When Can You Enroll In Prescription Drug Coverage
You have a few options as to when you can sign up.
- Your Initial Enrollment Period: This occurs when you first become eligible for Medicare.
- Open Enrollment Period : From October 15 to December 7 each year, you can enroll in a prescription drug plan.
- Medicare Advantage Open Enrollment Period: From January 1 to March 31 each year, if you are already enrolled in a Medicare Advantage plan without drug coverage, you can switch to a plan that includes the coverage.
- Special Enrollment Period: Certain events, like moving or losing your insurance coverage, make you eligible to enroll outside the usual times.
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.
Is The Magic Number
As you are turning 65, you will be eligible for Medicare. Medicare eligibility starts at age 65 and enrollment is possible at any age after that. While Medicaid eligibility is at any age, Medicare provides coverage once you are in your Golden years. Three months prior to your 65th birthday, a Medicare application can be started. Our insurance professionals are able to get you started with your applications to jump start the process.
Signing Up For Medicare
Many different factors determine when you can sign up for Medicare. For most, the first time they can sign up is when they turn 65. However, there are instances where you can become eligible for Medicare before age 65.
Signing up for Medicare is simple. Three months before the month of your 65th birthday, your initial enrollment window will open. This period lasts through your birthday month and ends on the last day of the third month following.
In total, your initial enrollment period lasts seven full months. This is a once-in-a-lifetime enrollment window that you do not want to miss.
If for any reason, you happen to miss it, there are other opportunities to enroll. Keep in mind that no part of Medicare is mandatory. However, if you dont sign up when youre first eligible, you could incur penalties when you eventually sign up. The only way around the late penalties that result from delaying Medicare enrollment is to have .
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Am I Eligible For Medicare
To receive Medicare, you must be eligible for Social Security benefits.
Part A Eligibility
Most people age 65 or older are eligible for Medicare Part A based on their own employment, or their spouse’s employment. Most people have enough Social Security credits to get Part A for free. Others must purchase it.
You are eligible for Medicare Part A if you meet one of the following criteria:
- You are eligible for Social Security or Railroad Retirement benefits, even if you do not receive those benefits.
- You are entitled to Social Security benefits based on a spouse’s, or divorced spouse’s work record, and that spouse is at least 62 years old.
- You have worked long enough in a federal, state, or local government job to be eligible for Medicare.
If you are under 65, you are eligible for Medicare Part A if you meet one of the following criteria:
- You have received Social Security disability benefits for 24 months.
- You have received Social Security benefits as a disabled widow, divorced disabled widow, or a disabled child for 24 months.
- You have worked long enough in a federal, state, or local government job and meet the requirements of the Social Security disability program.
- You have permanent kidney failure that requires maintenance dialysis or a kidney transplant.
- You are diagnosed with ALS or Lou Gehrig’s disease.
Part B Eligibility
If you are eligible for Part A, you can enroll in Medicare Part B which has a monthly premium.
Will I Need To Prove My Age?
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What Is The Medicare Part B Late
If you do not sign up for Medicare Part B when you are first eligible, you may need to pay a late enrollment penalty for as long as you have Medicare. Your monthly Part B premium could be 10% higher for every full 12-month period that you were eligible for Part B, but didnât take it. This higher premium could be in effect for as long as you are enrolled in Medicare. For those who are not automatically enrolled, there are various Medicare enrollment periods during which you can apply for Medicare. Be aware that, with certain exceptions, there are late-enrollment penalties for not signing up for Medicare when you are first eligible.
One exception is if you have health coverage through an employer health plan or through your spouseâs employer plan, you can delay Medicare Part B enrollment without paying a late-enrollment penalty. This health coverage must be based on current employment, meaning that COBRA or retiree benefits arenât considered current employer health coverage.
Preparing For Medicare Supplement Open Enrollment
The eligible Medicare-enrolled people will be issued a Medicare ID card about 4 months from application time to apply if the Medicare card is mailed to them. Once you have the health insurance card, you may have to get supplemental health insurance from Medigap. Most Medicare & Medicaid Supplement providers will accept your Medicare Supplement Application within six months of your Medicare Part B enrollment. The carrier processes your application once you have entered the open enrollment period for Medigap, with no medical questions.
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What Happens After I Register For Medicare
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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In most circumstances, youll get a Medicare I.D. card several weeks after your initial application is approved. Unfortunately, waiting times can be as long as 90 days in some cases.
However, if you automatically enroll in Medicare because you already get Social Security benefits, you will receive your I.D. card two months before turning 65.
When Does Medicare Start
Your Medicare start date depends on the reason you qualify for Medicare, as well as when you apply. Regardless of the way you qualify, Medicare groups the times and circumstances in which you can enroll into three enrollment periods:
- Initial Enrollment Period : The period surrounding the date you are first eligible for Medicare.
- Special Enrollment Period : A time when you can enroll after the IEP without facing late enrollment penalties. The SEP is normally used when you turn 65 but want to delay Medicare while you still have employer coverage for yourself or through your spouse.
- General Enrollment Period : A set time each year when anyone who is eligible for Medicare can apply, regardless of the reason. You’ll typically pay late enrollment penalties ? if you enroll during the GEP.
Your Medicare start date is based on why you qualify whether it’s age, disability, kidney failure or a chronic health condition and which enrollment period you use when you apply. All three Medicare enrollment periods can be used for most Medicare application scenarios. One exception is that there is no Special Enrollment Period for enrollees with kidney failure, also known as end-stage renal disease .
When To Enroll In Medicare
3 months before you turn 65
You can start enrolling in Medicare 3 months before your 65th birthday. Youll need to be eligible for Part A and Part B before you can get Part C . Youll need Part A, Part B, or both before you can get Part D.
Not sure what services each part covers? Learn the basics of Medicare.
Step 1 Learn about your Medicare benefits
As soon as possible, visit SocialSecurity.gov or call Social Security at , 8 a.m. to 7 p.m., Monday through Friday, to learn about your Part A and Part B benefits. The answers to these questions will help you enroll.
- Will I get Part A at no cost? Typically, you can get Part A at no cost if you or your spouse paid into Medicare for at least 10 years. If not, you can buy it.
- Do I need to enroll in Part A and Part B? Find out if youll be automatically enrolled in Part A and Part B, or if you should sign up.
- How will Social Security bill me for my Medicare premiums? The monthly premium is automatically deducted from your Social Security check each month. If youre not collecting Social Security, youll get a bill from the federal government every 3 months.
- When will I get my Medicare card? The federal government will mail your red, white, and blue Medicare card after youre enrolled. You should get it 3 months before your 65th birthday if you’re automatically enrolled. If you need to enroll in Part A and Part B, it can take up to 2 months to get your Medicare card.
Step 2 Enroll in Part A and Part B
When Does Medicare Start For Esrd
If you enroll when you’re first eligible, your Medicare due to end-stage renal disease starts right away.
You’re usually eligible for Medicare after the fourth month of kidney dialysis.
- Initial Enrollment Period : If you have kidney failure, also called ESRD, you’re not automatically enrolled in Medicare and must apply manually. The IEP for ESRD patients depends on the type of treatment. For example, patients receiving dialysis at home are eligible for Medicare starting with the first month of treatment, if training requirements are met.
- Special Enrollment Period : There is no SEP for ESRD Medicare.
- General Enrollment Period : If you don’t enroll in Medicare when you are first eligible , you must wait for a GEP and may pay late enrollment penalties. Your Medicare would start on July 1.
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Can Medicare Supplement Plans Be Purchased At Any Time
You may use your Medicare Supplement plan anytime. So if you open a Medigap Open enrollment window before closing, you are still welcome to apply. In most cases though you may also have medical testing underwritten or answers to health concerns at the application stage. Outside your Medicare Supplement open enrollment period, an insurer may refuse coverage based on your health history. It’s only possible to overcome this problem using the issue rights guarantee if your circumstances permit special enrollments. Many states are governed by unique open admission rules which may include birthday rules.
How To Sign Up For Medicare Heres What You Need To Know
You can enroll in Medicare Part A and/or Medicare Part B in the following ways:
- Online at www.SocialSecurity.gov.
- In person at your local Social Security office.
If you worked at a railroad, enroll in Medicare by contacting the Railroad Retirement Board at 1-877-772-5772 . You can call Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.
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What Is The Medigap Open Enrollment Period
Under US Federal laws the open enrollment period starts on the month you are older than 65. During your open enrollment period, Medigap companies will offer you a policy at the lowest possible rates, no matter what the medical condition or age.
You can qualify for two-month Medicaid Special Enrollment periods – as described above. Your plans are closed, no longer serving you in your neighborhood, or drastically reduce their providers network.
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.
Get Started With Medicare
Medicare is health insurance for people 65 or older. Youre first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease , or ALS .
Follow these steps to learn about Medicare, how to sign up, and your coverage options. Learn about it at your own pace.
Making The Most Of Your Medigap Open Enrollment
Timing can influence the cost of coverage, ease of getting coverage, or the available options. Medicare Supplement open enrollment is the only time most can apply for a Medigap letter plan without a health question being asked. In order for insurance carriers to approve the applicant, it is necessary that you provide all relevant medical information. If you enroll in Medicare Supplement open enrollment periods, you won’t have any health complications. Therefore, if we are to educate our clients about Medicare supplement enrollment in this unique period, we must educate ourselves.
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Common Questions About Applying For Medicare
What is Medicare?
Medicare is a national health insurance program that offers hospital and medical insurance through two different parts. Medicare Part A provides inpatient hospital coverage, hospice care, skilled nursing facility, home health care, and more. Part B provides outpatient services, including doctor visits, surgeries, durable medical equipment, and more. Medicare does not cover 100% of the cost of these services.
When will I get my Original Medicare card?
In other words how long does it take to get your Medicare card after applying? In most cases, you will receive your Medicare card about 3 weeks after you apply. If you are already receiving Social Security benefits when you turn 65, your card will just show up in your mailbox about 2 months before you turn 65. When you receive it, be sure that you do not forget to enroll in Part D if you need drug coverage before your Initial Enrollment Period ends.
Do I automatically get Medicare when I turn 65?
Maybe! If you are already receiving Social Security benefits at least four months before your 65th birthday month, youll be automatically enrolled in Medicare at 65. However, if not, you will need to enroll in Medicare yourself.
When is open enrollment for Medicare? Do you have to apply for Medicare every year?
Sign Up: Within 8 Months After Your Family Member Stopped Working
- Your current coverage might not pay for health services if you dont have both Part A and Part B .
- If you have Medicare due to a disability or ALS , youll already have Part A coverage.
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?
Consider Whether You Need Medicare Supplement Insurance
You might already know that Medicare doesnt pay 100% of approved charges. For example, Medicare Part B coverage pays 80% of covered medical costs after you meet the annual deductible. That means youre responsible for the remaining 20% and for paying your deductible.
Thats why many people who choose Original Medicare also buy Medicare Supplement Insurance, often called a Medigap policy, to help pay for some or all of these gaps in benefits. Private insurance companies sell these policies. They help pay for other costs, including coinsurance and copays.
When Is The Medicare Part D Annual Election Period
If you did not enroll in prescription drug coverage during IEP, you can sign up for prescription drug coverage during the Annual Election Period that runs every year from October 15 to December 7.
During AEP, you can:
- Sign up for a Medicare prescription drug plan.
- Drop a Medicare prescription drug plan.
- Join a Medicare Advantage plan that includes prescription drug coverage.
- Switch from a Medicare Advantage plan that doesnât include prescription drug coverage to a Medicare Advantage plan that does .
Outside of the Part D Initial Enrollment Period and the Annual Election Period, usually the only time you can make changes to prescription drug coverage without a qualifying Special Election Period is during the Medicare Advantage Open Enrollment Period but only if you are dropping Medicare Advantage coverage and switching back to Original Medicare. The Medicare Advantage Open Enrollment Period runs from January 1 to March 31.
Medicare Part A and Part B do not include prescription drug coverage, and if you switch back to Original Medicare during the Medicare Advantage Open Enrollment Period, you will have until March 31 to join a stand-alone Medicare prescription drug plan.
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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.