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.
Options For Employees With Large Employer Coverage
The first, and possibly the most favored option is delaying Medicare enrollment. The reason you can do this is that your employee group plan acts as your creditable coverage. When you have , you are able to delay signing up for Medicare until you lose that creditable coverage.
There are no penalties because your employer coverage is primary, and Medicare is secondary. Many people enroll in Part A and delay Parts B and D until they retire.
However, you may not want to delay Medicare. Your answer to the fourth and final question will help you determine whether you want to enroll in Medicare and let it coordinate with your employer coverage or delay Medicare to save yourself from paying unnecessary Part B and D premiums while you are still working.
How Medicare Works With Your Other Insurance
When you have more than one insurance provider, there are certain rules that determine who pays what it owes first and who pays based on the remaining balance. For seniors who don’t have other insurance, Medicare is obviously the primary payer. However, when you have other insurance, it’s a little more complicated.
Depending on the type of insurance you have , Medicare can either be the primary or the secondary payer. If Medicare would be a secondary payer to your current insurance, you can delay signing up for Medicare Part B. If your current insurance would become a secondary payer to Medicare, you should sign up during your initial enrollment period, which is the seven-month period that begins three months prior to the month you’ll turn 65.
It’s also worth noting that although I’m specifically mentioning Medicare Part B, which is medical insurance, this applies to Part A as well. However, Medicare Part A is free to the vast majority of Americans, so it’s probably worth signing up for Part A whether you’re required to or not. On the other hand, Medicare Part B has a monthly premium you’ll have to pay , which is why it can make sense to delay signing up if it’s not going to be your primary insurance.
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When Would I Enroll If I Delay Or Only Take Part A
If you are able to delay enrolling in either all or part of Medicare, you will have a Special Enrollment Period of eight months that begins when the employer coverage is lost or when your spouse retires. During this time, youll be able to enroll in Medicare Parts A & B. You can also enroll in a Part D prescription drug plan. And, after you enroll in Part B, youll be able to enroll in a Medicare supplement insurance plan or a Medicare Advantage plan.
How Social Security Benefits Can Affect Medicare Enrollment
If you are receiving Social Security benefits when you turn 65, youll be automatically enrolled in Medicare Parts A and B, even if youre working. Your Medicare card will arrive in the mail about 3 months before your 65th birthday.
Once youre enrolled in Medicare, a monthly Part B premium will be automatically deducted from your Social Security check. If you dont want Medicare Part B, you need to notify Medicare to opt out. There will be instructions for doing this on the back of your Medicare card.
If youre not receiving Social Security or Railroad Retirement Board benefits, you will need to enroll yourself in Medicare when you become eligible.
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Your Medicare Special Enrollment Period
If your employer has at least 20 employees and youre still working and covered under that plan when you turn 65, you can delay your enrollment in Medicare . In that case, youll get an eight-month special enrollment period to sign up for Medicare if and when you leave your job or your employer stops offering coverage. It will start the month after you separate from your employer, or the month after your group health coverage ends whichever happens sooner.
Sign up during those eight months, and you wont have to worry about premium surcharges for being late. And the eight-month special enrollment period is also available if youre delaying Part B enrollment because youre covered under your spouses employer-sponsored plan, assuming their employer has at least 20 employees.
But note that in either case, it has to be a current employer. If youre covered under COBRA or a retiree plan, you wont avoid the Part B late enrollment penalty when you eventually enroll, and you wont have access to a special enrollment period to sign up for Part B youll have to wait for the general enrollment period instead.
Who Needs To Sign Up For A Medicare Part D Plan
As you can see in the example above, the Part D penalty can be significant. With Part D premiums starting at around $15 in most states, most people find it beneficial to have at least minimal Part D coverage when they start with Medicare, even if their medication needs are non-existent.
If you are someone who does use prescription drugs, it certainly is beneficial to sign up for a Medicare Part D plan. The most advisable way to do this is to compare the plans based on how well they cover your specific medications. You can run a comparison on Medicare.gov to do this instructions for doing it are listed here.
If you have questions about your transition to Medicare Part D or anything else related to the transition you can reach us at 877.506.3378 or online.
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Get Started With Medicare
Medicare is health insurance for people 65 or older. Youre first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease , or ALS .
Follow these steps to learn about Medicare, how to sign up, and your coverage options. Learn about it at your own pace.
Ask These Questions Before You Delay Medicare
Whether or not you can delay Medicare past 65 when youre working really depends on a few simple questions.
1. Do you have employer health coverage?
2. Does your employer have 20 or more employees?
3. Is the coverage considered creditable?
If you can answer Yes! to all the above, you likely qualify for a Medicare Special Enrollment Period and can delay enrolling without penalty. Whats the next step? and information sent directly to your inbox.
Turning 65 What You Need To Know About Signing Up For Medicare
The first of the 78 million baby boomers turned 65 on January 1, 2011, and some 10,000 boomers a day will reportedly reach that milestone between now and 2030. If you are about to turn 65, then it is time to think about Medicare. You become eligible for Medicare at age 65, and delaying your enrollment can result in penalties, so it is important to act right away.
There are a number of different options to consider when signing up for Medicare. Medicare consists of four major programs: Part A covers hospital stays, Part B covers physician fees, Part C permits Medicare beneficiaries to receive their medical care from among a number of delivery options, and Part D covers prescription medications. In addition, Medigap policies offer additional coverage to individuals enrolled in Parts A and B.
Local Elder Law Attorneys in Your City
Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you don’t need to do anything. You will be automatically enrolled in Medicare Parts A and B effective the month you turn 65. If you do not receive Social Security benefits, then you will need to sign up for Medicare by calling the Social Security Administration at 800-772-1213 or online at . It is best to do it as early as possible so your coverage begins as soon as you turn 65.
How To Apply For Medicare In Florida
You can sign up for Original Medicare at any Social Security office or online. The Social Security Administration has a secure online portal where you can sign up in about 10 minutes.If youre getting Social Security benefits at least four months before your 65th birthday, youre automatically enrolled in Medicare Part A and Part B. Social Security will send you Medicare information and a Medicare card prior to your 65th birthday.
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Who Can Delay Signing Up For Medicare
So, whose insurance remains the primary payer? In a nutshell, if you have coverage through your or your spouse’s current employment, and the employer has 20 or more employees, your insurance plan remains the primary payer.
If you aren’t sure if your employer meets the “group health coverage” criteria, ask your employer’s benefits manager.
If you do qualify, you can delay signing up for Medicare for as long as you are still working. Once the employment or your employer-based health coverage ends, you’ll have eight months to sign up for Medicare Part B without paying a penalty, which is a permanently higher premium.
It’s also important to note that regardless of whether you’re still working or not, if you’ve already signed up for Social Security benefits, you’ll be automatically enrolled in Medicare Parts A and B when you turn 65. If you don’t want to keep Part B, you’ll need to cancel it .
Im Working Past 65 But My Health Coverage Is From My Spouses Employer
A pretty common situation to face, if your health care coverage is from a spouses employer, you may be able to delay Medicare or you may need to enroll when you first become eligible. In this case, the employer still needs to have 20 or more employees. However, the big difference is that employers can have rules for covered dependents 65 and older that may require the individual to get Medicare at 65 in order to remain on the employer plan.
Therefore, if you have employer coverage through a spouses employer, you need to ask the employers benefits administrator directly about your Medicare enrollment choices.
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Enrolling In Medicare Advantage Or Part D At Age 65
If you did not sign up for any private Medicare insurance plans during your Initial Enrollment Period when you first qualified for Medicare because of your disability, you may have another opportunity to do so during the Annual Enrollment Period , which takes place from each year.
Learn more about the Medicare Advantage and Medicare Part D plan options that are available where you live by comparing plans online for free today. You can also get started comparing plans by calling to speak with a licensed insurance agent.
Compare Medicare plans in your area
Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
About the author
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.
Where you’ve seen coverage of Christian’s research and reports:
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.
Medicare has neither reviewed nor endorsed this information.
Review Your Social Security Benefits Plan
You can choose when to start collecting Social Security benefits any time within ages 62 to 70. If you’ve started payments, then you’ve already made this decision for your retirement planning. If you haven’t started collecting payments yet, consider when you’d like to begin.
The longer you wait, the larger your monthly payments will be until they max out when you turn 70. At age 65, decide whether you need that extra income now or if you’d rather wait a little longer so you can earn more for the rest of your retirement.
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Why Are You Forced Into Medicare
If you or your spouse worked for at least 10 years in a job where Medicare taxes were withheld , you’ll become automatically eligible for Medicare once you turn 65.
Recent immigrants are not eligible for Medicare, but once they’ve been legal permanent residents for five years and are at least 65, they have the option to purchase Medicare coverageas opposed to getting Medicare Part A for freewhich is the same option available to long-term U.S. residents who, for one reason or another, don’t have a work history that gives them access to premium-free Medicare Part A . Note that immigrants who go on to work for at least 10 years in the US do then become eligible for premium-free Part A Medicare if they’re 65 or older, just like anyone else who has paid into the Medicare system for at least a decade.
Once you become eligible for premium-free Medicare Part A, you have to enroll in Medicare Part A or you forfeit your Social Security benefits. Most individuals are unwilling to forfeit their Social Security benefits, and thus accept the enrollment into Medicare. Note that you’re only required to accept Medicare Part Awhich is premium-free if you’re receiving Social Security benefitsin order to retain your Social Security benefits. You are allowed to reject Medicare Part Bwhich has a premiumif you choose to do so, although you could be subject to a late enrollment penalty if you choose to enroll in Part B at a later date. .
Learn More About Medicare
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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.
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Review Your Retirement Accounts And Investments
Before turning 65, you should also consider your retirement planning investment strategy. As you get older, the focus should shift from growing your savings through stocks to protecting your nest egg as well as generating income through safer assets like bonds. Look up your different retirement accounts and make sure the investment mix matches your goals.
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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How Much Is The Medicare Part D Late Enrollment Penalty
The Medicare Part D Late Enrollment Penalty is calculated based on how long you have been without creditable prescription coverage. In other words, your penalty is applied when you enroll in a prescription plan. If you wait longer, the penalty will be higher. The penalty is 1% per month that you dont have a plan. The 1% per month is multiplied by the national base beneficiary premium for 2018, this is $35.02.
For example, if you turned 65 in April of 2015, have no other drug coverage, and enrolled in a Part D plan to start 1/1/18, your penalty would start after your initial election period expired . Your penalty would be for 29 months .29 x $35.02 = $10.16. They round this to the nearest .10, so you would pay $10.20/mo on top of the Part D premium of the plan you select.
It is important to note that the national base beneficiary premium for Part D changes over time. Thus, your Part D late enrollment penalty can also change over time.
Also, the penalty is a permanent penalty. It stays with you as long as you have a Part D plan and does not go away or get reduced over time.