If You Are Approaching Or At Age 65
If you are approaching age 65 and you already receive Social Security or Railroad Retirement benefits through early retirement, you will be automatically enrolled in Medicare Parts A and B when you turn 65. Approximately 3 months prior to your 65th birthday, Medicare will send you an initial enrollment package containing general information about Medicare, a questionnaire and your red-white-and-blue Medicare card.
If you receive the initial enrollment package and you want both Medicare Part A and Part B , simply sign your Medicare card and keep it in your wallet.
If you are approaching age 65 and youre not receiving early retirement Social Security or Railroad Retirement benefits, you can apply for Medicare during your 7-month initial enrollment period . Your IEP begins 3 months before you turn 65, includes the month of your birthday and ends 3 months later. Note: To apply for Medicare Parts A and B, you must contact the Social Security Administration at ssa.gov or 1-800-772-1213. You will also need to sign up separately for a Part D plan to cover your prescription drug benefits. Learn more about Medicare Part D.
Changing From Employer Or Spouse Coverage
There are two forms that you will need in order to apply for Medicare Part B. Print these forms, get them filled out, and drop them off at your local Social Security office. The first for you need is the Part B enrollment form found here: Medicare Part B enrollment application. Another important form is for your employer to show that you have had coverage since you were first eligible for Medicare at age 65. This is to ensure no penalty is added to your monthly Part B premiums. Here is the form needed for the employer coverage:
What do I need to do if I have Part A, but am losing my group plan coverage?
To sign up for Medicare Part B, you need to fill out application form CMS40B and take or mail it to your local Social Security office. You will also want to send your employer a CMS-L564E form to be filled out and sent in with your CMS40B application. There is an 8-month Special Enrollment Period that begins the month your group coverage ends or when the employment it is based on ends, whichever comes first.
Can I Apply For Medicare At Age 62 Or Do I Have To Be 65
Although you may be able to begin withdrawing Social Security benefits for retirement at age 62, Medicare isn’t available to most people until they turn 65. But if you are under the age of 65, you could be eligible for Medicare if you meet any of the following criteria.
- You have been receiving Social Security disability benefits for at least 24 months.
- You receive a disability pension from the Railroad Retirement Board and meet certain criteria.
- You have Lou Gehrigs disease .
- You have ESRD requiring regular dialysis or a kidney transplant, and you or your spouse has paid Social Security taxes for a length of time that depends on your age.
If none of these situations apply to you, you’ll have to wait until age 65 to begin receiving your Medicare benefits. However, you can begin the sign-up process three months before the month you turn 65 during your IEP .
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I Want To Delay Part B
If you qualify and decide you want to delay enrolling in Medicare Part B, you should not face any late enrollment penalties for Part B. When you lose your employer coverage, you will get an 8-month Special Enrollment Period during which to enroll in Medicare Part B, and Part A if you havent done so already.
Youll also be able to enroll in a Medicare Advantage plan or Part D prescription drug plan in the first two months of this period. Note: if you enroll in Part C or Part D after the first two months of your Special Enrollment Period, you may face late enrollment penalties for Part D. Youll want to also ensure you provide proof of creditable coverage when you enroll in Part D.
You do not need to notify Medicare that you will be delaying Part B unless you are already receiving Social Security or Railroad Retirement Board benefits.
Medicare Part B Enrollment Sometimes Automatic Sometimes Not
U.S. citizens and legal permanent residents of at least five continuous years may be eligible for Medicare coverage. Youâre usually enrolled in Medicare Part A and Part B automatically when you turn 65 or qualify by disability at any age and you receive Social Security Administration or Railroad Retirement Board benefits. For details about how you qualify for automatic enrollment, see Medicare Enrollment.
Youâre not automatically enrolled in Medicare Part B in all situations. Here are a few examples of when you may qualify for Part B, but you need to sign up manually:
- If you live in Puerto Rico, youâre typically signed up for Medicare Part A automatically when you turn 65 if youâre collecting SSA or RRB benefits. However, you need to manually.
- If you have end-stage renal disease , regardless of your age, you may qualify for Medicare but you generally have to apply manually.
- If youâre not receiving SSA or RRB benefits when you turn 65, if you want to enroll in Medicare Part B, you need to sign up for it.
You can sign up for Medicare Part B during the following enrollment periods:
To add Medicare Part B, contact the Social Security Administration at 1-800-772-1213 , 7AM-7PM, Monday to Friday. For additional information, contact Medicare at 1-800-MEDICARE , 24 hours a day, 7 days a week.
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During A Special Enrollment Period
This SEP is available only if you have health insurance from an employer for which you or your spouse actively works. It allows you to delay enrolling in Part B until the employment or the coverage ends whichever occurs first.
The SEP actually lasts throughout the time you have coverage from current employment and for up to eight months after it ends. If you enroll at any point during this time frame, your Medicare coverage will begin on the first day of the following month, and you will not be liable for late penalties regardless of how old you are when you finally sign up.
Be aware that an IEP always trumps an SEP if the two should happen to overlap. For example, if your IEP ends on Aug. 31, and you retire on the same date, you will not be entitled to an SEP. Therefore, if you delayed enrollment until after Aug. 31, you would not be able to sign up until the following general enrollment period and your coverage would not begin until July 1 so you would be left for almost a year without coverage. Even if you signed up during the final months of your IEP, your coverage would still be delayed by two or three months. But, to continue this example, if you retired on Sept. 1, under the rules of the SEP, you could enroll in August and receive Medicare starting Sept. 1 with no loss of coverage.
Two other Medicare enrollment scenarios have different rules.
When And How To Apply For Medicare
Learn about Medicare enrollment periods and how to sign up for all the coverage you need.
Youre about to get Medicare! Thats great news because the program helps pay for your health care costs and brings peace of mind. But learning how Medicare works and how to apply can be overwhelming. This article breaks down the key Medicare enrollment periods, how they work, and helps you plan for your big enrollment day.
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When You Must Enroll In Medicare Part B
You may be required to get Medicare Part B even when youre still working. There are two situations in which youmust get Part B when you turn 65.
In each of the above cases, you wont qualify for a Special Enrollment Period and cannot delay enrolling without incurring late enrollment penalties.
Additionally, some employer plans will automatically become secondary to Medicare when you become eligible. In this case, Medicare becomes your primary insurance and would pay first. If you do not have Medicare and need health care, you would essentially have almost no coverage from your employer plan. One such plan that operates like this is the militarys TriCare for Life.
Sign Up: Within 8 Months After You Or Your Spouse Stopped Working
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 for as long as you have Part B. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?
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Have You Or Your Spouse Worked For At Least 10 Years At Jobs Where You Paid Medicare Taxes
Generally, youre first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65.
Avoid the penalty If you dont sign up when youre first eligible, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?
Do You Have To Sign Up
If you receive Social Security benefits at least 3 months before you turn 65, in most cases you will automatically receive Medicare Part A and Part B on the first day of the month when you turn 65. If your birthday falls on the first day of the month, your Medicare Part A and Part B coverage will begin on the first day of the previous month.
You will automatically receive Medicare Part A and Part B if you have received Social Security disability benefits for at least 2 years. If you reside in Puerto Rico, you will automatically be enrolled in Medicare Part A, but will have to sign up for Medicare Part B in order to receive it.
If you are not receiving Social Security benefits at least four months before you turn 65, you will have to sign up with Social Security in order to receive Medicare Part A and Part B coverage. To sign up you can apply online at SSA.gov. Additionally, when you receive coverage, you can decide to receive Part C or Part D for additional coverage.
You will receive coverage at different times depending on the exact situation. If you enroll one to three months before you reach 65 years of age, you will receive Medicare benefits the month that you hit 65. If you enroll the month you reach 65, you will receive Medicare one month after. If you enroll one month after you reach 65, you will receive Medicare two months after. If you wait two to three months after you reach 65, then you will have Medicare three months after the month you enrolled.
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Is Medicare Mandatory
Medicare is a federal benefit that you pay for through taxes during your working years. At age 65, or if you have certain disabilities, you become eligible for health coverage through various parts of the Medicare program.
While Medicare isnt necessarily mandatory, it is automatically offered in some situations and may take some effort to opt out of.
What Can I Do Next
Generally, youre first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65.
Because the company has less than 20 employees, your job-based coverage might not pay for health services if you dont have both Part A and Part B.
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When To Apply For Medicare Part A And Part B
The Initial Enrollment Period is usually the first time you can apply for Medicare. There are a few special circumstances that might allow you to enroll earlier . But in general, people apply for Medicare within their seven-month IEP.
Heres what the Initial Enrollment Period looks like:
- Three full months before your 65th birthday month
- The entire month in which you turn 65
- Three full months after your birthday month
If you miss your sign-up window for Medicare Part A and Part B during your Initial Enrollment Period, there is also a General Enrollment Period every year from January 1 to March 31. And if you defer your Part B coverage , there is a Special Enrollment Period.
As a word of caution, if youre signing up for Medicare outside of your IEP, there are some pitfalls that are easily stepped into. You can read more about enrollment periods here.
In General Its 65 But You Might Be Eligible Sooner
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When you think of Medicare, you probably assume that its for people of retirement age. Thats true, but the program covers more than just those who have worked all their life. You might be eligible right now and not know it. Our research has found that while more than 80% of beneficiaries are people aged 65 or older, others receive services at a younger age due to a qualifying disability.
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When Should You Apply For Medicare
In most cases, you should apply for Medicare as soon as you’re eligible. The initial enrollment period starts three months before the month you turn 65, includes your birth month, and extends three months past the month you turn 65, giving you a seven-month window to apply. Your Part B coverage will likely be delayed if you enroll the month you turn 65 , so apply early to avoid a gap in coverage.
Medicare imposes a hefty late enrollment penalty if you enroll in Part B or D after the initial enrollment period and don’t qualify for a special enrollment period .You might qualify for a SEP if you have coverage, including creditable drug coverage from an employer or a union . Medicare does not charge a late enrollment penalty for enrolling in a Medicare Advantage plan or Medicare Supplement plan after IEP. But it’s best to apply for Medigap as soon as you’re eligibleif you apply within the first six months of having Part B coverage, you can’t be denied a Medigap policy or be required to pay more because of health conditions. Here’s how enrollment works depending on whether or not you already receive Social Security benefits.
If you already receive Social Security benefits:
You should also check out the Medicare Enrollment Booklet which contains clear, concise information about both Medicare Part A and Part B.
If you are not yet receiving Social Security benefits:
When to get prescription drug coverage:
Theres A Push For Change
If the rules governing the transition to Medicare sound complicated, rest assured that experts agree. Moving into Medicare from other kinds of health insurance can be so complicated that it should be a required chapter in Retirement 101, Mr. Moeller said.
The only government warning about the risks associated with late enrollment comes in the form of a very brief notice near the end of the annual Social Security Administration statement of benefits.
The Medicare Rights Center and other advocacy groups have proposed legislation that would require the federal government to notify people approaching eligibility about enrollment rules, and how Medicare works with other types of insurance. The legislation the Beneficiary Enrollment Notification and Eligibility Simplification Act, also would eliminate coverage gaps now experienced by enrollees during the Initial Enrollment Period and General Enrollment Period. The legislation was introduced in Congress last year, and will be reintroduced this year.
In the meantime, Mr. Baker proposes a simple rule of thumb to help people approaching Medicare eligibility to avoid costly errors.
If you are eligible for Medicare, you should really consider it to be your default, primary coverage. If you are going to decline Medicare, think very carefully and take the time to really understand all the rules.
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What Medicare Part B Covers
First, lets take a look at what Medicare Part B actually covers. Medicare Part B covers medical treatments and services under two classifications: medically necessary services and preventive services. What qualifies something as medically necessary? In general, medically necessary services must be medical treatments that are required to treat a recognized medical condition or illness. Necessary services and items might include the following:
- Diagnostic equipment
- Supplies, such as walkers or wheelchairs
For example, diabetics need regular doctor visits to ensure appropriate blood levels, as well as appropriate diagnostic coverage to ensure accurate readings.
Medicare Part B beneficiaries also gain access to preventive services, like yearly screenings for the flu or certain cancers. In addition, Part B may cover other medical procedures and treatments that fall within the necessary or preventive range. Ambulance services, clinical research, mental health counseling and some prescription drugs for outpatient treatment may all be covered under Medicare Part B.
As of the 2019 plan year, the Centers for Medicare and Medicaid Services has lifted coverage caps on critical services covered under Medicare Part B. These include physical therapy, speech language pathology and occupational therapy.
But original Medicare doesnt cover everything. You may need to obtain supplemental insurance, such as Medigap, if you need coverage for the following: