When Can I Apply For Medicare
You can apply for Medicare up to 3 months before you become eligible, the month that you become eligible, and then 3 months after you become eligible. This 7-month window is referred to as the Initial Enrollment Period . 1 The month that you become first eligible for Medicare is the month that you turn 65 if youre eligible related to a disability, the month that you become first eligible is the 25th month of your disability payments.1
If youre about to become eligible for Medicare, you may want to start shopping soon. If you miss your IEP, you may have to wait until the Annual Enrollment Period , which usually occurs from October 15 December 7 each year.2
Get Access To Additional Benefits When You Apply For Medicare
During your seven-month initial enrollment period, if you apply for Medicare online using mySocial Security or any other sign-up method:
- No medical underwriting applies when purchasing Medigap, which means insurers must accept you, even with pre-existing medical conditions.
- Avoids a late enrollment fee for Medicare Part A or B, which can be long-lasting and costly.
- Avoids a late enrollment fee for Medicare Part D prescription drug insurance.
Although you can easily sign up for Medicare online, deciding which benefits to pursue for your situation is not always so easy.
Many choose to keep Original Medicare, while many others get their healthcare benefits through a Medicare Advantage plan.
As a whole, Medicare Advantage is private insurance. Each plan comes through private Medicare-approved Part C carriers.
Essentially, this is a choice between Original Medicare, a government run program, and Medicare Advantage, a group of private plans.
If selecting Original Medicare, then one should also consider Medigap insurance in addition to prescription benefits from a separate Medicare Part D policy.
What Does Medical Insurance Cover
Medical insurance consists of medical services that a person can benefit from. When an insured person buys medical insurance, they are given all the medical benefits written in the plan.
Medical insurance policies are made by experts and medical professionals who are aware of patients and any laymans medical needs in daily life. Some medical insurance plans are focused on long-term illness coverage, while some only cover accidents.
The medical insurance plans also depend on the type of plan you subscribe to and how much you pay for it. The higher premium you pay, the more benefits you will get in terms of coverage.
Medical insurance covers the cost of:
Accident or sudden injury bills
Laboratory and other diagnostic tests
Surgeries, minor or major
There are other medical services that can be covered as well based on the program you apply to.
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When Do I Need To Sign Up For Medicare Part A
As stated above, if youre collecting Social Security benefits, youll automatically get Part A and Part B. If youre not automatically enrolled, the best time to enroll in Part A is during your Initial Enrollment Period.
As long as you worked a minimum of ten years, Part A will be premium-free. Even if youre still working, it makes sense to join Part A to help keep your out-of-pocket medical costs to a minimum.
Signing Up For Original Medicare
If you dont meet the requirements for automatic Medicare enrollment, you can apply for Medicare online, in person, or by phone.
To sign up, youll need a few important documents:
Your birth certificate, or other proof of birth
Proof of U.S. citizenship or legal residence
Social Security card if youre already drawing benefits
Your current health insurance information
Employment information, if applicable
U.S. military discharge papers
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Medicare Supplement Plan Eligibility
Medicare supplemental insurance, often called Medigap because it fills in the out-of-pocket coverage gaps in Medicare Parts A and B, is purchased from private insurers.
Medigap helps cover copayments, coinsurance and deductibles from Medicare Part A and Part B.
To be eligible for Medigap coverage, you must meet one of these qualifications:
- You must be 65 or older.
- You have been diagnosed with Lou Gehrigs disease.
- You have been receiving Social Security or Railroad Board disability payments for 24 months.
- You must have been diagnosed with end-stage renal disease, requiring regular dialysis or a kidney transplant.
You cannot enroll in a Medicare Advantage plan and a Medigap plan at the same time. You have to choose one or the other.
Qualified Disabled Working Individual Program
Qualified Disabled Working Individual Program is for those who need financial assistance to pay a premium for Part A.
You are only qualified for this program if you are a disabled person or if you have an income-based job. This Medicare Savings Program is also eligible for those who lost disability benefits in Social Security or have no one covering the cost of the premium for Part A when returned to work.
Read Also: What Is Medicare Advantage Plus
What Documents Do I Need To Apply For Medicare
To apply for Medicare, you will need the following documentation:
If you enrolled in Part A only and are ready to enroll in Part B, you will need to complete form 40B. If you delayed enrolling due to having employer group coverage, you will need your employer to complete form L564 and submit it along with form 40B.
FYI: To learn more about Medicare documentation, read my guide: What Documents Do I Need to Apply for Medicare?
Do I Need Medicare If I Am Covered By My Spouse’s Insurance
If you have insurance through a spouse’s employer, you may also be able to delay Medicare past age 65. However, this depends on the rules the employer has for covered dependents of Medicare age. Some employers may require covered dependents to enroll in Medicare at age 65 in order to remain on the employer plan. In this case, you’ll need to talk directly with the employer’s benefits administrator to learn about what you can do about Medicare enrollment.
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What Does Medicare Cover
Medicare helps pay for certain health care services and durable medical equipment. To have full Medicare coverage, Medicare beneficiaries must have Part A and Part B .
The following is a partial list of Medicare-covered services. The covered services listed below may require payment of deductibles and Co-Payments.
If you have questions about covered services, call Medicare at 1-800-633-4227.
What Are The Parts Of Medicare
Medicare consists of parts that are divided because every person might need different services. These parts are made by medical professionals and experts to provide maximum benefits. The Medicare Savings Program provides assistance to these parts as well.
There are three parts in Medicare that you should know:
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Medicare Advantage Eligibility Requirements
While regular Medicare Advantage does not cover ESRD, you may qualify for a Medicare Special Needs Plan. SNPs are special types of Advantage plans specifically designed for a particular condition or financial situation.
You can keep your Medicare Advantage plan if you purchased it before developing ESRD. And you can buy an Advantage plan after being medically determined to no longer have ESRD usually from a successful kidney transplant.
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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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 .
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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Employer Or Military Retiree Coverage
If you or your spouse has an Employer Group Health Plan as retiree health coverage from an employer or the military , you may not need additional insurance. Review the EGHPs costs and benefits and contact your employer benefits representative or SHIIP to learn how your coverage works with Medicare.
Documents For Medicare Advantage And Medigap
Whether you sign up for Medicare Advantage or Medigap, youll need both your Medicare number and the date your Original Medicare coverage started. This information will be on your Medicare card. You can also access this information through your dashboard on the Social Security website if you created an account to enroll.
FYI: Medigap covers the gaps in Medicare such as copayments, coinsurance, and deductibles. Read my guide on the best Medicare Supplement plans.
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What Is The Income Limit For Medicare Savings Program
Now that you know the four types of Medicare Savings Program, you should know the income limit of each program set by the state and Medicare. These income limits help you determine whether you are eligible for a certain program or not.
Your income and resource must fall under this limit so that you can apply for Medicare Savings Program:
Advantages Of The Initial Signup Period
The initial signup period is the ideal time to study and select the best combination of Medicare programs.
Enrolling when first eligible avoids late fees and restrictions that can come from applying at later times. The initial signup is best for Medigap insurance, Part D Prescription Drug coverage, and Part C Medicare Advantage.
When applying online, doing so at the first opportunity will help you to get the combination of benefits and coverage that suits your needs.
Typical combinations include:
- Original Medicare , with Prescription drug insurance .
- Original Medicare , with a Medigap policy, as well as Prescription drug insurance .
- Medicare Advantage , especially when offered with built-in prescription coverage, known as MAPD plans.
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Enrolling In Medicare With A Qualifying Disability Or Medical Condition
With a qualifying disability, you usually become Medicare-eligible after you’ve received disability benefits for 24 months. You will have a 7-month Initial Enrollment Period that includes your 25th month of disability, the 3 months before and the 3 months after.
You may also qualify for Medicare due to Lou Gehrig’s disease or end-stage renal disease . Enrollment for ALS or ESRD is unique, so you’ll want to review the rules for each carefully.
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AARP encourages you to consider your needs when selecting products and does not make product recommendations for individuals.
Please note that each insurer has sole financial responsibility for its products.
AARP® Medicare Supplement Insurance Plans
AARP endorses the AARP Medicare Supplement Insurance Plans, insured by UnitedHealthcare.
Insured by UnitedHealthcare Insurance Company, Hartford, CT or UnitedHealthcare Insurance Company of America, Schaumburg, IL or UnitedHealthcare Insurance Company of New York, Islandia, NY . Each insurer has sole financial responsibility for its products. Policy form No. GRP 79171 GPS-1 .
Not connected with or endorsed by the U.S. Government or the federal Medicare program.
When Can I Sign Up For Medicare
If youre aging into Medicare at 65, you can sign up for Medicare up to three months before your birthday. Coverage will begin on the first day of your birth month. If you start collecting Social Security before you turn 65, youll automatically be enrolled in both Part A and Part B of Medicare, and the monthly premium for Part B will be deducted from your Social Security check.
If youre disabled and collecting disability income, youll be automatically enrolled into both Part A and Part B on the 25th month of collecting. If youve been diagnosed with ALS or ESRD, youll be automatically enrolled as soon as you begin collecting SSDI. There is no 24-month waiting period.
Most beneficiaries opt to enroll in Part A since its premium-free. If you have another form of creditable coverage, like employer group insurance, you can opt to delay enrolling in Part B. Please note, if you do not have another form of creditable coverage and delay enrolling into Part B, you could face late-enrollment penalties in the future.
There are a few different enrollment periods for Medicare beneficiaries.
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When Should You Apply For Medicare If You Have Employer Health Coverage
Most people should sign up for Medicare Part A when theyre first eligible because it rarely costs anything. But some people delay enrolling in Part B because they dont want to pay the monthly premium. The decision usually depends on the type of health coverage you already have.
You can put off enrolling in Part B at age 65 if you have group health coverage through your or your spouses job and the employer has at least 20 employees.6 Youll be able to enroll with no penalty during the Special Enrollment Period that follows the end of your employers insurance. You can also choose to enroll in Part B while still insured and pay the premium.
If your employer has fewer than 20 employees, you should apply for Part A and Part B as soon as youre eligible.7
Be sure to talk to your employers benefits administrator about how signing up for Medicare will affect your coverage or Health Savings Account .8 You cannot contribute to an HSA if you have Medicare Part A. Your administrator can help you time the beginning and end of your coverage through work and your new health insurance so theres no gap in your coverage.
When your group coverage is ending, youll need to complete documentation and submit it to your Social Security office. If you have questions, ask Social Security.
Monthly Medicare Premiums For 2021
The standard Part B premium for 2021 is $148.50. If youre single and filed an individual tax return, or married and filed a joint tax return, the following chart applies to you:
|Modified Adjusted Gross Income||Part B monthly premium amount||Prescription drug coverage monthly premium amount|
|Individuals with a MAGI of less than or equal to $88,000 Married couples with a MAGI of $176,000 or less||2021 standard premium = $148.50|
|Your plan premium + $77.10|
What Are My Rights As A Medicare Beneficiary
As a Medicare beneficiary, you have certain guaranteed rights. These rights protect you when you get health care, they assure you access to needed health care services, and protect you against unethical practices.
You have these rights whether you are in Original Medicare or another Medicare health plan.
Your rights include, but are not limited to:
The Right to Receive Emergency Care
If you have severe pain, an injury, or a sudden illness that you believe may cause your health serious danger without immediate care, you have the right to receive emergency care. You never need prior approval for emergency care, and you may receive emergency care anywhere in the United States.
The Right to Appeal Decisions About Payments or Services for Medical Care
If you are enrolled in Original Medicare, you have the right to appeal denial of a payment for a service you have been provided. If you are enrolled in another Medicare health plan, you have the right to appeal the plan’s denial for a service to be provided.
The Right to Information About All Treatment Options
You have the right to know about all your health care treatment options from your health care provider. Medicare forbids its health plans from making any rules that would stop a doctor from telling you everything you need to know about your health care. If you think your Medicare health plan may have kept a provider from telling you everything you need to know about your health care options, then you have the right to appeal.