Do You Need To Enroll In Medicare Every Year
If you are not sure whether you need to enroll in Medicare every year when the enrollment period is opened, the team at Hyers & Associates is here to help. Weve detailed information below, however, we also welcome your call anytime.
In most cases, you do not need to enroll in Medicare each year. You do want to check your coverage elections to make sure you have the most suitable policies for the upcoming year. Our team is always available to take your call and help you with any questions or concerns you might have.
The Parts Of Medicare
Social Security enrolls you in Original Medicare .
- Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
- Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.
Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.
- Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
- Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
- Medicare Part D helps cover the cost of prescription drugs.
Most people age 65 or older are eligible for free Medical hospital insurance if they have worked and paid Medicare taxes long enough. You can enroll in Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .
Do You Have To Renew Original Medicare Part B
You do not have to renew Part B coverage as long as you continue to pay the monthly premiums. In most cases, this premium is subtracted on a monthly basis from your Social Security payments or, if you dont receive Social Security, youll get a monthly bill.
If you do not pay your premium for three months in a row, youll get a cancellation notice. While you can pay your missed payments after your cancelation notice, you only have a short time to do so, and then you will lose your Part B coverage.
You can then re-enroll in Part B in the General Enrollment Period , though youll likely face a late enrollment penalty.
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If You Already Receive Benefits From Social Security:
If you already get benefits from Social Security or the Railroad Retirement Board, you are automatically entitled to Medicare Part A and Part B starting the first day of the month you turn age 65. You will not need to do anything to enroll. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If your 65th birthday is February 20, 2010, your Medicare effective date would be February 1, 2010.
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If Youre Enrolling For The First Time
If you are already getting Social Security benefits when you turn 65, you will automatically be enrolled in Medicare Parts A & B. You will know this has happened as youll find a Welcome to Medicare packet in your mailbox. You may also receive automatic enrollment if:
- If for any reason you dont currently have Medicare coverage. This may have happened if you delayed starting your Social Security at age 65.
- You have had Social Security Administration or Railroad Benefits for disability for 24 months or more.
- You delayed enrolling in Medicare Part A or B.
Also, if you have any of the following health problems different enrollment rules apply:
- If you have ALS, also known as Lou Gehrigs disease, your Medicare enrollment begins as soon as your coverage for these diseases gains approval.
- If you are younger than age 65, but have end-stage kidney failure, and need dialysis or a kidney transplant you may qualify for Medicare.
When youre ready to enroll in Medicare you can do that by:
- Go to your local Social Security office.
- Enroll online over the internet at the Social Security website.
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How To Apply For Medicare By Phone
Applying for Medicare by phone is just as easy as applying for Medicare online. Contact Social Security at 1-800-772-1213 and tell the representative that you wish to apply for Medicare. If you have Railroad Retirement, you can contact the U.S. Railroad Retirement Board at 1-877-772-5772. Sometimes you will be helped immediately. If the volume of calls is high, Social Security will schedule a telephone appointment with you to take your application over the phone.
Your SS representative may send you some forms to complete. Generally these forms are simple. One caveat about phone applications for Medicare is that they take longer. The forms have to be mailed to you, and then you complete them and mail back. This can cause delays. Use the phone enrollment option only if you have a month or two lead time before your intended Medicare effective date.
Finally, there are some people who just feel better handling their Medicare enrollment in person. So lets close by going over how to apply for Medicare in person.
Applying For Medicare When You Have Large Employer Coverage
Medicare can coordinate with your employer insurance even if you or your spouse are still working. If you or your spouse are actively working at an employer with 20+ employees and you are covered by that insurance, Medicare will be secondary to the employer coverage.
In that case, you can choose whether to enroll in Medicare Part B or delay your enrollment into Part B until later. Your group health plan likely has coverage for medical services already built in, so delaying Part B enrollment can save you money until you retire from your job.
When to apply for Medicare varies for each person. Whats worse is that even though these rules exist, there are often workers at Social Security who will get them wrong. This can really affect you, so contact a Medicare insurance broker like Boomer Benefits for help. We have solved Medicare enrollment issues for our clients with plain facts in many conference calls with Social Security.
Lastly, if you are still working at 65, well evaluate the costs of your employer coverage compared to Medicare. If staying at your employer insurance makes more sense, we can help you decide whether to enroll in Parts A or B or both.
Please note, you will qualify for a Special Enrollment Period after 65 and will need to submit documentation when you apply for Medicare due to loss of employer coverage. The two documents include CMS form 40B and CMS form L564 which is your proof that you had creditable coverage during employment.
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How To Avoid The Medicare Part D Late Enrollment Penalty
You are not required to do your Medicare Part D enrollment during your IEP. However, if you go without Medicare Part D or other creditable prescription drug coverage for a continuous period of 63 days or longer after your IEP is over, you could be subject to a Part D late enrollment penalty. Coverage could come from a stand-alone prescription drug plan, a Medicare Advantage plan with prescription drug coverage , or another type of creditable prescription drug coverage.
The amount of the Part D late enrollment penalty depends on how long you went without prescription drug coverage. Medicare calculates the amount by multiplying the number of months you didnt have prescription drug coverage by 1% of the national base beneficiary premium. In 2021, the national base beneficiary premium is $33.06.
The penalty amount is added to your monthly premium and you will continue to pay the penalty as long as you are enrolled in Medicare Part D. You can avoid this penalty by ensuring you dont go without creditable prescription drug coverage for 63 days or longer. Creditable coverage pays at least as much as standard Medicare coverage for prescription drugs.
Medicare Part D enrollment is the first step in getting the coverage you need for your prescription medications. With multiple plans to choose from, it is helpful to compare plans carefully to find the right plan for you. You can start by entering your zip code on this page.
New To Medicare?
Other Reasons To Make A Change
There are other questions you should think about. Have you experienced changes in your health which will affect your choices? Do you want to consider trying the Medicare Advantage Program? Are your preferred doctors and hospitals still in network? Has your current Part D Prescription Coverage provider changed their pricing? And have they changed the prescriptions they will cover?
If you answered yes to any of these questions you should take a closer look at whether you want to maintain your current program. It is possible they wont cover drugs you currently take. Or have added new some medications and need to change your drug coverage list? This is your one opportunity to take a second look at your coverage before committing for another year.
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Ask: Have My Health Care Needs Changed
Things change in life, and some changes may affect the kind or amount of health care you need. For example:
- A new diagnosis might mean more doctor visits or new medications
- An advancing illness may increase the number or length of hospital stays or require home care
- Additional medications may be needed to manage chronic conditions such as diabetes, arthritis or heart disease
- Maybe you have a planned surgery coming up.
Examples like these can help get you thinking, but whats important is to look carefully at your health care needs past, present and, as much as possible, future. Only then can you choose the type of coverage and specific plans that may best meet your personal needs.
Once you have a good handle on your health care needs, its time to look at your current coverage.
What If I Dont Sign Up For Part B Because I Have Other Health Insurance
If you have health insurance through your employer, your spouses employer, or a union, you can keep your coverage. You wont have to pay a penalty for waiting to sign up for Part B. But, if you lose your coverage or stop working for that employer, the clock begins to tick.
Usually, you will be allowed to sign up for Part B right away, during a Special Enrollment Period. This is an eight-month period beginning when the employment coverage ends. If you do not enroll during this period, youll have to pay a Part B penalty for each full 12 months you wait, beyond the date, the SEP began.
For example, if youre still working when you turn 65, you can keep your employer health insurance instead of signing up for Part B. If you then retire at age 67, you can avoid a penalty by signing up for Part B during your eight-month SEP. If you instead decide to wait until age 70 to enroll, you will pay a 30% penalty every month. 10% for every 12-month period you delayed.
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What Are The Circumstances That May Require Me To Renew Medicare Coverage
So long as you pay your monthly premium and continue to collect Social Security, you will never need to renew your Original Medicare plan. Parts A and B are provided by the federal government and are not subject to the changes that may affect private insurers.
Conversely, Medicare Advantage and Medicare Part D are offered by private insurers and therefore come with the same caveats youd expect from any insurance plan.
The most common reason for needing to re-enroll in your plan is if your plan becomes unavailable in your area. This is most commonly due to a move but can also occur if a plan changes its service area. An insurance company might also decide to stop offering a specific plan. Finally, the government might stop offering a Medicare Advantage or Medicare Part D plan due to a low star ranking.
Regardless of the reason, plan members affected by these changes are typically eligible for a Special Enrollment Period, allowing them to sign up for a different plan outside of typical enrollment periods.
How To Apply For Medicare Through Social Security
Apply online: The easiest way to file for Medicare is to complete an online application 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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B Late Enrollment Penalty
If you dont sign up for Part B when youre eligible, you will most likely have to pay a late penalty. This penalty will last for as long as you have Part B.
To calculate the penalty, take your standard monthly premium amount and increase it by 10 percent for each 12-months you could have had Part B but didnt. For example, if you could have had Part B for two years but didnt, youd have to pay a 20 percent penalty. Your monthly premium would be increased by 20 percent for as long as you have Part B.
When To Sign Up For Medicare Plans
When you sign up for the various Medicare coverages and when each one comes into effect varies with the different Plans. A general outline follows specific situations or health conditions touch off a number of different enrollment periods. For fuller details see the publications.
Enrolling in Medicare parts A & B:
Part A
For qualified individuals, you should sign up during the Initial Enrollment Period of seven months around the month you turn 65 . Note that this may be before you can or choose to file for Social Security benefits. If you enroll prior to the birthday month, you will start being covered as of your birthday month. If you enroll during the last four months of the period, coverage will start with an additional months delay.
If you didnt sign up for Part A during your Initial Enrollment Period, you can sign up during the General Enrollment Period between January 1 and March 31 each year. Coverage will begin July 1. If you are a qualified individual, there may be a penalty premium for late sign-up, as mentioned above .
In certain cases, if you did not sign up for Plan A when initially eligible because you were covered under a group health plan based on current employment, you can sign up later during a Special Enrollment Period. See Publication 11219 for details.
Part B :
Part C and Part D :
Some addiitonal information on Medicare sign up can be found at the following non-US government links:
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Applying For Medicare With Our Free Assistance
Still concerned about how to sign up for Medicare? Dont want to go in it alone or feel unsure about your Medicare enrollment dates?
You dont have to submit your Medicare application alone. We are here to help you register for Medicare.
If Medicare will be your primary health insurance, and youd like a personal guide to take you from applying for Medicare all the way through to setting up your Medigap and Part D plans, we are your go-to source for help. Our service is free, and afterward you also get access to our Client Service Team for free for the life of your policy.
Get someone on your side contact Boomer Benefits for help with your plan options today!
I Turn 65 In A Few Months When Should I Sign Up For Medicare
En español | If you already receive Social Security benefits, Social Security will automatically sign you up for Medicare Part A and Part B though you can decline Part B enrollment if you want to. Otherwise, you need to apply for Medicare. The best time to do that depends entirely on your own situation. Broadly, there are two options:
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If Your Spouse Is Younger Than 65
He or she has two options for getting covered when you transition to Medicare. They can:
- Receive benefits through their employer
- Purchase coverage through an individual insurance plan
Our advisors are here to assist your spouse in finding an individual health plan, which can bridge the gap until he or she meets the age requirement for Medicare.
What Is A Non
You will receive a Medicare plan non-renewal notice in October if your insurance company is not renewing its contract with Medicare. Participating health plans may not to renew their contract with Medicare if the plan lost a significant amount of revenue during the year.
The non-renewal notice should let you know if you will be consolidated into another plan that is very similar to your previous plan. Insurance companies call this mapping.
If you dont want to be mapped into a new Medicare Advantage plan, you can take one of the following steps:
- search for and choose a new plan during the annual election period
- do nothing and let your Medicare coverage revert to original Medicare by default
If a plan sponsor isnt renewing its contract, you should be notified of alternative Medicare Advantage plans that are available in your region.
- Costs. This includes deductibles, copays, and premiums.
- Coverage. Changes may include new services offered and updated drug tiers.
- Service area. This includes covered service areas or in-network status of certain pharmacies.
When your plan notifies you of these changes, theyll usually go into effect the following January. If aspects of your plan are changing, review them carefully to consider if your plan is still affordable and effective for your healthcare needs.
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