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.
How Often Do You Have To Enroll In Medicare
In general, once youre enrolled in Medicare, you dont need to take action to renew your coverage every year. This is true whether you are in Original Medicare, a Medicare Advantage plan, or a Medicare prescription drug plan. As long as you continue to pay any necessary premiums, your Medicare coverage should automatically renew every year with a few exceptions as described below.
Sign Up For A Mymedicaregov Account
After you sign up for Medicare, you can create a MyMedicare.gov account to manage your coverage.
With your MyMedicare.gov account, you can:
- Get details about the plans youre enrolled in and what they cover.
- Update your personal information.
Creating an account on MyMedicare.gov is quick and easy.
How to Sign Up for MyMedicare.gov
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Signing Up For A Medicare Part D Plan
Medicare Part D drug coverage is optional and available to anyone with Medicare Part A and Part B.
Two Ways to Get Medicare Prescription Drug Coverage
In both cases, you must already be enrolled in Original Medicare.
You can explore and compare available Part D plans on the Medicare website.
You can also call your local State Health Insurance Assistance Program for free help.
Once you find a plan that meets your needs, there are a few ways to sign up.
Four Ways to Sign Up for a Part D Drug Plan
To sign up for a Medicare Part D plan, you will need your Medicare number and the date your Part A and Part B coverage started. You can find this information on your Medicare card or on MyMedicare.gov.
Other Information You Need to Provide
- Your primary mailing address
- Whether you had or have other drug coverage
- How you want to pay your premiums
Coverage usually begins the first day of the month after enrollment.
If you switch plans during the open enrollment period , your new coverage will start Jan. 1.
When Is The Medicare Advantage Plan Annual Election Period:
You can also add, drop, or change your Medicare Advantage plan during the Annual Election Period, which occurs from October 15 to December 7 of every year. During this period, you may:
- Switch from Original Medicare to a Medicare Advantage plan, and vice versa.
- Switch from one Medicare Advantage plan to a different one.
- Switch from a Medicare Advantage plan without prescription drug coverage to a Medicare Advantage plan that covers prescription drugs, and vice versa.
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How To Enroll In Medicare
If you arent automatically enrolled, you can enroll in Medicare Part A and/or Medicare Part B in the following ways:
- In person at your local Social Security office.
- If you worked at a railroad, contact the Railroad Retirement Board . Call 1-877-772-5772 , Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.
What Are The Steps To Buying A Medicare Supplement Insurance Plan
The steps to buying a Medigap policy are:
- Enroll in Medicare Part B.
- Buy the Medigap policy.
Choose carefully as you may be subjected to medical underwriting if you wish to change plans later. Medical underwriting could deny you a policy or make you pay more for a policy based on your health conditions.
*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plans official plan documents to understand how that plan handles pre-existing conditions.
**Medicare Supplement plans that cover the Medicare Part B deductible will eventually be discontinued. If you have a Plan C or Plan F, you can keep it. But if you qualify for Medicare on January 1, 2020 or later, you wont be able to buy one of these plans. You might be able to buy a high-deductible version of Plan G in 2020, if available.
The product and service descriptions, if any, provided on these eHealth Insurance Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.
New To Medicare?
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Sign Up: Within 8 Months After Your Family Member Stops Working
- If you have Medicare due to a disability or ALS , youll already have Part A .
- Youll pay a monthly premium for Part B , so you may want to wait to sign up for Part B.
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?
Medicare Annual Enrollment Period
Once you sign up for Original Medicare Part A and Part B, you are covered and dont need to renew it. But every year, during the Medicare Annual Enrollment Period you have an opportunity to change your Medicare health or prescription drug plan. This happens annually from Oct. 15 through Dec. 7. If you make a change during this enrollment period, your new plan benefits are effective Jan. 1 of the following year.
Read more info in our Medicare Annual Enrollment Period Guide.
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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.
Medigap policies are not required but enrolling in one can help you pay out-of-pocket costs, including deductibles, coinsurance and copayments.
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
D Late Enrollment Penalty
You may incur a late enrollment penalty if at any time after your initial enrollment penalty, theres a period of 63 or more days in a row where you dont have Part D or creditable prescription drug coverage. Youll have to pay the penalty for as long as you have Medicare coverage.
To calculate the penalty, multiply 1 percent of the national base beneficiary premium by the number of full, uncovered months you didnt have creditable coverage. The premium is then rounded to the nearest $0.10 and added to your Part D monthly premium.
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When Can You Buy A Medigap Policy
Once youre age 65 and enrolled in Medicare Part B for the first time, you have a six-month Medigap Open Enrollment Period in which you can buy a Medigap policy. During this period, you can buy any Medigap policy sold in your state, even if you have health problems .
If, though, you apply for Medicare Supplement Insurance after your Medigap Open Enrollment Period, you could be turned down for a policy if you have certain health conditions.
Medicare Supplement Open Enrollment Period
If youre looking to supplement your Original Medicare coverage to help with additional costs, the best time to buy a Medicare Supplement plan is during the six-month enrollment period that starts the first day of the month you turn 65 as long as you have signed up for Medicare Part B.
If you dont sign up for a Medicare Supplement plan during this Open Enrollment Period, you may not be able to buy a Medicare Supplement plan. Unless you have a guaranteed issue right, you may be required to answer medical questions.
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What Documents Do I Need To Enroll In Medicare
Youll need to prove that youre eligible for Medicare when you first enroll. In some cases, Medicare might already have this information.
If youre already receiving Social Security retirement benefits or Social Security Disability Insurance, you wont need to submit any additional documentation. Social Security and Medicare will already have all the information they need to process your enrollment.
If you dont receive any kind of Social Security benefits, youll need to provide documentation to enroll in Medicare.
You can enroll online, over the phone, or in person at a Social Security office. No matter how you apply, youll need to provide certain information.
Generally, this includes:
Most of this information can be provided simply by filling out the application. Some details, though, will need extra documentation. These documents may include:
You might not need all these documents, but its a good idea to have as many of them ready as you can. Social Security will let you know whats needed.
Any documents you send should be originals. Social Security will accept copies of W-2s, tax documents, and medical records, but everything else needs to be an original document.
Social Security will send the documents back to you after theyre reviewed.
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 Medicare Advantage Open Enrollment Period:
The Medicare Advantage Open Enrollment Period is a limited annual enrollment period. It goes from January 1 March 31 every year. During this time, you can:
- Switch Medicare Advantage plans, if you already have a Medicare Advantage plan
- Disenroll from your Medicare Advantage plan and return to Original Medicare.
You cannot use this period to make most other coverage changes. However, if you decide to drop your Medicare Advantage plan, you can also use this period to join a stand-alone Medicare prescription drug plan, since Original Medicare doesnt include prescription drug coverage.
Outside of the Annual Election Period and the Medicare Advantage Open Enrollment Period, you cannot generally make changes to your Medicare Advantage plan unless you qualify for a Special Election Period.
How Do I Know Im Enrolled In Medicare
After you apply for Medicare, Social Security will review and process your application. Theyll contact you if they need more information.
When youre approved for Medicare Part A and/or Part B, Social Security will send you a welcome packet that includes the following:
- Your confirmation letter
- Your red, white and blue Medicare ID card
- A Welcome to Medicare booklet that walks you through decisions you may have to make with your Medicare coverage
- The Medicare & You handbook
If youve applied for a private Medicare plan such as a Medicare Advantage, Medicare Cost, Medigap or Medicare Prescription Drug plan, when your enrollment is accepted youll get a separate confirmation letter and ID card.
Medicare helps pay for your health care costs and covers preventive care including a visit with your doctor each year. So once you get Medicare Part B, schedule your initial Welcome to Medicare visit with your doctor. And each year you get an Annual Wellness Visit with your doctor.
For more helpful tips, review this checklist, how to use Medicare your first year.
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Do I Need To Have Original Medicare To Apply For Medigap
The short answer is yes. To have a Medigap policy, you must first have Medicare Part A and Part B. Your Medigap Open Enrollment Period begins on the first day of the month that youre both 65 or older and enrolled in Medicare Part B. During this open enrollment period, your insurer cant do any of following because of your health problems: deny you coverage, charge you more for a policy, or make you wait for coverage to start, except as related to a pre-existing condition*. Outside of Medigaps Open Enrollment Period, you may be denied a policy or charged more for a policy if you have health problems.
Even if you are 65, you are not eligible for Medigap Open Enrollment until you are enrolled in Medicare Part B. Keep in mind that Medigap only works with Original Medicare. You cant use these plans to pay for Medicare Advantage costs.
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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If You Missed Enrolling Your Initial Or General Enrollment Period
If a group health plan covers you through your or your spouses employer or union, you can sign up for Medicare Part A or Part B anytime.
If your employment or group health plan ends, you have an eight-month Special Enrollment Period to sign up for Part A and Part B without facing a late enrollment penalty. Keep in mind that retiree health plans and COBRA dont qualify you for a Special Enrollment Period when that coverage ends.
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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When Will You Get Your Medicare Card
Your Medicare card will arrive in your Welcome to Medicare packet. Once youve submitted your application, the packet will arrive about two weeks after youve been approved.12
If youre already receiving benefits from Social Security or the Railroad Retirement Board, expect the packet to arrive about three months before you turn 65.
When Does Your Medigap Policy Coverage Begin
Once you receive your Medicare card, you can apply for a Medigap policy. Its best to apply as soon as you have your Medicare card. If you apply one to three months before your 65th birthday month, that will allow enough time for your application to be processed and will also ensure your Medicare Supplement Insurance coverage begins the same month that Medicare kicks in for you.
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