Ready To Apply For Medicare Part D
Ready to apply? Check out Medicare’s plan finder or just give us a call. We’ll be happy to help guide you through the process.
1. Kaiser Family Foundation, 10 Things to Know about Medicare Part D Coverage and Costs in 2019″
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General Enrollment/medicare Advantage Open Enrollment
From January 1 to March 31, you can change or drop Medicare Advantage plans with Part D coverage or join original Medicare during this time.
You cant join a Part D plan during this time if you have original Medicare.
If you have questions about your Medicare part D coverage or enrollment periods, reach out to the insurance company from whom you purchase your coverage, contact the State Health Insurance Assistance Programs National Network or call 800-MEDICARE.
Initial Coverage Election Period For Medicare Advantage Plans
Youre eligible to enroll in a Medicare Advantage plan if:
- You have Medicare Part A and Part B.
- You live in the service area of a Medicare Advantage plan.
- You dont have end-stage renal disease .
During your Initial Coverage Election Period, you are usually initially eligible to enroll in a Medicare Advantage plan . For the most part, this period coincides with the above-mentioned Initial Enrollment Period for Original Medicare. If you wait three months to enroll in Medicare Part B, your ICEP will begin three months before you have both Medicare Part A and Part B coverage and will expire on the last day of the month before Medicare Part B coverage begins.
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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.
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Change Medicare Plans During Medicare Advantage Open Enrollment Period
If youre enrolled in Medicare Advantage and want to switch back to Original Medicare, Part A and Part B, you can do so during the Medicare Advantage Open Enrollment Period , which runs from January 1-March 31 each year. You will also have until March 31 to join a stand-alone Medicare Prescription Drug Plan , and your coverage will go into effect the first day of the month after your new plan gets your enrollment form.
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Am I Automatically Signed Up For Medicare When I Turn 65
The short answer is no, unless you are already receiving Social Security or Railroad Retirement Board benefits. If youre already receiving those benefits, youll receive your Medicare card in the mail before your 65th birthday.
Otherwise, youll have to sign up for Medicare on your own and you may or may not be notified about your eligibility. Thats why it is even more important to know your Initial Enrollment Period dates so you are ready to enroll when its your time.
Can I Decline Medicare Altogether
Medicare isnt exactly mandatory, but it can be complicated to decline. Late enrollment comes with penalties, and some parts of the program are optional to add, like Medicare parts C and D. Medicare parts A and B are the foundation of Medicare, though, and to decline these comes with consequences.
The Social Security Administration oversees the Medicare program and recommends signing up for Medicare when you are initially eligible, even if you dont plan to retire or use your benefits right away. The exception is when you are still participating in an employer-based health plan, in which case you can sign up for Medicare late, usually without penalty.
While you can decline Medicare altogether, Part A at the very least is premium-free for most people, and wont cost you anything if you elect not to use it. Declining your Medicare Part A and Part B benefits completely is possible, but you are required to withdraw from all of your monthly benefits to do so. This means you can no longer receive Social Security or RRB benefits and must repay anything you have already received when you withdraw from the program.
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Applying For Medicare With Employer Coverage
Can you still enroll in Medicare coverage, even if youre not yet seeking retirement? The answer is yes! Medicare coverage can coincide with your group coverage through your employer. If your employer has more than 20 employees, your group coverage will work as your primary insurance, and Medicare will be your secondary insurance.
You can choose to apply for Part B, or you can wait until leaving your employer group coverage. For more information on the benefits of obtaining Medicare while receiving group coverage through work, give our team a call, and we can review the pros and cons.
Sometimes beneficiaries dont want to apply for Part B when they initially become eligible because of employer health coverage. Should you lose your health insurance through your employer, or if you prefer to switch over to Medicare, you can apply any time while receiving coverage through your employer.
When Does Medicare Part D Open Enrollment Start
Medicare Part D Open Enrollment 2022 starts on October 15. This date began Medicares Annual Election Period or Annual Enrollment Period . To access Part D benefits during this time, you can:
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Why Might I Want To Change Medicare Supplement Plans
You may be satisfied with your current Medicare Supplement Plan. But there are certain situations where you may want to change your plan. Here are some examples:
- He found a supplementary Medicare insurance plan for a lower premium. Maybe he even found the same plan for less money, offered by a different insurance company.
Each Standard Medicare Supplement plan with the same letter name has the same basic benefits, no matter where you buy the plan. For example, each Medicare Supplement A includes the same basic benefits. So if you have a Medicare Supplement A plan and you see that a plan of the same name is sold by a different insurance company, the basic benefits will be the same. Please note that Massachusetts, Minnesota and Wisconsin have standardized plans differently.
- You found that you need more benefits than your Medicare insurance supplement plan and want to switch to a plan with more benefits.
- You found that you do not need or want all of the benefits offered by your Medicare Supplement plan, and you would like to switch to a plan with fewer basic benefits and perhaps a lower premium.
- You would like to buy your plan from another insurance company.
Two Ways To Get Medicare Drug Coverage
Drug Plan with Original Medicare
If you choose Original Medicare, you can purchase a stand-alone Medicare Part D prescription drug plan through a private insurance company. For example, UnitedHealth Group, Humana, and CVS Health together insure about 56 percent of Medicare Part D enrollees. In 2021, half of Part D enrollees chose a stand-alone plan.3
Drug Plan with Medicare Advantage
If you enroll in a Medicare Advantage plan, most policies include prescription drug insurance. Half of Part D enrollees chose Medicare Advantage prescription drug plans .4 Aetna, Humana, and Blue Cross Blue Shield are some of the many insurance companies that offer Medicare Advantage plans with prescription drug coverage.
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What Are The Different Types Of Medicare
There are four types of Medicare: A, B, C, and D. Part A covers payments for treatment in a medical facility. Part B covers medical services including doctor’s visits, medical equipment, outpatient care, outpatient procedures, purchase of blood, mammograms, cardiac rehabilitation, and cancer treatments. Part C, also known as Medicare Advantage, seeks to cover any coverage gaps. Part D covers prescription drug benefits.
Enrolling In Medicare Part D: What Youll Need
Before you can enroll in Medicare Part D, youll first need to be enrolled in Medicare Part A and/or Part B. Once you enroll in either of those, you can start doing the crucial preparations for enrolling in a Part D plan.
The most important preparation you can do before finding a Part D plan is recording information about your medications. No matter how you sign up for Part D, youll need to follow this step because the medications you take will determine which plan works best for you.
Start by gathering all your prescription drugs into one place . If it’s prescribed to you and you take it regularly, put it all on the table. Then, write down these three things for each medication:
Once you have these recorded, youll be able to compare plans, apples-to-apples. But even though your medication information is the primary factor in considering a plan, there could be other criteria to consider. Examples may include restrictions, ordering options, or a plans track record.
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If You Return From Overseas
Basic Medicare does not provide coverage beyond U.S. borders in most circumstances.
And, unless you meet an exception i.e., you have health coverage abroad, either through you or your spouse’s employer or a national health plan if you are self-employed you may face late-enrollment penalties for Part B if you didn’t sign up at age 65.
On the other hand, If you have acceptable overseas coverage and return to the U.S., you get eight months upon losing it to sign up for Part B if you hadn’t already.
Be aware that you’d also need to prove that you had qualifying coverage while working overseas, said Medicare expert Patricia Barry, author of “Medicare for Dummies.” That means you should hold onto things like tax returns, pay stubs, medical statements and records of doctor visits and bills.
For people living abroad who sign up for Part D upon returning to the U.S., there is no late-enrollment penalty as long as you get coverage within two months.
You also would get two months to sign up for an Advantage Plan if you already were enrolled in Part B while overseas.
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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How To Pay For Part D
After youve signed up, youll pay monthly Part D premiums to the insurance company. You may either receive bills or sign up for automatic payments. You also may be able to request that your premium be deducted from your monthly Social Security or Railroad Retirement Board payment.
Medicare beneficiaries with low incomes and few assets may qualify for the federal Extra Help program that givesfinancial assistance to pay for Part D premiums, deductibles and copayments.
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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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When Can I Sign Up For Medicare Part D
If you do not enroll in a Part D plan during your seven-month Medicare Initial Enrollment Period and decide to enroll later on, you will likely have to wait until the next Annual Election Period, which runs from October 15 to December 7 of each calendar year.
If you didnt sign up for Part D coverage when you first became eligible , then you will likely have to pay a Part D late enrollment penalty.
The penalty can vary based on how long you didnt have Part D or creditable drug coverage, and your penalty amount could increase each year.
Canceling Vs Changing Plans
When youre unhappy with your prescription drug coverage, switch plans rather than canceling it. If you cancel your prescription drug coverage and do not pick up creditable drug coverage from another provider, you leave yourself at risk. should an unforeseeable health situation occur in the future. If you drop your plan altogether, you wont be able to sign up for another prescription drug plan until the Annual Enrollment Period in the fall, and your drug coverage wouldnt begin until January of the following year. This could leave you with gaps in coverage and high out-of-pocket costs. You will also be subject to a costly late enrollment penalty if you decide to re-enroll in Medicare prescription drug coverage at another time.
You can make changes to your Medicare Part D plan during the Annual Enrollment Period. During this time you can switch from one stand-alone Medicare Part D Prescription Drug Plan to another stand-alone Part D plan, or switch to a Medicare Advantage Prescription Drug Plan .
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How To Apply For Medicare
Medicare enrollment is easier than ever. Once you meet eligibility requirements, you are ready to choose from a variety of plans in which to enroll. As we mentioned earlier, some beneficiaries can receive automatic enrollment, and some have to apply manually.
There are three ways to apply for Medicare Part A and Part B:
If you have previously been a railroad employee, you can enroll in Medicare by contacting the Railroad Retirement Board, Monday Friday, from 9:00 AM 3:30 PM at 1-877-772-5772.
Medicare applications generally take between 30-60 days to obtain approval.
Through A Private Insurance Company
Different insurance companies and even some pharmacies offer online resources to compare Part D plans. Keep in mind these tools may be tailored to their own plans. You can apply online through the plans website, by contacting the insurance company by phone, or by visiting a local insurance agency.
Remember you will need your Medicare identification number and the starting dates of your Medicare coverage to complete your applications.
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The Initial Enrollment Period For Original Medicare
When you first enroll in Medicare, youll be enrolled in Original Medicare , a federally run health care program.
Because of their age, the majority of people are eligible for Medicare. If this describes you, your first opportunity to enroll in Medicare is often during your Initial Enrollment Period, which lasts seven months. It begins three months before your 65th birthday includes your 65th birthday month, and concludes three months after. Most people dont have to sign up if youre already getting Social Security or Railroad Retirement Board payments when you turn 65, youll be automatically enrolled in Medicare. If you need to register personally, you can do so during your Initial Enrollment Period .
If youve been collecting Social Security or Railroad Retirement Board disability benefits for two years, you might be eligible for Medicare before you turn 65. In the 25th month of disability benefits, youll be automatically enrolled in Medicare Parts A and B. If you have amyotrophic lateral sclerosis or end-stage renal disease, you may be eligible for Medicare at any age.
Even if you qualify for automatic enrollment in Medicare Part A, you must enroll in Medicare Part B if you live in Puerto Rico. To avoid late-enrollment fines, you may choose to do so during your IEP.
Some people choose to put off signing up for Medicare Part B. You must pay a premium . Perhaps youre still covered under your employers healthcare plan. Learn more about deferring enrollment in Part B.