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 prescription 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 prescription drug coverage.
Should I Take Medicare Part B
You should take Medicare Part A when you are eligible. However, some people may not want to apply for Medicare Part B when they become eligible.
You can delay enrollment in Medicare Part B without penalty if you fit one of the following categories.
Employer group health plans may cover items normally not covered by Medicare Part B. If so, and you meet one of the categories above or below, then you may not need to enroll in Medicare Part B and pay the monthly premium.
If you are:
- a spouse of an active worker
- a disabled, active worker
- a disabled spouse of an active worker
and choose coverage under the employer group health plan, you can refuse Medicare Part B during the automatic or initial enrollment period. You wait to sign up for Medicare Part B during the special enrollment period, an eight month period that begins the month the group health coverage ends or the month employment ends, whichever comes first.
You will not be enrolling late, so you will not have any penalty.
If you choose coverage under the employer group health plan and are still working, Medicare will be the “secondary payer,” which means the employer plan pays first.
If the employer group health plan does not pay all the patient’s expenses, Medicare may pay the entire balance, a portion, or nothing. An employer group health plan must be primary or nothing.
When To Apply For Medicare: Whats The Initial Enrollment Period
For most people, the Medicare Initial Enrollment Period is a seven-month period. It starts three months before the month you turn 65, includes your birthday month, and goes three more months after that. So if your 65th birthday is in November, your IEP runs from August through February.
Your IEP is different if youre not yet 65, but you qualify for Medicare by disability. For example, you might be automatically enrolled during your 25th month in a row of receiving Social Security disability benefits.
Learn how enrollment works if youre under 65 but eligible for Medicare through disability.
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When Is The Medicare Part D Annual Election Period
If you did not enroll in prescription drug coverage during IEP, you can sign up for prescription drug coverage during the Annual Election Period that runs every year from October 15 to December 7.
During AEP, you can:
- Sign up for a Medicare prescription drug plan.
- Drop a Medicare prescription drug plan.
- Join a Medicare Advantage plan that includes prescription drug coverage.
- Switch from a Medicare Advantage plan that doesnât include prescription drug coverage to a Medicare Advantage plan that does .
Outside of the Part D Initial Enrollment Period and the Annual Election Period, usually the only time you can make changes to prescription drug coverage without a qualifying Special Election Period is during the Medicare Advantage Open Enrollment Period but only if you are dropping Medicare Advantage coverage and switching back to Original Medicare. The Medicare Advantage Open Enrollment Period runs from January 1 to March 31.
Medicare Part A and Part B do not include prescription drug coverage, and if you switch back to Original Medicare during the Medicare Advantage Open Enrollment Period, you will have until March 31 to join a stand-alone Medicare prescription drug plan.
What Is Optus Doing About The Cyber
Optus is collaborating with the AFP, OAIC, FBI, and other industry regulators to investigate the attack and protect against any further data breaches. The Australian federal government is slated to announce new data security in the wake of the hack, though itâs still awaiting further details from the investigation.
Optus has temporarily paused its online or over-the-phone SIM swaps and replacements, as well as any change of ownership requests, to stop criminals from taking control of accounts. These processes can be completed in-store instead with the appropriate ID.
Optus has also announced it will provide free one-year Equifax Protect subscriptions to customers most affected by the attack, such as those whose personal details and ID were stolen. This service can help affected customers monitor their credit and prevent identity theft.
Eligible customers will be contacted directly via email, SMS, or post by Optus with details on how to sign up to their subscription. Optus will not be sending clickable links and customers will only be contacted with details if they’ve already been notified the data breach involves them.
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Does The Medicare Levy Surcharge Apply If I Have Private Hospital Cover For Part Of The Year
The MLS is calculated on a daily rate, so if you pick up a private health insurance policy part-way through the year, you wont pay for the entire year.
But if you dont maintain the cover for the full financial year, youre going to have to cough up for the surcharge for every day you dont have hospital cover.
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 thatemployers 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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When To Sign Up For Medicare
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.
Common Questions About Applying For Medicare
What is Medicare?
Medicare is a national health insurance program that offers hospital and medical insurance through two different parts. Medicare Part A provides inpatient hospital coverage, hospice care, skilled nursing facility, home health care, and more. Part B provides outpatient services, including doctor visits, surgeries, durable medical equipment, and more. Medicare does not cover 100% of the cost of these services.
When will I get my Original Medicare card?
In other words how long does it take to get your Medicare card after applying? In most cases, you will receive your Medicare card about 3 weeks after you apply. If you are already receiving Social Security benefits when you turn 65, your card will just show up in your mailbox about 2 months before you turn 65. When you receive it, be sure that you do not forget to enroll in Part D if you need drug coverage before your Initial Enrollment Period ends.
Do I automatically get Medicare when I turn 65?
Maybe! If you are already receiving Social Security benefits at least four months before your 65th birthday month, youll be automatically enrolled in Medicare at 65. However, if not, you will need to enroll in Medicare yourself.
When is open enrollment for Medicare? Do you have to apply for Medicare every year?
Read Also: What Is Medicare In Simple Terms
Also Check: What Does Medicare Advantage Cover
How To Sign Up For Medicare Advantage: When Can I Enroll
Medicare Advantage, also known as Medicare Part C, is another way to receive Original Medicare benefits and is offered through private insurance companies that have contracts with Medicare. At minimum, all Medicare Advantage plans must offer the same Medicare Part A and Part B benefits as Original Medicare. Some Medicare Advantage plans also include additional benefits, such as prescription drug coverage. You must have Original Medicare, Part A and B, to enroll in a Medicare Advantage plan through a private insurer.
You can enroll in a Medicare Advantage plan during two enrollment periods, the Initial Coverage Election Period and Annual Election Period.
Be Aware Of Other Enrollment Periods
Most people sign up for Medicare during the seven-month initial enrollment period around their 65th birthday.
But what if you missed your initial enrollment period and want to make changes or add additional coverage?
There are specific times each year when you can do this.
Alternate Medicare Enrollment Periods
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Do I Qualify For A Medicare Special Enrollment Period
Perhaps, if you or your spouse is still working and you have health insurance from that employer. The special enrollment period allows you to sign up for Medicare Part B throughout the time you have coverage from your or your spouses employer and for up to eight months after the job or insurance ends, whichever occurs first.
If you enroll at any point during this time, your Medicare coverage will begin the first day of the following month. And you will not be liable for late penalties, no matter how old you are when you finally sign up.
Your decision also depends on the size of your employer and whether the employers plan is first in line to pay your medical bills or second.
Larger companies. If you or your spouse work for a company with 20 or more employees, you can delay signing up for Medicare until the employment ends or the coverage stops, whichever happens first. These large employers must offer you and your spouse the same benefits they offer younger employees and their spouses, which means that the employers coverage can continue to be your primary coverage and pay your medical bills first.
Many people enroll in Medicare Part A at 65 even though they have employer coverage, because its free if they or their spouse has paid 40 or more quarters of Medicare taxes. But they often delay signing up for Part B while theyre still working so they dont have to pay premiums for both Medicare and the employer coverage.
Keep in mind
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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How Can I Avoid The Medicare Levy Surcharge
A small number of people may be able to avoid the surcharge. If your income is less than $90,000, if youre a dependent child living with your parents and studying full-time aged up to 24 years of age, and if you or your partner meet the medical exemptions listed here, you may be able to avoid paying.
Of course, the other way to avoid paying the MLS is to take out a private health policy that includes hospital cover. Its worth working out whether the levy on your income will cost you more than your annual hospital health insurance cover.
What If I Cant Get Copies
You should submit your application even if you dont have copies of some of these documents. Social Security might be able to help you track them down.
In fact, Social Security can often request copies and verification from your states Bureau of Vital Statistics. If not, it can help you get the forms you need in order to get the documents yourself.
The way you enroll in Medicare depends on which parts of Medicare you choose. There are different methods for enrolling in original Medicare as opposed to Medicare Advantage , Medigap, and Part D plans.
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When To Enroll In Medicare If I Am Receiving Disability Benefits
If you are under 65 and receiving certain disability benefits from Social Security or the Railroad Retirement Board, you will be automatically enrolled in Original Medicare, Part A and Part B, after 24 months of disability benefits. The exception to this is if you have end-stage renal disease . If you have ESRD and had a kidney transplant or need regular kidney dialysis, you can apply for Medicare. If you have amyotrophic lateral sclerosis , you will automatically be enrolled in Original Medicare in the same month that your disability benefits start
Who Has Been Affected By The Optus Data Breach
Optus estimates that up to 9.8 million Australians could have their data compromised due to the attack, with 2.8 million severely impacted. Optus has also identified 14,900 valid Medicare numbers in the exposed records. Optus is in the process of informing customers affected by the data breach, though news outlets report that many users have had to contact the telco directly to find out if theyâve been involved.
Optus executives have also warned the attack impacts customers as far back as 2017, so even ex-Optus users should take note. Anecdotally, some customers who left Optus dating back to 2012 claim to have been implicated, though these claims have not been verified.
According to Optus, customers on most Optus MVNOs such as amaysim, Coles Mobile, and Catch Mobile have not been impacted. GOMO customers, on the other hand, may have been affected. Optus will be contacting impacted GOMO users within the coming days.
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What Happens After I Apply For Medicare Online
Once you complete your online application, Medicare will review it to ensure all information is complete. Make sure you have accurate contact information in case Medicare needs to contact you about your application information and so that you receive your Medicare enrollment information and ID cards.
Once your application is processed, you will receive a decision letter in the mail. If you have any questions during the application process or after you have submitted your application, you can always call the number above for assistance.
Do you have questions about when to apply for Medicare or what plans and options are best for you? Id like to help you understand your options. If youd prefer, you can get information via email or schedule a telephone call by clicking one of the links at the bottom of the page. To see a list of plans in your area you may be eligible for, click the Compare Plans button.
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Becoming eligible for Medicare can be daunting. But dont worry, were here to help you understand Medicare in 15 minutes or less.
Costs And Funding Challenges
Over the long-term, Medicare faces significant financial challenges because of rising overall health care costs, increasing enrollment as the population ages, and a decreasing ratio of workers to enrollees. Total Medicare spending is projected to increase from $523 billion in 2010 to around $900 billion by 2020. From 2010 to 2030, Medicare enrollment is projected to increase dramatically, from 47 million to 79 million, and the ratio of workers to enrollees is expected to decrease from 3.7 to 2.4. However, the ratio of workers to retirees has declined steadily for decades, and social insurance systems have remained sustainable due to rising worker productivity. There is some evidence that productivity gains will continue to offset demographic trends in the near future.
The Congressional Budget Office wrote in 2008 that “future growth in spending per beneficiary for Medicare and Medicaidthe federal government’s major health care programswill be the most important determinant of long-term trends in federal spending. Changing those programs in ways that reduce the growth of costswhich will be difficult, in part because of the complexity of health policy choicesis ultimately the nation’s central long-term challenge in setting federal fiscal policy.”
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Do I Need Other Documents If Im Enrolling In A Specific Part Of Medicare
Youll need to provide the documents listed above when you enroll in Medicare Part A and Medicare Part B . Together, parts A and B are known as original Medicare.
Youll need to enroll in original Medicare before you can enroll in any other Medicare parts. Other parts of Medicare include:
- Medicare Part D, which is prescription drug coverage
- Medicare supplement insurance, also called Medigap
You shouldnt need to submit any additional documentation when you enroll in these other parts.
Youll just be asked to provide your Medicare number and your Medicare Part A start date. You can find your Medicare number and Part A start date on your Medicare card.
You can get new copies of any documents you no longer have. Its a good idea to start gathering documents before you apply for Medicare.
If you need new copies of any documents, you can follow the steps below.
