Wednesday, May 22, 2024

Do You Have To File For Medicare

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When To Sign Up For Medicare

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If youre not enrolled automatically, you should sign up in the three months before your 65th birthday. That way, coverage will start on the first day of your birthday month .

You technically have seven months around your 65th birthday to enroll: the three months before your birthday month, your birthday month and the three months after. This is called your initial enrollment period. If your birthday is the first of the month, your initial enrollment period includes the four months before your birthday month and two months after.

Your coverage could be delayed if you wait until your birthday month or the three months afterward to apply for Medicare. And if you miss your initial window, you may need to sign up during Medicare’s general enrollment period. However, you may be subject to a permanent penalty unless you have continuous coverage from a large employer group health insurance plan.

Signing Up For Medicare Part A And Part B

If youre collecting Social Security benefits, youll automatically enroll in Medicare Part A and Part B upon turning 65. However, if youre not automatically enrolled, the best time to enroll in Medicare Part A is during your initial enrollment period.

If you worked a minimum of ten years while paying Medicare taxes, you can receive Medicare Part A premium-free. So, regardless of whether youre still working when you become eligible for Medicare, it makes sense to get Medicare Part A as soon as you can. This will help keep your out-of-pocket hospital inpatient costs to a minimum.

With Medicare Part B, you have different enrollment options. Medicare Part B medical insurance requires every beneficiary to pay a monthly premium. Therefore, if you have health coverage at age 65, you may delay Medicare Part B without penalties unless you lose creditable coverage before getting Medicare Part B.

Common reasons beneficiaries delay Medicare Part B include:

  • Health insurance through a previous employer
  • To remain with spousal coverage, if available, as Medicare Part B premiums are based on income reported two years prior
  • Union coverage
  • Employer coverage

Signing Up For Medicare Might Make Sense Even If You Have Private Insurance

If youre about to turn 65 and you have private health insurance coverage, you may be wondering if you need to sign up for Medicare. The short answer is it depends. You might be able to delay enrolling in some parts of Medicare however, not signing up for other parts can cost you.

Navigating Medicares options, enrollment deadlines, and requirements can be confusing. But its important to know when you need to apply for coverageespecially if you have other health insurance coverageso you dont get hit with costly penalties. Heres how Medicare works, what to consider when you already have health insurance, and how to avoid penalties for late enrollment.

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If Im Still Working At Age 65 When Do I Sign Up For Medicare

En español | If you arent already receiving Social Security benefits at age 65, you wont be signed up automatically. So youll have to make a decision.

Whether you need to enroll in Medicare if you continue to work and have health benefits through your job depends on the size of the employer. The same rules apply if your health insurance is through your spouses job.

Can You Get Social Security And Not Sign Up For Medicare

What Age Do I Apply For Medicare?

Yes, many people receive Social Security without signing up for Medicare.

Most people arent eligible for Medicare until they turn 65. As you can start collecting Social Security retirement benefits at 62, individuals may have Social Security without Medicare for several years.

Most people enroll in Part B once they turn 65, but you may decide to delay enrolling in Part B if you or your spouse has health insurance through an employer. Be sure to learn more about how Medicare enrollment works in your specific case, though. If you delay enrollment in Medicare Part B when youre first eligible and you dont have other creditable coverage, you could face late enrollment penalties for the rest of the time that you have Part B once you sign up.

As most people dont pay a premium for Part A, theres no reason to cancel the coverage, even if you dont think you need it. You are free to decline other Medicare plans, such as Parts B and D, though again you should make sure you wont cause yourself to go without coverage or have to pay late enrollment penalties in the future.

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Did You Answer Yes To Question 1

If so, then you will most likely need to sign up for Medicare at age 65. Retirees that dont sign up for Medicare when they first become eligible can suffer from late penalties.

If you are a retiree who has a retiree health plan provided by a former employer, then you need to sign up for Medicare Parts A and B. Medicare is usually mandatory in this circumstance because it is primary to retiree health plans. If you dont enroll, you may be penalized for not signing up for Medicare on time.

People with retiree health plans should sign up for Medicare when they are first eligible. Usually, retiree health plans and Medicare work well together and provide substantial coverage.

On the other hand, maybe youre a retiree whose former employer doesnt offer retiree coverage, so you have an individual Health Insurance policy through the ACA marketplace exchange.

In this circumstance, it is mandatory to sign up for Medicare unless you are one of the few people who pay premiums for Part A. Youll still want to sign up for Medicare at age 65 to avoid late penalties, delayed coverage, and loss of Social Security benefits.

Visit this post for more information on why you should leave your ACA plan and transition to Medicare.

If you answered No to question 1 because you are still working, move on to question 2.

How Old Do You Have To Be To Get Original Medicare

The typical age to enroll in Original Medicare is 65 years or older. However, in certain cases, you may be eligible to enroll in Medicare at a younger age.

To be eligible for Medicare at age 65, you must be an American citizen for at least five years.

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Are you wondering if you can get Medicare before age 65? You may be eligible for Medicare before age 65 if you receive Social Security Disability benefits or if you have specific diagnoses. To receive Original Medicare before age 65 you must meet one of the following qualifications:

  • Receiving Social Security Disability Income for 24+ months

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Sign Up: Within 8 Months After Your Family Member Stopped Working

  • Your current coverage might not pay for health services if you dont have both Part A and Part B .
  • If you have Medicare due to a disability or ALS , youll already have Part A coverage.

Avoid the penalty & gap in coverageIf you miss this 8-month Special Enrollment Period, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty until you turn 65. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?

Penalties For Not Signing Up For Medicare: Medicare Part D

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Medicare Part D is prescription drug coverage that you get from private, Medicare-approved insurance companies. Itâs optional, yet thereâs a late enrollment penalty if you donât sign up when youâre first eligible for Medicare, and decide at some later date that you want this coverage.

However, if you have prescription drug coverage that pays, on average, at least as much as Medicareâs standard prescription drug coverage would pay, you might not have to pay this penalty. This is called having âcreditableâ coverage.

For example, suppose that:

  • You became eligible for Medicare in mid-September of 2020. You enrolled in Part A and Part B, but you skipped Part D âfor now.â
  • You donât have creditable prescription drug coverage from any other source .
  • In October of 2022, you decide to sign up for prescription drug coverage under Medicare Part D. You can generally choose either a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan.

So in this example, you might pay $.30 x 24 = $7.20. Your Medicare prescription drug plan will add $7.20 to your premium, and youâll pay the penalty as long as you have Medicare prescription drug coverage.

Be aware that the Part D national base beneficiary premium can change from year to year, so your penalty amount might also change.

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When Do I Need To File Medicare Claim

Original Medicare has both participating and non-participating providers. Participating providers accept Medicares reimbursement plus your coinsurance as full payment, and have agreed to always bill Medicare for your care. Non-participating providers can charge you up to 115 percent of Medicares rate and dont have to file claims with Medicare, although some choose to do so. This means you may have to submit your own healthcare claim if you see a non-participating provider.

Primary And Secondary Payers

Your Medicare and private insurance benefits are coordinated, which means they work together. Typically, a primary payer will pay insurance claims first and a secondary payer will only kick in for costs not covered by the primary payer. The secondary payer may not pay all of the remaining uncovered costs, and you may be responsible for any additional balance.

In many instances, if you are age 65 and covered by either a retiree plan or a plan with fewer than 20 employees, then Medicare is your primary payer and private insurance is your secondary. If this is your situation, you should enroll in Part A and B, along with D if your private insurance plan doesnt have creditable prescription drug coverage.

If youre covered by a plan with 20 or more employees, Medicare is often the secondary payer. Medicare may pay costs that your employers plan doesnt.

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Already Enrolled In Medicare

If you have Medicare, you can get information and services online. Find out how to .

If you are enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B . If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.

You can use one of the following options to submit your enrollment request under the Special Enrollment Period:

  • Fax or mail your CMS-40B, CMS-L564, and secondary evidence to your local Social Security office .
  • Note: When completing the forms CMS-40B and CMS-L564

    • State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
    • If possible, your employer should complete Section B.
    • If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
      • Income tax form that shows health insurance premiums paid.
      • W-2s reflecting pre-tax medical contributions.
      • Pay stubs that reflect health insurance premium deductions.
      • Health insurance cards with a policy effective date.
      • Explanations of benefits paid by the GHP or LGHP.
      • Statements or receipts that reflect payment of health insurance premiums.

    Some people with limited resources and income may also be able to get .

    How Old Do You Have To Be To Get Medicare Part C Or Medicare Supplement

    If I

    To get Medicare Part C or Medicare Supplement plans, you must be enrolled in Original Medicare. This means, you must be at least 65 years old or meet the Medicare criteria for enrolling under age 65. If you do not meet these criteria, you can get Medicare at age 65.

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    Medicare Part C and Medicare Supplement plans both act as a supplemental coverage to Original Medicare. However, you cannot have both plans. You are only able to enroll in Medigap OR Part C. If you enroll in Medicare Part C, the plan becomes your primary coverage over Original Medicare. If you enroll in a Medicare Supplement plan, it will pay secondary to Original Medicare. Because they require you to have Original Medicare, you cannot enroll in a plan without Medicare Part A and Part B.

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    Dont Register For Medicare Alone

    If youre uncomfortable with applying for Medicare alone, we can help! Our services are entirely free for you. When applying, if you would like an agent by your side, we can walk you through setting up all your coverage.

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    Can I Decline Medicare Altogether

    Medicare isnt exactly mandatory, but it can be complicated to decline. Late enrollment comes with penalties, and some parts of the program are optional to add, like Medicare parts C and D. Medicare parts A and B are the foundation of Medicare, though, and to decline these comes with consequences.

    The Social Security Administration oversees the Medicare program and recommends signing up for Medicare when you are initially eligible, even if you dont plan to retire or use your benefits right away. The exception is when you are still participating in an employer-based health plan, in which case you can sign up for Medicare late, usually without penalty.

    While you can decline Medicare altogether, Part A at the very least is premium-free for most people, and wont cost you anything if you elect not to use it. Declining your Medicare Part A and Part B benefits completely is possible, but you are required to withdraw from all of your monthly benefits to do so. This means you can no longer receive Social Security or RRB benefits and must repay anything you have already received when you withdraw from the program.

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    When Should I Sign Up For Medicare

    Generally, we advise people to file for Medicare benefits 3 months before age 65. Remember, Medicare benefits can begin no earlier than age 65. If you are already receiving Social Security, you will automatically be enrolled in Medicare Parts A and B without an additional application. However, because you must pay a premium for Part B coverage, you have the option of turning it down. You will receive a Medicare card about two months before age 65. If you would like to file for Medicare only, you can apply by calling 1-800-772-1213. Our representatives there can make an appointment for you at any convenient Social Security office and advise you what to bring with you. When you apply for Medicare, we often also take an application for monthly benefits. You can apply for retirement benefits online.

    If you didnt sign up when you were first eligible for Medicare, you can sign up during the General Enrollment Period between January 1 and March 31 each year, unless you are eligible for a Special Enrollment Period.

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    • Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.

    Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months of turning 65, you might have to wait to sign up and pay a monthly late enrollment penalty.

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    Can I Get Medicare At Age 62

    Retirement and Medicare typically go hand in hand. So, if you retire at age 62 are you eligible to enroll in Medicare? Unfortunately, you would not be eligible for Medicare if you retire at age 62. You can typically get Medicare at age 65.

    If you retire before age 65, you may be eligible for Social Security benefits at age 62, but that will not allow you to enroll in Medicare coverage. You will need to wait until your Initial Enrollment Period begins three months before your 65th birthday to begin the Medicare enrollment process.

    What Happens If You Dont Sign Up For Medicare

    Its always your choice whether you sign up for Medicare, but you should understand the consequences of not signing up for this health insurance, including:

    • Youll pay the full amount for all medical care unless you have private health insurance
    • You may face delays getting Medicare coverage in future
    • Youll face penalties if you change your mind and sign up for Medicare later

    Automatic enrollment for Social Security beneficiaries makes getting Medicare easy. While you always have a choice about which Medicare plans you keep, consider their benefits now and in the future before making any decisions about your insurance-based coverage.

    Zia Sherrell is a digital health journalist with over a decade of healthcare experience, a bachelors degree in science from the University of Leeds and a masters degree in public health from the University of Manchester. Her work has appeared in Netdoctor, Medical News Today, Healthline, Business Insider, Cosmopolitan, Yahoo, Harper’s Bazaar, Men’s Health and more.

    When shes not typing madly, Zia enjoys traveling and chasing after her dogs.

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