coverage, you could pay some form of penalty.
Well go over some of the things you might consider before deciding to enroll in Medicare while still being employed.
- limited stays in a skilled nursing facility
If youre eligible for premium-free Medicare Part A, theres often very little downside to enrolling. You may be eligible for premium-free Part A if you paid into Medicare through payroll taxes for at least 10 years of employment.
If you work for a large company with more than 20 employees, a Medicare policy can act as a secondary payer and can help to fill in gaps in your existing coverage without any additional cost on your end.
If you work for a small company or have a health insurance plan through your employer with minimal coverage, enrolling in Medicare may help reduce your medical expenses.
Medicare will often become the primary payer in these cases and may provide better coverage than you currently receive. In fact, your small employers insurance may not cover you if they discover youre eligible for Medicare benefits and havent enrolled.
Review Options Available In Your County
Different health plans are available based on the county where you live. If you already have Medicaid, youve been in touch with a county worker who helps you with your plan. As you approach your 65th birthday, your county worker will provide you with a list of options so you can choose the right plan for your needs.
Your options at age 65 include plans called Minnesota Senior Care Plus or Minnesota Senior Health Options .
- Determine if you are dual eligible for Medicare and Medicaid. If you are, a plan that combines the services of both programs may be a good choice for you. You dont need to worry about coordinating coverage between both programs and can have it all in one.
- Understand whats covered in each plan type
- Compare MSHO vs. MSC+ plans to decide which plan is best for you
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Do You Have More Questions About Enrolling In Medicare
I can help you compare costs and coverage, as well as Medicare plan types, available in your area. To get started:
- Feel free to let me know if youd like to discuss anything with me by phone or email the links for requesting those are below as well.
New To Medicare?
Becoming eligible for Medicare can be daunting. But don’t worry, we’re here to help you understand Medicare in 15 minutes or less.
How To Apply For Medicare Through Social Security
Apply online: The easiest way to complete the Medicare enrollment application is online at ssa.gov. Its convenient to sign up from home. You can start and stop the application and save your information. After you submit your application, youll get a receipt to print and keep. You can also check the status of your application.
Apply in person: Visit your local Social Security office. You can find the nearest office with the Social Security office locator. They recommend that you make an appointment.
Apply by phone: Call Social Security at 800-772-1213 .
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Medicare Initial Enrollment Period
Your first chance to enroll in Medicare is around age 65 when you have a seven-month window to apply. During the Medicare Initial Enrollment Period, you can enroll in Original Medicare Parts A and B. You can look at plans or sign up at any time during the three months before, the month of, and the three months after your 65th birthday. Need coverage the month you turn 65? Sign up in the three-month window before your birthday.
Take a deeper dive in our related article about all-things Medicare Initial Enrollment Period.
Know Your Medicare Plan Options
Everyone has different health care needs. The best Medicare plan for you may look different from what works for others in your life. Having a cancer diagnosis adds an additional layer to consider. Before making any enrollment decisions, its important to do your research and understand how Medicare is structured.
The U.S. governments Medicare websiteoffers helpful information. Or you can call 1-800-MEDICARE. You can also get free guidance through the State Health Insurance Assistance Program . This federally funded counseling service offers objective support to help you understand your options. Call SHIP at 1-877-839-2675 or visit the SHIP National Technical Assistance Center website.
As you do your research, these are some of the Medicare plans you may encounter:
- Part A of original Medicare covers inpatient hospitalization, skilled nursing care, hospice, and some home care services.
- Part B of original Medicare covers outpatient services such as doctors visits, physical and occupational therapy, preventive screenings, and some medical equipment and supplies.
- Part D covers outpatient prescription drugs.
- Part C or Medicare Advantage is an alternative coverage plan offered through federally approved private insurance companies. These plans are required to provide at least the same coverage as Parts A and B and in most cases, Part D. However, they may have different rules, costs, and coverage restrictions.
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Retiring At 67 Understanding Your Medicare Benefits
For anyone born after 1960 or after, the full retirement age is 67. This is the age that you will be able to receive your full retirement benefits. However, if you are planning to retire at the age of 67, you should be aware that you may need to make some decisions about your health insurance prior to retirement. Medicare provides coverage for all adults over the age of 65 or with long-term disabilities, but to take advantage of this care, you must enroll at the appropriate time to receive the best coverage at the best price.
When Should You Apply for Medicare Coverage?
In order to receive Medicare coverage, you will need to apply during the initial enrollment period. This period begins three months prior to your birthday and ends three months after you turn 65. In order to receive Medicare benefits, it is critical that you enroll in coverage during this initial period so that you can ensure you gain coverage that will last you throughout the remainder of your life.
Upon initial enrollment, you can enroll in both Medicare Part A and Part B. Part A enrollment is required, whereas Part B enrollment is optional. However, if you decide to decline Part B enrollment and that you would like to receive this coverage at a later time, you may experience a delay in coverage and be forced to pay a higher premium payment.
What Medicare Coverage Will You Receive?
Things You Should Know
How to find out whether or not you are eligible for Medicare Part A and Part B benefits if you are retired and under age 65 and your spouse or you are disabled
If you or your spouse is disabled and receiving Social Security disability benefits, contact Social Security about Medicare-eligibility. If eligible, contact the GIC at 617.727.2310 to request a Medicare Plan enrollment form.
If you have been a state employee and have never contributed to Social Security
You may still be eligible for Medicare benefits through your spouse. When you turn age 65, visit Social Securitys website or call Social Security to apply to see if you are eligible.
What happens to your spouse’s coverage if you enroll in a GIC Medicare Supplemental Plan
Your spouse will continue to be covered under in a GIC non-Medicare plan if he/she is under age 65 until he or she becomes eligible for Medicare. See the Benefit Decision Guide for under and over age 65 health insurance products. If your spouse is over age 65, he/she must enroll in the same Medicare supplemental plan that you have joined.
What you need to do at age 65 if your spouse or yourself was not eligible for Medicare Part A for free, but now, you and your spouse have subsequently become eligible for Medicare Part A for free
You or your spouse must notify the GIC in writing when you become eligible for Medicare Part A. The GIC will notify you of your coverage options. Failure to do this may result in loss of GIC coverage.
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D Late Enrollment Penalty
The Part D late enrollment penalty is similar to the Part B late enrollment penalty, in that you have to keep paying it for as long as you have Part D coverage. But it’s calculated a little differently. For each month that you were eligible but didn’t enroll , you’ll pay an extra 1% of the national base beneficiary amount.
In 2020, the national base beneficiary amount is $32.74/month. Medicare Part D premiums vary significantly from one plan to another, but the penalty amount isn’t based on a percentage of your specific planit’s based instead on a percentage of the national base beneficiary amount. Just as with other parts of Medicare, Part D premiums change from one year to the next, and the national base beneficiary amount generally increases over time.
So a person who delayed Medicare Part D enrollment by 27 months would be paying an extra $8.84/month , on top of their Part D plan’s monthly premium in 2020. A person who had delayed their Part D enrollment by 52 months would be paying an extra $17.02/month. As time goes by, that amount could increase if the national base beneficiary amount increases . People subject to the Part D late enrollment penalty can pick from among several plans, with varying premiums. But the Part D penalty will continue to be added to their premiums for as long as they have Part D coverage.
Questions To Ask Your Employer Benefits Manager Include:
- Will my health insurance change if I enrolled in Medicare? If so, how?
- How much is deducted from my paycheck for my employer health insurance?
- Do I have through my employer?
- How will my covered dependents be impacted if I choose to get Medicare?
This information will help you weigh your choices and decide whats best for you. You may decide to enroll in Medicare Part A, Part B or both. Or you may be able to and want to delay enrolling in Medicare all together until you retire.
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I Did Not Enroll In Medicare When I Turned 65 And Was First Eligible Can I Sign Up Later
En español | Your initial enrollment period for Medicare lasts for seven months, of which the fourth is the one in which you turn 65. For example, if your birthday is in June, your IEP begins March 1 and ends Sept. 30. If you miss signing up for Medicare during your IEP or if you deliberately postponed enrollment because you receive health coverage from a current employer you have two options to sign up, depending on your situation:
Special Enrollment Period
If you are covered under a group health plan provided by an employer for which you or your spouse actively works, you have the right to delay enrollment in Medicare until the employment or the coverage ends whichever happens first. The whole time that you have this coverage, and for up to eight months after it ends, counts as a special enrollment period during which you can sign up for Medicare without risking late penalties. While active employment continues, you can specify the date on which you want Medicare coverage to begin, up to three months in advance. Otherwise, your coverage begins on the first day of the month after you enroll.
If you need Medicare prescription drug coverage, you will not be hit with late penalties if you join a Part D drug plan within two months of the employer drug coverage ending.
General Enrollment Period
If you need Medicare prescription drug coverage, you can sign up with a Part D drug plan during April, May or June in order to begin coverage on July 1.