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.
Already Enrolled In Medicare
If you have Medicare, you can get information and services online. Find out how to .
If you are enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B . If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.
You can use one of the following options to submit your enrollment request under the Special Enrollment Period:
- State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
- If possible, your employer should complete Section B.
- If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
- Income tax form that shows health insurance premiums paid.
- W-2s reflecting pre-tax medical contributions.
- Pay stubs that reflect health insurance premium deductions.
- Health insurance cards with a policy effective date.
- Explanations of benefits paid by the GHP or LGHP.
- Statements or receipts that reflect payment of health insurance premiums.
Some people with limited resources and income may also be able to get .
What Happens After I Register For Medicare Online
Once you have submitted your application, it will be reviewed by Medicare to ensure all the information is accurate and complete. You should double-check your contact information to make sure it is correct. This is important to ensure prompt delivery of your Identification Card, as well as in the event Medicare needs to contact you about your enrollment.
After your application is received and processed, a letter will be mailed to you with the decision. If you encounter any questions or problems during the process, you can always contact Social Security for assistance.
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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.
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 Can A Person Enroll In A Medicare Advantage Plan
Medicare Advantage is an alternative to Traditional Medicare for which a person selects a plan through a private insurance company. The private insurer then administers and pays their benefits.
Medicare Advantage plans include parts A and B, as well as additional benefits, such as prescription drug coverage.
A person can sign up for Medicare Advantage during their initial 7-month Enrollment Period.
If a person signs up for a Medicare Advantage plan during that time but wishes to make changes or revert to Traditional Medicare, they have 12 months to switch back if the plan does not meet their needs.
A person with Original Medicare can also sign up for Medicare Advantage during the Fall Open Enrollment Period. This time slot runs between .
A person can also switch from one Medicare Advantage plan to the other during that time.
Some people may qualify for additional times when they can apply for Medicare benefits outside of their enrollment periods. Medicare calls these Special Enrollment Periods.
Some examples of these periods include, but are not limited to, the following:
These Special Enrollment Periods still only leave about 2 months to enroll in Traditional Medicare or a new Medicare Advantage policy before an enrollee faces penalty fees or gaps in coverage.
When Can I Enroll In Medicare If I Do Not Qualify For Retirement Benefits
If you are not eligible for retirement benefits from Social Security or the RRB, you will not be automatically enrolled into Original Medicare. However, you can still sign up for Medicare Part A and/or Part B during your IEP. You may not be able to get premium-free Medicare Part A, and the cost of your monthly Part A premium will depend on how long you worked and paid Medicare taxes. You will still have to pay a Medicare Part B premium.
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C: Medicare Advantage Plans
Individuals can choose to enroll in traditional Medicare Part A and/or B or select a Medicare Advantage Plan. These plans typically work as HMO and PPO insurance plans that you might be experienced with through employer-sponsored health insurance programs.
While these plans must follow Medicare rules and offer benefits at least on par with traditional Medicare, they can also offer additional coverage options.
Some Medicare Advantage plans may offer dental, vision and hearing coverage or wellness programs to help pay for gym memberships, for example. They might also have different rules for how you access coverage, such as whether you need a referral from your primary care physician before you can see a specialist.
Most Medicare Advantage plans offer prescription drug coverage.
Because they offer different benefits, Medicare Advantage plan costs may vary with regard to premiums, deductibles and coinsurance. Some plans may offer $0 monthly premiums. If you’re considering one of these plans, make sure you understand the benefits structure so you know if you’re getting a good value for whatever premiums you might pay.
Is It Mandatory To Sign Up For Medicare At Age 65
May 28, 2021 By Danielle Kunkle Roberts
Many people who are still working wonder whether it is mandatory to at age 65. Not knowing the proper answer could cost you, literally. So, is it mandatory to sign up for Medicare at age 65?
It is mandatory to sign up for Medicare Part A once you enroll in Social Security. The two are permanently linked. However, Medicare Parts B, C, and D are optional and you can delay enrollment if you have creditable coverage.
Sothe straightest answer I can give you is yes and no. Heres why:
Your specific circumstances affect the answer to the Medicare at 65 question. In order to discover a more precise answer for this question for YOU, you will need to answer some questions.
The answers to these questions will ultimately determine your personal answer for that frustrating question Is it mandatory to sign up for Medicare at age 65?
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How Do I Apply For Traditional Medicare
If youre not automatically enrolled in Medicare Part A and Part B, you need to sign up. You should enroll during your IEP, or a Special Enrollment Period if you qualify for one. As mentioned above, one example of a Special Enrollment Period might be if you delayed enrollment in Medicare Part A and/or Part B because you had employer coverage.
You typically sign up for Medicare through the Social Security Administration . You can go to the website at ssa.gov. Or, go in person to a Social Security office. You can reach the SSA at 1-800-772-1213 . Representatives are available Monday through Friday, from 7AM to 7PM, in all U.S. time zones.
How Long Does It Take To Sign Up
That depends on the method you choose. It can take as little as 10 minutes to sign up online, a month or more by phone or, if you prefer to sign up in person, it will depend on how long it takes to get an appointment.
- Medicaid number, if applicable, with start and end dates.
- Start and end dates for group health insurance through your employer.
- Start and end dates of employment with the employer providing your group health plan.
Once your account is set up, you can start the Medicare application process here. Its unlikely that youll need to sign anything physically.
When youre finished applying online, youll get a confirmation number. Keep it handy and use it to check the status of your application through your My Social Security account. Social Security will let you know if more information is needed.4
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Enrolling In Medicare Part D
Medicare Part D covers prescription drugs. You can add a stand-alone prescription drug plan to augment your Medicare A and B, or you can choose a Medicare Advantage plan that provides all of the benefits of Medicare A and B, plus prescription drugs and often other benefits as well.
Youre first eligible to enroll in Part D when youre first eligible for Medicare. When you apply, you will enroll in a private plan and must enroll during a seven-month period that starts three months prior to the month that you reach age 65. If you dont enroll during this period, you may pay a late-enrollment penalty that will raise your Part D premium when you do decide to purchase coverage .
If youre Medicare-eligible because youre disabled AND youve reached age 65, you can enroll in a Part D plan, switch Part D plans, or drop your Part D plan during this seven-month period.
If youre newly eligible because youre disabled, you can enroll starting 21 months after you began receiving RRB or Social Security benefits and have through the 28th month to enroll . Your Part D coverage will start at the beginning of your 25th month of receiving RRB or Social Security benefits.
And if, later on, you want to change to a different Part D plan, you can do that during Medicares Open Enrollment period that runs from October 15 to December 7 each year.
After youve chosen from the various PDP offerings, you can enroll by:
- filling out the paperwork sent by mail from Medicare, or
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.
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Penalty Fees For Late Enrollment
Medicare charges penalty fees for those who do not enroll in their Initial Enrollment Period, or they do not qualify for an exception due to employer insurance or other coverage.
Unless a person qualifies for a special exception, they will pay a monthly premium that is 10% higher for every 12-month period they were eligible for Medicare but did not sign up.
A person can qualify for a Medicare plan before 65 years of age if they meet certain criteria:
- They have end stage renal disease and need dialysis or are on the kidney transplant list.
- They have amyotrophic lateral sclerosis .
- Their doctor confirms that they have a disability.
An estimated 6.2 million people qualify for Medicare because they are disabled, according to the Medicaid and CHIP Payment and Access Commission. However, significantly fewer people use these benefits.
A doctor may declare a disability for people due to several types of medical conditions, including:
- Intellectual or developmental disabilities: These might include Down syndrome, cerebral palsy, or autism.
- Physical conditions: Traumatic brain injury, severe back injuries, or quadriplegia qualify as disabilities.
- Severe behavioral or psychological disorders: People with bipolar disorder or schizophrenia can qualify for Medicare early.
A doctor must submit paperwork to Medicare, declaring that a person has a disability. The individual may have a waiting period before they qualify for full Medicare benefits.
When Do I Apply For Other Kinds Of Medicare Coverage
Are you thinking about signing up for a Medicare Advantage plan, a stand-alone Medicare prescription drug plan, or a Medicare Supplement insurance plan?
No matter what type of Medicare coverage you want, youll generally want to start by signing up for Original Medicare, Part A and Part B. Then, its usually a good idea to sign up for any other type of Medicare coverage you want, promptly.
Heres a quick rundown on the main Medicare coverage options you have besides Original Medicare and when to sign up.
- Medicare Advantage this program gives you an alternative way to get your Medicare Part A and Part B benefits . You need Part A and Part B to qualify, and then the plan manages those benefits for you. If you dont enroll during your Medicare Initial Enrollment Period , you might have to wait to sign up. Learn about Medicare Advantage enrollment periods.
- Stand-alone Medicare prescription drug plan you might want this type of plan if you need prescription drug coverage. You need Part A or Part B to qualify. If you dont enroll during your Medicare Initial Enrollment Period , you might have to wait to sign up. Learn about Medicare Part D enrollment periods.
Be aware that if you have a Medicare Advantage plan, it might include prescription drug coverage, so you wouldnt need a stand-alone plan. In fact, you generally cant have both a Medicare Advantage prescription drug plan and a stand-alone Part D prescription drug plan.
New To Medicare?
Ways To Apply For Disability Benefits:
- If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
Once your disability benefits start, well mail you a welcome package with your Medicare card.
Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months after your Part A starts, you might have to wait to sign up for Part B and pay a monthly late enrollment penalty.
During Your Initial Enrollment Period
This lasts for seven months, of which the fourth one is the month in which you turn 65. For example, if your 65th birthday is in June, your IEP begins March 1 and ends Sept. 30.
To avoid late penalties and delayed coverage, you need to sign up for Medicare during your IEP in these circumstances:
- You have no other health insurance
- You have health insurance that you bought yourself
- You have retiree benefits from a former employer
- You have COBRA coverage that extends the insurance you or your spouse received from an employer while working
- You have veterans benefits from the Department of Veterans Affairs health system
- Youre in a nonmarital domestic relationship with someone of the same or opposite sex and you are covered by his or her employer insurance
If you enroll during the first three months of your IEP, your Medicare coverage begins on the first day of the month you turn 65 . If you sign up during the fourth month, coverage begins on the first day of the following month. But if you leave it until the fifth, sixth or seventh month, coverage will be delayed by two or three months. For example, if your birthday is in June and you sign up in September , coverage will not begin until Dec. 1.
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