Friday, December 2, 2022

When Can You Join Medicare

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Why You May Consider Signing Up For Medicare At 65

ESRD Medicare Eligibles can now join Medicare Advantage Plans

If youre approaching age 65 and are not going to keep working, you have employer coverage from an employer with fewer than 20 employees, or your spouses employer requires you to get Medicare to stay on their health plan, then you need to enroll during whats known as your Medicare Initial Enrollment Period . If you dont, youll likely face financial premium penalties for enrolling late.

Your IEP is a 7-month window that generally includes the month of your 65th birthday, the 3 months before and the 3 months after For example, if your 65th birthday is on June 20, then your IEP starts on March 1 and ends on September 30.

This is the time to learn about your Medicare coverage options and get what you do or dont need coverage for. Most who have to get Medicare at age 65 will get Part A , Part B and some form of prescription drug coverage through either a stand-alone Part D plan or a Medicare Advantage plan.

Depending on your situation such as if you still have or want to keep employer coverage you may not need every part of Medicare available. But keep in mind here a simple rule: If you are not eligible for a Medicare Special Enrollment Period you need to get Parts A, B and D when youre first eligible to avoid financial penalties. Also, if youre still working, its a good idea to check with your employer plan benefits administrator to see how Medicare might work with that coverage before making any final decisions.

Who Can Join A Medicare Advantage Plan

You can generally join one of these Medicare Advantage Plans:

If all of these apply:

  • You live in the service area of the plan you want to join. The plan can give you more information about its service area. If you live in another state for part of the year, ask if the plan will cover you there.
  • You have Medicare Part A and Part B.
  • You’re a U.S. citizen or lawfully present in the U.S.
Note

Starting January 2021, people with ESRD can choose either Original Medicare or a Medicare Advantage Plan when deciding how to get Medicare coverage. Learn more.

Medicare General Enrollment Period

If you dont sign up for Medicare Part A and/or Part B when youre eligible, you can apply for Medicare for the first time using the General Enrollment Period from Jan. 1 through March 31 every year. Coverage begins July 1.

This enrollment period is only available to people who didnt sign up during their Initial Enrollment Period and who arent eligible for a Special Enrollment Period.

Note: You may have to pay a higher premium for Part A and/or Part B due to late enrollment.

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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.

Your First Chance To Sign Up

Age To Sign Up For Medicare

Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

Avoid the penaltyIf you miss your 7-month Initial Enrollment Period, you may have to wait to sign up and pay a monthly late enrollment penalty for as long as you have Part B coverage. The penalty goes up the longer you wait. You may also have to pay a penalty if you have to pay a Part A premium, also called Premium-Part A.

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When Can I Join A Medicare Part D Prescription Drug Plan

En español | You can get Medicare prescription drug coverage in one of two ways: through a stand-alone Part D drug plan or through a Medicare Advantage managed care plan which includes Part D drug coverage in its benefits package. Both types of plan are offered by private insurance companies that are regulated by Medicare.

Whether you choose a stand-alone Part D drug plan or a Medicare Advantage plan, you must enroll during a designated enrollment period:

  • Your initial enrollment period , which runs for seven months, of which the fourth is the month of your 65th birthday.
  • A special enrollment period , which youre entitled to in certain circumstances:

If you qualify for Extra Help or enter or leave a nursing home, you can join a Part D drug plan or switch to another at any time of the year.

If you lose creditable drug coverage from elsewhere such as an employer, union, retiree benefits, COBRA, Medicaid, or the Veterans Affairs health care program you can sign up with a drug plan within two months of this coverage ending.

If you move outside of your current drug plans service area , you can sign up with a new plan, either before or within two months of the move.

If your current Part D plan withdraws service from your area, you can switch to another plan before or when your current coverage ends.

If a plan violates its contract with you, you can ask Medicare to investigate if Medicare agrees, you can switch to another plan at that time.

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.

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Medicare Eligibility Requirements For 2020

Not sure if youre eligible for Medicare health insurance? The Social Security Administration enrolls some people automatically. But dont expect that or wait for your Medicare card to show up. Find out if youre eligible now so you can enroll at the right time and avoid any Late Enrollment Penalties .

Theres more than one way to qualify for Medicare, and enrolling in the different parts of Medicare differ as well. Plus, how you qualify may determine how you can receive coverage and what your premiums might be.

If youre looking for more of a crash course in the different parts of Medicare and how the program works as a whole, check out our Ultimate Medicare Guide. Otherwise, read on.

When Can I Enroll In A Medicare Advantage Plan

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You must have Medicare Part A and Medicare Part B to enroll in a Medicare Advantage plan. People can enroll in a Medicare Advantage plan for the first time using the Initial Coverage Election Period. If you enroll in Medicare Part B when you are first eligible to do so, using the Initial Enrollment Period for Medicare Part A and Part B, the Initial Coverage Election Period will be the same as the Medicare Part B Initial Enrollment Period.

For example, Mary Doe Joness Medicare Initial Enrollment Period is January 1, through July 31, 2021. She went to Social Security and filled out an application on January 15, 2021. Her Medicare Part B coverage was effective April 1, 2021. Her Initial Coverage Election Period for Medicare Advantage is also January 1 July 31, 2021. If she chooses a Medicare Advantage plan in January and submits an enrollment request, her Medicare Advantage plan would typically begin April 1, 2021.

If you delayed your enrollment in Medicare Part B, your Initial Coverage Election Period is only the three months before Medicare Part B coverage begins.

For example, John Doe Jones was first eligible to enroll in Medicare Part B in September, 2019. He delayed his enrollment, enrolling for the first time using the General Enrollment Period for 2020 . His coverage for Medicare Part B was effective July 1, 2020. His Initial Coverage Election Period was April June 2020.

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Should You Give Up Your Hsa

If youre still working at age 65 and are covered by a group health plan at work, or have a spouse whose group health plan youre covered by, you dont need to sign up for Medicare .

Normally, eligible Medicare enrollees who fail to sign up during the initial seven-month enrollment period leading up to and following their 65th birthday face lifelong Part B premium surcharges for enrolling late. That penalty, however, doesnt apply if you have group health coverage in place when you turn 65. Rather, you get a special enrollment period for Medicare that begins once you separate from your employer or once your group coverage ends whichever comes first.

That said, many 65-year-olds who have group health coverage sign up for Medicare Part A only, since theres generally no premium attached to it. This way, Medicare serves as secondary insurance for hospital care. The main reason not to sign up for Part A when youre still covered by a group health plan is if youd like to continue funding an HSA, since you cant do so once enrolled.

HSAs offer immediate tax savings, since contributions exclude a portion of your income from taxation the year theyre made. And the more money you put into your HSA, the more funds youll have available in retirement, when your medical costs start building. Therefore, if youre eligible for an HSA, it often pays to delay your Medicare enrollment and continue reaping that benefit.

Who Is Eligible For Medicare

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease . Medicare has two parts, Part A and Part B . You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:

  • You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
  • You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
  • You or your spouse had Medicare-covered government employment.

To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool.

If you did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:

  • You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You are a kidney dialysis or kidney transplant patient.

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.

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What Is The Penalty For Having An Hsa And Medicare

Once you enroll in Medicare, the IRS sets your contribution limit to your HSA to zero. What this means is, beginning the first month youre enrolled in Medicare, youre not allowed to contribute any monies into your HSA.

This limit also pertains to any period of retroactive Medicare coverage. If you continue to contribute, or your Medicare coverage becomes retroactive, you may have to pay a 6% excise tax on those excess contributions. If you happen to have excess contributions, you can withdraw some or all to avoid paying the excise tax.

What Is The Medicare Advantage Disenrollment Period

When Can You Sign Up For Medicare Supplement

The Medicare Advantage Disenrollment Period, which is now called the Medicare Advantage Open Enrollment Period, is the time of year that someone who is on a Medicare Advantage Plan can make one change to another MAP or to a Supplement with a Part D plan, says Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans. You can also switch to Original Medicare without a Supplement or prescription drug coverage during this period, but this would leave you with less coverage than your MAP.

The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 of each year. This is important especially if a member used the plan in the first couple of months of the year and found out that their provider no longer participates in the plan or that they chose the wrong carrier and plan for their needs, Gavino says.

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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.

What Happens If You Need To Change Plans During A Period You Cannot Change Plans

The only way to change Medicare Advantage Plans outside of the standard annual enrollment periods is by qualifying for a Special Enrollment Period. include, but are not limited to:

  • Moving outside of your current plans service area.
  • Moving to a new address within your current plans service area but which has new plan options.
  • Moving into or out of a skilled nursing facility or long-term hospital care.
  • You are eligible for both Medicare and Medicaid.
  • Becoming ineligible for Medicaid.
  • If Medicare takes an official action because of a problem with your current plan that affects you.
  • If Medicare terminates or does not renew your current plans contract.
  • You joined a plan or chose not to join a plan due to an error by a federal employee.

You generally have 2 months to make a change to your Medicare Advantage Plan during a SEP.

For a complete list of special circumstances that qualify you for a SEP, click here: Special circumstances .

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What Else Do I Need To Know

  • Medicare can help cover your costs for health care, like hospital visits and doctors services.
  • Most people dont pay a premium for Part A, but you do pay a monthly premium for Part B.
  • If you cant afford the monthly premium, there are programs to help lower your costs. Get details about cost saving programs.

Will I Get Medicare At 62 If I Retire Then

What Is A Medicare Private-Fee-For-Service Plan? Should You Join A Medicare PFFS Plan?

If you retire before the age of 65, you may be able to continue to get medical insurance coverage through your employer, or you can purchase coverage from a private insurance company until you turn 65. While waiting for Medicare enrollment eligibility, you may contact your State Health Insurance Assistance Program to discuss your options.

Here are some ways you may be eligible for Medicare at age 62:

  • You may qualify for Medicare due to a disability if you have been receiving SSDI checks for more than 24 months.
  • You have been diagnosed with End-Stage Renal Disease .
  • You are getting dialysis treatments or have had a kidney transplant.

Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealths Medicare related content is compliant with CMS regulations, you can rest assured youre getting accurate information so you can make the right decisions for your coverage. Read more to learn about our Compliance Program.

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Can I Change Medicare Advantage Plans Anytime

Updated: September 16, 2021Expert reviewed by: Kelly Blackwell, Certified Senior Advisor®Medicare Advantage Plans, also called Medicare Part C, are an alternative to Original Medicare. They provide the same coverage as Medicare Part A and Part B, and sometimes offer additional benefits not included in Original Medicare, like drug, dental and vision coverage.

Kelly Blackwell

Kelly Blackwell is a Certified Senior Advisor ®. She has been a healthcare professional for over 30 years, with experience working as a bedside nurse and as a Clinical Manager. She has a passion for educating, assisting and advising seniors throughout the healthcare process.

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