When Can I Enroll In Medicare Prescription Drug Coverage
Medicare prescription drug coverage is optional and does not occur automatically. You can receive coverage for prescription drugs by either signing up for a stand-alone Medicare prescription drug plan or a Medicare Advantage plan that includes drug coverage, also known as a Medicare Advantage Prescription Drug plan. Medicare prescription drug plans and Medicare Advantage plans are available through private insurers. Please note that you cannot have both a stand-alone Medicare prescription drug plan and a Medicare Advantage plan that includes drug coverage.
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 Sign Up If You Missed The Initial Enrollment Period
If you didnt sign up when you were first eligible and you dont have current healthcare coverage elsewhere , youll have to wait for the next General Enrollment Period which runs each year from January 1 through March 31.
Your coverage will then begin in July of that year, and you may have to pay a late enrollment penalty on your Medicare Part B premium for as long as you have Part B coverage. Your premium will go up by 10% for every 12-month period you werent enrolled.
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You Automatically Get Medicare When You Turn 65
- 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.
Medicaid Or Medicare Savings Programs
Medicare beneficiaries with limited income or very high medical costs may be eligible to receive assistance from the Medicaid program. There are also Medicare Savings Programs for other limited-income beneficiaries that may help pay for Medicare premiums, deductibles, and coinsurance. There are specified income and resources limits for both programs. Contact your local county Department of Social Services or SHIIP to apply for one of these programs.
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Ways To Apply For Disability Benefits:
- If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
Once your disability benefits start, well mail you a welcome package with your Medicare card.
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 after your Part A starts, you might have to wait to sign up for Part B and pay a monthly late enrollment penalty.
How Do I Enroll In Medicare
Administration at 1-800-772-1213 to enroll in Medicare or to ask questions about whether you are eligible. You can also visit their web site at www.socialsecurity.gov.
The Medicare.gov Web site also has a tool to help you determine if you are eligibile for Medicare and when you can enroll. It is called the Medicare Eligibility Tool.
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When To Sign Up For Medicare Part B
If youre retiring, the best time to enroll in Part B is during your Initial Enrollment Period. For those still working past 65, check with your health administrators whether your employer coverage is creditable.
If it is, you can enroll in Part B when you retire or leave your group health plan. Youll be eligible for a Special Enrollment Period when you can enroll without any penalties. If your group health plan is not considered creditable coverage, then you should register for Part B during your Initial Enrollment Period.
If you missed your Initial Enrollment Period, the next enrollment window you can enroll in Part A and Part B is the General Enrollment Period.
How To Enroll In And Switch Medicare Advantage Plans
You can join, switch, or drop a Medicare Advantage Plan at these times:
You can join, switch, or drop a Medicare Advantage Plan at these times:
In most cases, you must stay enrolled for that calendar year starting the date your coverage begins. However, in certain situations, you may be able to join, switch, or drop a Medicare Advantage Plan at other times. This is referred to as a Special Election Period . For a full list of qualifying circumstances, please visit Medicare.gov. Some of these situations include the following:
- If you move out of your plans service area
- If you moved to a new address that is still in your plans service area, but have new plan options in your new location
- If you have both Medicare and Medicaid
- If you qualify for Extra Help to pay for your prescription drug costs
- If you live in an institution
When Can I Start Receiving Medicare Part A Benefits
You can start receiving Medicare Part A benefits with no premium once you are 65 or older if you or your spouse worked and paid Medicare taxes for at least 10 years. You can know you are eligible for premium-free Medicare A if one of the following applies to you:
- You currently receive or are eligible for Social Security.
- You currently receive or are eligible for Railroad Retirement Board benefits.
- You or your spouse served in a Medicare-covered government job.
If you received Social Security or RRB benefits at least four months prior to turning 65, you will receive Medicare Part A automatically. If not, you need to file an application with the Social Security Administration.
Medigap Open Enrollment Period
Your Medigap Open Enrollment Period is the six-month window that begins the first day of the month you turn 65 and are enrolled in Part B. For example, if you turn 65 and are enrolled in Part B in January, you can buy a Medigap policy between January and June. This enrollment window cant be changed or repeated.
During this open enrollment period, you can buy any Medigap policy sold in your state, even if you have health problems.
But after your open enrollment period, you may not be able to buy a Medigap policy depending on your health status and may be subject to a health review.
Your new coverage begins on the first day of the month after you sign up.
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When Is The Earliest You Can Sign Up
Youre first eligible for Medicare starting three months before you turn 65. That kicks off whats known as your Initial Enrollment Period.
The Initial Enrollment Period covers seven months: the three months before your 65th birth month, the month of your 65th birthday and the three months following your 65th birth month. For example, lets say your birthday is sometime in May. The three months before are February, March and April, and the three months following are June, July and August.
Keep in mind that the date you apply for Medicare will affect the start date of your coverage. To receive Medicare Part A and Medicare Part B beginning the first day of the month you turn 65, you must sign up during the three months before your 65th birth month. If you wait to sign up during your birth month or the next three months, your start date will be delayed by one, two or three months.
If your birthday is on the first day of your birth month, Part A and Part B will start the first day of the prior month. So, if, say, your birthday is September 1, your benefits will begin on August 1.
Medicare General Enrollment Period
If you did not enroll during the IEP when you were first eligible, you can enroll during the General Enrollment Period. The general enrollment period for Original Medicare is from January 1 through March 31 of each year. Keep in mind that you may have to pay a late enrollment penalty for Medicare Part A and/or Part B if you did not sign up when you were first eligible.
Dont Register For Medicare Alone
If youre uncomfortable with applying for Medicare alone, we can help! Our services are completely free for you. If you would like an agent by your side when applying, contact us. We can walk you through setting up all your coverage, including Medicare, Medigap, Part D, and more.
Plus, when you use us to apply, you get unlimited support from our Client Service Team. That means if you have any issues with claims or appeals, we can help at no additional cost. You can compare rates online or give us a call today at the number above.
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How Does Medicare Work With Employer Insurance
More and more people are starting to work past the traditional retirement age of 65 and continue to get healthcare benefits through their employer. When this happens, and they also have Medicare benefits, questions arise. Understanding how Medicare works with your employers health insurance benefits or your spouses job can help you decide if you want to sign up for Medicare when you become eligible or wait.
The first thing you want to think about is whether Medicare will be the primary or secondary payer to your current insurance through your employer. If Medicare is primary, it means that Medicare will pay any health expenses first. Your health insurance through your employer will pay second and cover either some or all of the costs left over. If Medicare pays secondary to your insurance through your employer, your employers insurance pays first. Medicare covers any remaining costs.
Depending on your employers size, Medicare will work with your employers health insurance coverage in different ways. If your company has 20 employees or less and youre over 65, Medicare will pay primary. Since your employer has less than 20 employees, Medicare calls this employer health insurance coverage a small group health plan. If your employers insurance covers more than 20 employees, Medicare will pay secondary and call your work-related coverage a Group Health Plan .
Delaying Medicare Coverage
Medicare and COBRA
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Applying For Medicare By Phone
Just like applying online, applying for Medicare by phone is easy. You can contact a representative at 1-800-772-1213.
Depending on the volume of calls, there might be a wait time. If the wait time is above average, you can schedule an appointment to have a representative call you.
The only downfall with applying for Medicare by phone is that it can take longer compared to online. If youre ahead of the game and start well before your birthday, then applying by phone shouldnt cause any issues. If you do not wish to apply online or by phone, you can choose to do so in person.
When Do I Have To Sign Up For Medicare
If youre collecting Social Security, youll automatically be enrolled in both Part A and Part B. If youre not receiving Social Security, then youll want to sign up manually during your Initial Enrollment Period.
Three months before your 65th birthday, your Initial Enrollment Period window will start. Your IEP is a once-in-a-lifetime enrollment window that you dont want to miss.
If you do happen to miss it, youll have another opportunity to enroll during another enrollment period. However, you could get a penalty for not signing up when you first become eligible. The only way around the penalty is if you have creditable coverage.
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Signing Up For A Medigap Policy
To purchase a Medigap supplement insurance policy, you must first enroll in Medicare Part A and Part B.
The best time to enroll in a Medigap plan is when you are first eligible.
This is a six-month enrollment period that begins the month youre 65 and enrolled in Medicare Part B.
If you apply for Medigap coverage after this six-month window, private insurance companies may not sell you a policy if youre in poor health.
You can find a Medigap policy by using an online tool on the Medicare website, contacting your local SHIP or calling your State Insurance Department.
How to Sign Up for a Medigap Policy Online
Is Everyone Eligible For Medicare Easy Pay
The short answer is yes. If you pay out-of-pocket monthly premiums for Medicare Part A or Part B, you can sign up for Medicare Easy Pay.
However, if youre behind in your payments, you may need to catch up first before you can sign up. Thats because your first automatic deduction can only be up to three months of premium payments. Subsequent monthly payments can only equal one months premium plus an additional $10 maximum. If you owe more than this, youll need to pay another way until youre all caught up.
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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.
How Do I Join A Medicare Advantage Plan Or Medicare Prescription Drug Plan
Medicare Prescription Drug Plan State Health Insurance Assistance ProgramSee How do I join a Medicare drug plan? for more information on how to enroll in a Medicare prescription drug plan .Special Rules for People with End-Stage Renal DiseaseOriginal Medicare PlanMedicare Prescription Drug Plan Medicare AdvantageRead more at https://Q1FAQ.com/75.htmlNote:Special Needs PlanTTY
Your drug discount card is available to you at no cost. Tips & Disclaimers
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How Do I Choose A Part D Drug Plan
You can get Medicare Part D coverage from a stand-alone drug plan or a Medicare Advantage plan with built-in Part D coverage.
There are approximately 20-30 different Part D drug plans offered by a number of different health insurance companies in each state . All Part D drug plans must offer a standard set of drug benefits as required by Medicare. Moreover, drug plans may include additional medications on their formularies.
The cost to join a plan depends on whether the plan offers benefits beyond those mandated by Medicare . The following may cause the monthly premium to be more expensive:
- The plan covers additional medications on its formulary
- The plan does not have a deductible at the beginning of the year
The ten most popular stand-alone Part D plans for 2020 have premiums that vary from $17/month to $76/month. Some of those plans are enhanced and some are basicin general, the enhanced plans have higher premiums, while the basic plans have lower premiums.
One of the most helpful online resources is the government’s Medicare plan finder tool, which allows you to compare PDPs, learn about plans offered in your state, and view each plan’s drug formulary. You can compare plans side-by-side and display only those plans that cover your medications.
When & How Do I Sign Up For Medicare
You can sign up anytime while you are still working and you have health insurance through that employer. You also have 8 months after you stop working to sign up.
- Your 8-month Special Enrollment Period starts when you stop working, even if you choose COBRA or other coverage thats not Medicare.
- Your coverage will start the month after Social Security gets your completed forms.
To qualify for the Special Enrollment Period, youll need to have your employer fill out a Form CMS-L564 . If the employer cant fill it out, complete Section B of the form as best you can, but dont sign it. Youll need to submit proof of job-based health insurance when you sign up. Forms of job-based health insurance proof:
The way you sign up depends on if you already have Part A coverage or if youre signing up for both Part A and Part B. Get forms and ways to sign up.
Avoid the penalty & gap in coverage
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