Medicare Advantage Where You Live
Medicare Advantage plans can be administered on state and local levels.
- Some types of plans may be available in certain regions of a state but not in others.
- Some plans may come with certain premiums and other costs in one part of a state while the same plan features different costs in another county.
- Some health insurance companies and Medicare Advantage plan providers may offer plans in one part of a state but not in others.
Learn more about Medicare Advantage plan costs and availability in your state.
I Want To Enroll In Medicare What Are My Next Steps
Once you’re ready to enroll in Medicare, you’ll want to consider the following next steps:
S To Sign Up For A Part D Plan
1. Compare the Part D options in your area by using the Plan Finder tool at Medicare.gov.
You can log in to your Medicare account to get information about the plans in your area. You also can use the tool without logging in.
2. If you select Continue without logging in, youll be able to choose the type of coverage you want, such as a Part D drug plan. Enter your zip code and select your county.
3. Now indicate whether you get help with your medical expenses. If youre not sure, you can find out by logging in to your Medicare account.
4. If you dont receive any help, youll be asked if you want to see your drug costs when you compare plans. Click Yes so you can get a sense of how much you would spend with each plan.
5. Enter the names of your medications. Be sure to include ones you take regularly so that youll get a good estimate of ongoing costs. Youll also need to select the dosage and quantity and indicate how frequently you need to refill your prescriptions. To add another medication, click Add Another Drug. When youre finished, click Done Adding Drugs.
6. Choose up to five pharmacies where you want to fill your prescriptions. Many plans charge lower copayments for preferred pharmacies. You can see how plans work with the pharmacies and what your copayments would be for each one. Enter the names of pharmacies you use or search by your address or zip code.
For help signing up for a Part D plan, contact your State Health Insurance Assistance Program .
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Sign Up For Original Medicare
In most cases, you wont receive Medicare benefits automatically unless you sign up. But if you already receive benefits from Social Security or the Railroad Retirement Board, youll be automatically enrolled.
If you dont enroll in Part B during the seven months around your 65th birthday, your Initial Enrollment Period, you could incur a penalty.
There is an exception, though: If youre still working and have health coverage through your job, you can sign up for Part A, which usually involves no premium, and you may be able to delay signing up for Medicare Part B . To avoid penalties for delayed enrollment, you must have medical coverage through your or your spouses job.
If you or your spouse have worked for at least 10 years, you typically wont pay a premium for Medicare Part A coverage.
Medicare Advantage Enrollment Period
Whether youre enrolling in Medicare Part C for the first time or want to make changes to an existing Medicare Advantage plan, there are many things to keep in mind. Youll need to know if you qualify for an enrollment period, when your benefits will start, and what happens if you dont meet the deadlines.
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Penalty Fees For Late Enrollment
Medicare charges penalty fees for those who do not enroll in their Initial Enrollment Period, or they do not qualify for an exception due to employer insurance or other coverage.
Unless a person qualifies for a special exception, they will pay a monthly premium that is 10% higher for every 12-month period they were eligible for Medicare but did not sign up.
A person can qualify for a Medicare plan before 65 years of age if they meet certain criteria:
- They have end stage renal disease and need dialysis or are on the kidney transplant list.
- They have amyotrophic lateral sclerosis .
- Their doctor confirms that they have a disability.
An estimated 6.2 million people qualify for Medicare because they are disabled, according to the Medicaid and CHIP Payment and Access Commission. However, significantly fewer people use these benefits.
A doctor may declare a disability for people due to several types of medical conditions, including:
- Intellectual or developmental disabilities: These might include Down syndrome, cerebral palsy, or autism.
- Physical conditions: Traumatic brain injury, severe back injuries, or quadriplegia qualify as disabilities.
- Severe behavioral or psychological disorders: People with bipolar disorder or schizophrenia can qualify for Medicare early.
A doctor must submit paperwork to Medicare, declaring that a person has a disability. The individual may have a waiting period before they qualify for full Medicare benefits.
When Do I Need To Sign Up For Medicare Part A
As stated above, if youre collecting Social Security benefits, youll automatically get Part A and Part B. If youre not automatically enrolled, the best time to enroll in Part A is during your Initial Enrollment Period.
As long as you worked a minimum of ten years, Part A will be premium-free. Even if youre still working, it makes sense to join Part A to help keep your out-of-pocket medical costs to a minimum.
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What Happens If You Need To Change Plans During A Period You Cannot Change Plans
The only way to change Medicare Advantage Plans outside of the standard annual enrollment periods is by qualifying for a Special Enrollment Period. include, but are not limited to:
- Moving outside of your current plans service area.
- Moving to a new address within your current plans service area but which has new plan options.
- Moving into or out of a skilled nursing facility or long-term hospital care.
- You are eligible for both Medicare and Medicaid.
- Becoming ineligible for Medicaid.
- If Medicare takes an official action because of a problem with your current plan that affects you.
- If Medicare terminates or does not renew your current plans contract.
- You joined a plan or chose not to join a plan due to an error by a federal employee.
You generally have 2 months to make a change to your Medicare Advantage Plan during a SEP.
For a complete list of special circumstances that qualify you for a SEP, click here: Special circumstances .
When Are You Eligible To Sign Up For Original Medicare
The best time to apply is during your initial enrollment period. Thats the three months before, the month you turn 65, and the three months after. This will help you avoid fees or delays in coverage. If you have questions or are wondering about signing up for Medicare while still working, we can . You can also find out more about .
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When Can You Sign Up For Medicare Supplement Plans
When it comes to Medicare Supplement plans, you can join at any time of the year. If your Open Enrollment window has passed, you can still apply. However, youll most likely have to go through medical underwriting and answer health questions during the application process.
Outside your one-time open enrollment window, a carrier can deny you coverage due to pre-existing conditions or health issues. The only way around this is if youre granted guaranteed issue rights due to a circumstance that would qualify you for a Special Enrollment Period.
Some states have unique open enrollment rules, such as birthday rules that allow you to enroll in Medigap around your birthday each year, without answering health questions. In Connecticut, there is a year-round open enrollment window for all beneficiaries.
Enrolling In Medicare With A Qualifying Disability Or Medical Condition
With a qualifying disability, you usually become Medicare-eligible after you’ve received disability benefits for 24 months. You will have a 7-month Initial Enrollment Period that includes your 25th month of disability, the 3 months before and the 3 months after.
You may also qualify for Medicare due to Lou Gehrig’s disease or end-stage renal disease . Enrollment for ALS or ESRD is unique, so you’ll want to review the rules for each carefully.
Scroll for Important Disclosures
UnitedHealthcare pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. AARP does not employ or endorse agents, brokers or producers.
AARP encourages you to consider your needs when selecting products and does not make product recommendations for individuals.
Please note that each insurer has sole financial responsibility for its products.
AARP® Medicare Supplement Insurance Plans
AARP endorses the AARP Medicare Supplement Insurance Plans, insured by UnitedHealthcare.
Insured by UnitedHealthcare Insurance Company, Hartford, CT or UnitedHealthcare Insurance Company of America, Schaumburg, IL or UnitedHealthcare Insurance Company of New York, Islandia, NY . Each insurer has sole financial responsibility for its products. Policy form No. GRP 79171 GPS-1 .
Not connected with or endorsed by the U.S. Government or the federal Medicare program.
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When Can I Sign Up For Medicare Part A And Part B
If youre already getting Social Security or Railroad Retirement Board benefits, usually you will be contacted a few months before you become eligible for Medicare and given the information you need. Most people will be enrolled in Medicare Part A and Part B automatically during their individual Initial Enrollment Periods. However, because you must pay a premium for Part B coverage, you have the option of turning it down. If you opt out of Part B and then decide to enroll later, you might end up paying a late-enrollment penalty.
If you dont qualify for automatic enrollment, you can sign up for Original Medicare, Part A and Part B during your initial enrollment period by contacting the Social Security Administration. You can call Social Security at 1-800-772-1213 or TTY 1-800-325-0778 between 7 a.m. and 7 p.m. Monday through Friday in every time zone.
If you turn down or delay your enrollment in Part B, you may have to pay a 10 percent Part B premium penalty for each 12-month period for which you qualified but delayed enrollment. This penalty is added to your monthly Part B premium, and would begin once you enroll in Part B. In 2021, the standard Medicare Part B premium amount is $148.50 .
Life Changes That Can Qualify You For A Special Enrollment Period
Important: If you had a change more than 60 days ago but since January 1, 2020
If you qualified for a Special Enrollment Period but missed your deadline to enroll in coverage because you were impacted by the COVID-19 emergency, you may be eligible for a Special Enrollment Period.
If you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days, you may qualify for this Special Enrollment Period through the application.
If you had a life event other than a loss of coverage more than 60 days ago and missed your Special Enrollment Period, contact the Marketplace Call Center at 1-800-318-2596 for more information.
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Open Enrollment Period For Medicare Supplement Plans
- Once-in-a-lifetime window
- Begins the same day as your Part B effective date
- No health questions during this time
- Not the same as the Medicare Annual Enrollment Period
Applying outside your open enrollment window can result in higher premiums, as well as restrict your coverage options. This window only lasts for six months for each new beneficiary.
Your Medicare Supplement Open Enrollment Period is not the same as the fall Annual Election Period. AEP pertains to Medicare Advantage and Part D plans and the dates are the same every year. With your individual Medigap Open Enrollment Period, the dates are unique to you and it only concerns Medicare Supplement plans.
Your individual Medicare Supplement Open Enrollment Period starts the first day of the month your Part B is in effect. You must also be 65 for this window to begin. For example, if your Part B coverage begins April 1st, then your individual Medicare Supplement Open Enrollment Period window will start then and continue for six months, ending September 30th.
For most, this period starts when they age into Medicare at 65 and enroll in Part B. Yet, others choose to delay enrolling in Part B due to through their large employer group plan. When they do retire and enroll in Part B, their Medicare Supplement Open Enrollment Period will commence on their Part B effective date.
How To Cancel Medicare Part B
You may be automatically enrolled in Part B medical insurance. When you receive your Medicare card and welcome packet in the mail, the back of your Medicare card will include instructions for disenrolling from Part B.
If you do not initially disenroll in Part B, you will have to do so by contacting your local Social Security office or calling 1-800-772-1213 .
You may not disenroll from Part B online. You will have to speak directly to a Social Security agent to complete the process.
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How Do I Know Im Enrolled In Medicare
After you apply for Medicare, Social Security will review and process your application. Theyll contact you if they need more information.
When youre approved for Medicare Part A and/or Part B, Social Security will send you a welcome packet that includes the following:
- Your confirmation letter
- Your red, white and blue Medicare ID card
- A Welcome to Medicare booklet that walks you through decisions you may have to make with your Medicare coverage
- The Medicare & You handbook
If youve applied for a private Medicare plan such as a Medicare Advantage, Medicare Cost, Medigap or Medicare Prescription Drug plan, when your enrollment is accepted youll get a separate confirmation letter and ID card.
Medicare helps pay for your health care costs and covers preventive care including a visit with your doctor each year. So once you get Medicare Part B, schedule your initial Welcome to Medicare visit with your doctor. And each year you get an Annual Wellness Visit with your doctor.
For more helpful tips, review this checklist, how to use Medicare your first year.
When Do I Sign Up For Medicare Advantage
Before you sign up for Medicare Advantage, make sure you weigh the pros and cons of Medicare Advantage vs. Medicare Supplements. If you choose to sign up for Medicare Advantage, you can do so during your IEP.
If you missed your IEP, you can join during the Medicare Annual Enrollment Period. For those currently enrolled in a Medicare Advantage plan, you also have another opportunity to make changes during the Medicare Advantage Open Enrollment Period.
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Are There Other Key Dates To Know
If someone did not sign up for Medicare Part B during their Initial Enrollment Period, they could apply during a General Enrollment Period that runs from .
If a person signs up during this time, their Medicare benefits will start on July 1 of the same year.
A Medicare Advantage Open Enrollment Period is also available between the same dates, during which a person can make one change to their Medicare coverage.
Such a change might involve switching from one Medicare Advantage plan to a different plan or returning to Traditional Medicare.
However, a person cannot switch from Original Medicare to Medicare Advantage during this time.
When Can You Enroll In Medicare Advantage
You can enroll in Medicare Advantage during your Initial Enrollment Period. But you must first sign up for Parts A and B during your Initial Enrollment Period.
You can also enroll if you qualify for a Special Enrollment Period. If you lose your health insurance at your job, you can sign up for a plan up to eight months after losing your coverage.
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Applying For Medicare With Employer Coverage
Can you still enroll in Medicare coverage, even if youre not yet seeking retirement? The answer is yes! Medicare coverage can coincide with your group coverage through your employer. If your employer has more than 20 employees, your group coverage will work as your primary insurance, and Medicare will be your secondary insurance.
You can choose to apply for Part B, or you can wait until leaving your employer group coverage. For more information on the benefits of obtaining Medicare while receiving group coverage through work, give our team a call, and we can review the pros and cons.
Sometimes beneficiaries dont want to apply for Part B when they initially become eligible because of employer health coverage. Should you lose your health insurance through your employer, or if you prefer to switch over to Medicare, you can apply any time while receiving coverage through your employer.
Do I Need Medicare Part B
We always advise our clients to contact their employer or union benefits administrator before delaying Part A and Part B to learn more about how their insurance works with Medicare. Employer coverage may require that you enroll in both Part A and Part B to receive full coverage.
Common reasons beneficiaries delay Part B include:
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