Medicare Faqs And Information To Consider
If you are already receiving Social Security benefits, Railroad Retirement benefits, or Federal Retiree benefits, your enrollment in Medicare is automatic. Your Medicare card should arrive in the mail shortly before your 65th birthday. Check the card when you receive it to verify that you are entitled to both Medicare Parts A and B.
Initial Enrollment Period:
If you are not eligible for Automatic Enrollment, contact the Social Security Administration at 800-772-1213 or enroll online at www.socialsecurity.gov, or visit the nearest Social Security office to enroll in Medicare Part A and Medicare Part B. You have a seven month window in which to enroll in Medicare without incurring a penalty. If youre not automatically enrolled in premium-free Part A, you can sign up for it once your Initial Enrollment Period starts. Your Part A coverage will start six months back from the date you apply for Medicare, but no earlier than the first month you were eligible for Medicare. However, you can only sign up for Part B during the times listed below.
General Enrollment Period:
- General Enrollment Period for Medicare Parts A & B
If you have coverage through a current employer, you are not required to enroll in Medicare Part A and B. Below are some things to keep in mind about each part of Medicare.
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If I’m 65 And Older And Get Health Insurance From Work Do I Have To Enroll In Medicare
No. If you’re still working, your company employs more than 20 people and you have work-based health insurance, you do not need to enroll in Medicare until your existing health insurance expires. When you stop working or your employer discontinues its group insurance plan, you have eight months to sign up for Medicare, regardless of whether you have COBRA or another health insurance plan.
If you do enroll in Medicare and also have work-based insurance, your work insurance will pay first and Medicare will pay second.
If you work for a company that employs fewer than 20 people, you’ll need to contact your company’s HR department for the specifics of your health insurance program. It’s likely that you can delay Medicare enrollment, but some employers require that people 65 and older must enroll in Medicare to receive company health insurance benefits.
For these smaller companies with less employees, Medicare pays first, and work-based insurance pays second.
If you turn 65 and don’t have work-based health insurance, you’ll need to enroll in Medicare within your seven-month initial enrollment period or pay a penalty that will make your premium more expensive.
If you want to completely opt out of Medicare Part A, it is possible, but you’ll have to give up your Social Security benefits entirely, and pay back any benefits that you’ve already received.
Signing Up For Medicare Part B At 65 If Youre Still Working
If youre still working at age 65 and youre not claiming Social Security benefits, the government will not automatically enroll you in Medicare Part B, which covers doctors visits, diagnostic tests, medical equipment, ambulance transportation, and mental health care.
If you work for a company with 20 or more employees and youre enrolled in your employers health insurance plan, you dont have to enroll in Part B. You also might not want to because it isnt free.
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Penalties If You Dont Enroll
If you fail to sign up for Part B when youre supposed to, youll face a 10 percent penalty for each year that you should have been enrolled. The amount gets tacked on to your monthly premium.
While Part D prescription coverage is optional, the penalty for not enrolling when you were first eligible is 1 percent for every month that you could have been signed up unless you have qualifying coverage through an employers plan.
We advise people even if they dont take medicine right now, at least sign up for the cheapest drug plan just so you dont face a penalty, Roberts said. And if something bad happens, youre making sure you arent caught with no coverage.
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Planning for retirement includes obtaining appropriate and affordable healthcare coverage. In that respect, for Americans 65 and older, any conversation about healthcare must include Medicare. Eligibility at age 65 means that health insurance becomes more affordable.
What Happens If I Miss My Iep
If you dont enroll in Medicare when youre first eligible, you can still sign up later, but you may end up paying a late penalty for Medicare Part B and/or D. Here are your other enrollment options:
- There is a Medicare General Enrollment Period , from Jan. 1 March 31 every year.
- There is a Special Enrollment Period, but there are restrictions and you must qualify to be eligible.
For more specific insights, check out our article about all Medicare enrollment periods.
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Signing Up For Medicare
Follow the steps below if you need to actively enroll in Medicare.
If you decide to enroll in Medicare during your Initial Enrollment Period, you can sign up for Parts A and/or B by:
- Visiting your local Social Security office
- Mailing a signed and dated letter to Social Security that includes your name, Social Security number, and the date you would like to be enrolled in Medicare
- Or, by applying online at www.ssa.gov
If you are eligible for Railroad Retirement benefits, enroll in Medicare by calling the Railroad Retirement Board or contacting your local RRB field office.
Keep proof of when you tried to enroll in Medicare, to protect yourself from incurring a Part B premium penalty if your application is lost.
- Take down the names of any representatives you speak to, along with the time and date of the conversation.
- If you enroll through the mail, use certified mail and request a return receipt.
- If you enroll at your local Social Security office, ask for a written receipt.
- If you apply online, print out and save your confirmation page.
Do I Have To Pay For Medicare
We get this question a lot, and we understand why you may be confused or upset. If you were employed for any extended period of time in your life, youre probably thinking, I already paid for Medicare through taxes! Its true that most people paid Medicare taxes during their working careers, but there are still some costs involved in Medicare for most people.
Those Medicare taxes that you paid all those years certainly helped fund the Medicare program, but its not enough. Healthcare is expensive!
Medicare parts A and B are different. If you worked for at least 39 quarters, you may not have to pay a premium for Part A at all. However, anyone who does not qualify for financial assistance will owe a premium for Part B. The Part B premium can change based on income, but the standard in 2020 is $144.60/month.
- If you worked over 39 quarters , your Part A premium will be $0
- If you worked 30-39 quarters, your Part A premium will be $252 in 2020
- IF you worked for less than 30 quarters, your Part A premium will be $458 in 2020.
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What To Do Next When You Become Eligible For Medicare
If you currently have a health plan through Covered California:
If you dont currently have a health plan through Covered California:
If youre currently enrolled in Medicare Part A, or eligible for premium-free Medicare Part A, you cant enroll in new coverage through Covered California. This is because Medicare Part A is considered minimum essential coverage under the Affordable Care Act. But depending on your income and assets, you may be eligible for additional coverage through Medi-Cal. Once youre enrolled in Medicare, you can contact your local county office or complete the Covered California application to see if you also qualify for Medi-Cal.
How To Apply Online For Just Medicare
Are you within three months of turning age 65 or older and not ready to start your monthly Social Security benefits yet? You can use our online retirement application to sign up just for Medicare and wait to apply for your retirement or spouses benefits later. It takes less than 10 minutes, and there are no forms to sign and usually no documentation is required.
To find out what documents and information you need to apply, go to the .
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Enroll In Medicare Part B Depends
Medicare Part B charges a premium, so if you can delay without penalty, you may want to. Most people pay the standard Part B premium, but people with higher incomes may pay more.
Some people who work past 65 and have employer coverage delay enrolling in Part B just to postpone paying the premium and then sign up later during a Special Enrollment Period.
If you dont qualify for a Special Enrollment Period, even if youre still going to work past 65, you need to get Part B during your Initial Enrollment Period to avoid financial penalties.
When Do I Apply For Other Kinds Of Medicare Coverage
Are you thinking about signing up for a Medicare Advantage plan, a stand-alone Medicare prescription drug plan, or a Medicare Supplement insurance plan?
No matter what type of Medicare coverage you want, youll generally want to start by signing up for Original Medicare, Part A and Part B. Then, its usually a good idea to sign up for any other type of Medicare coverage you want, promptly.
Heres a quick rundown on the main Medicare coverage options you have besides Original Medicare and when to sign up.
- Medicare Advantage this program gives you an alternative way to get your Medicare Part A and Part B benefits . You need Part A and Part B to qualify, and then the plan manages those benefits for you. If you dont enroll during your Medicare Initial Enrollment Period , you might have to wait to sign up. Learn about Medicare Advantage enrollment periods.
- Stand-alone Medicare prescription drug plan you might want this type of plan if you need prescription drug coverage. You need Part A or Part B to qualify. If you dont enroll during your Medicare Initial Enrollment Period , you might have to wait to sign up. Learn about Medicare Part D enrollment periods.
Be aware that if you have a Medicare Advantage plan, it might include prescription drug coverage, so you wouldnt need a stand-alone plan. In fact, you generally cant have both a Medicare Advantage prescription drug plan and a stand-alone Part D prescription drug plan.
New To Medicare?
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Delaying Enrollment Could Result In A Permanent Penalty
As described above, you can’t reject premium-free Medicare Part A without also giving up your Social Security benefits. But since your work history is allowing you access to Medicare Part A without any premiums, few people consider rejecting Part A coverage.
The other parts of Medicare, however, do involve premiums that you have to pay in order to keep the coverage in force. That includes Medicare Part B and Part D , as well as supplemental Medigap plans. Medicare Part C, otherwise known as Medicare Advantage, wraps all of the coverage into one plan and includes premiums for Part B as well as the Medicare Advantage plan itself.
So it’s understandable that some Medicare-eligible people, who are healthy and not using much in the way of medical services, might not want to enroll in Part D and/or Part B. Similarly, people who are eligible for Part A but with premiums might want to avoid enrolling in order to save money on premiums. But before deciding to postpone enrollment in any part of Medicare, it’s important to understand the penalties and the enrollment limitations that will apply if you decide to enroll in the future.
There are penalties associated with delaying your Medicare enrollment unless the reason you’re delaying is that you are still working and you’re covered by the employer’s health plan. If that’s the case, you’ll be eligible for a special enrollment period to sign up for Medicare when you eventually retire.
Do You Have To Pay For Medicare When You Retire
Medicare programs can help cover your healthcare needs during your retirement years. It is automatically offered when you turn age 65. While Medicare isnt necessarily mandatory, it may take some effort to opt out of.
You may be able to defer Medicare coverage, but its important to if you have a reason that makes you eligible for deferment or if youll face a penalty once you do enroll.
While you can decline Medicare altogether, Part A is usually premium-free for most people and wont cost you anything if you decide not to use it. Declining Medicare completely is possible, but if you do, youll be required to withdraw from all of your monthly benefits This means you can no longer receive Social Security or Railroad Retirement Board benefits and repay anything you have already received when you withdraw from the program.
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If You Work At A Large Company
The general rule for workers at companies with at least 20 employees is that you can delay signing up for Medicare until you lose your group insurance . At that point, you’d be subject to various deadlines to sign up or else face late-enrollment penalties.
While everyone’s situation is different, there’s a good chance your current insurance through work is a more cost-effective option, said Danielle Roberts, co-founder of insurance firm Boomer Benefits in Fort Worth, Texas.
This may be due to lower premiums and other cost-sharing aspects such as copays or co-insurance, or lower costs for prescriptions under the group plan.
“We often find that their insurance is already quite good and it doesn’t make sense to leave it,” Roberts said.
We often find that their insurance is already quite good and it doesn’t make sense to leave it.Danielle Robertsco-founder of Boomer Benefits
Again, however, if Part A is free, you can sign up as long as it wouldn’t interfere with your plans to contribute to a health savings account.
There are, of course, instances where Medicare might be the better option.
“If you’re going to, say, therapy every week and it’s a $40 co-pay, it might be cheaper to go on Medicare and get a supplement with it,” Gavino said.
On the other hand, if you take a specialty drug that is covered by your group plan, it might be wise to continue with it if that drug would be more expensive under Medicare.
What Should You Do Once You Get Medicare
Although you can rely on Original Medicare alone, 86% of Medicare enrollees also have some type of additional coverage.2 It can be from an employer, a privately-purchased plan or from a government-run program like Medicaid. Original Medicare pays for a great deal of healthcare, but still leaves you with potentially costly gaps in healthcare coverage. Supplementary plans can cover these gaps including deductibles and copayments at a fraction of the out-of-pocket rate.
MedicareGuide.coms plan selector is designed to intelligently bring you the best Medicare Supplement plans. These plans, also known as Medigap policies, fill the gaps in coverage that you would otherwise be charged by Original Medicare.
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Do You Pay For Medicare After Retirement
Budgeting for Medicare after retirementYou’ll need to pay monthly premiums, copayments, coinsurance, and deductibles. You can pay for premiums and other Medicare costs in several ways. While you could budget and save for healthcare throughout your life, other programs can help: Paying with Social Security.
Deductibles And Hospital Coinsurance
With Medicare Part A, youll also pay a deductible and coinsurance costs for each benefit period. In 2022, these costs are:
- $1,556 deductible for each benefit period
- $0 coinsurance for days 1 through 60 in each benefit period
- $389 daily coinsurance for days 61 through 90 in each benefit period
- $778 daily coinsurance for days 91 and beyond in each benefit period
Each day beyond day 90 is considered a lifetime reserve day. You have up to 60 of these days to use in your lifetime. Once youve used all of your lifetime reserve days, you must pay all the costs for the rest of your stay.
Benefit periods reset once youve been out of inpatient care for 60 days or when you begin inpatient care for a new condition.
If you have trouble paying for these costs, you can apply for a Medicare savings program. These state programs help cover the costs of your Medicare deductibles and coinsurance.
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Medicare Advantage Plan :
- Monthly premiums vary based on which plan you join. The amount can change each year.
- You must keep paying your Part B premium to stay in your plan.
- Deductibles, coinsurance, and copayments vary based on which plan you join.
- Plans also have a yearly limit on what you pay out-of-pocket. Once you pay the plans limit, the plan pays 100% for covered health services for the rest of the year.