Your Medicare Enrollment Period
Medicare has an initial enrollment period when you first sign up for Medicare then open enrollment periods when you can change coverage.
Your initial enrollment period is the seven-month period that begins three months before the month you turn 65 when you can sign up for Original Medicare .
If you miss your initial enrollment period, you can sign up during the general enrollment period running Jan.1 through March 31 each year specifically for people who missed initial enrollment. You can sign up for Medicare Part A and Part B, but you may have to pay a late-enrollment fee. Coverage will start July 1.
Medicare open enrollment periods themselves can be confusing because there are three different open enrollment periods, and two of them give you the chance to change your Medicare coverage.
Each one works differently. Heres how each one affects you.
Medicares Open Enrollment Periods
Can A Friend Or Family Talk About My Coverage With A Private Medicare Insurance Company
If youre enrolled in a private Medicare plan , the insurance company will have their own disclosure authorization form that youll need to complete so that they can discuss your coverage with a loved one.
Even if you were initially happy to select a Medicare plan on your own, its important to think about how this might change over time. Having a power of attorney in place will be vital if you ever become incapacitated and need a loved one to make decisions on your behalf.
The disclosure authorization forms for Medicare and private Medicare plans can be completed by the person youve named in your power of attorney, but completing these forms ahead of time will help to minimize roadblocks if someone needs to step in on your behalf.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
Situations That Allow Medicare Changes Anytime
If you move or there are changes in your coverage, you may be eligible for a special enrollment period or SEP.
Moving is a common circumstance that qualifies beneficiaries for a special enrollment period. Because private insurers sell Medicare Advantage and Medicare Part D drug plans, they rely on networks of health care providers and may only have limited doctors, hospitals and pharmacies available in a given area.
Examples of Special Circumstances Creating a Special Enrollment Period
- Left Medicare coverage for employer or union coverage
- Lost drug coverage
- Moving back to the U.S. after living abroad
- Moving into a long-term care facility or other institution
- Moving out of your plans service area
- Moving within the service area, but new options are available
- No longer eligible for Medicaid
- Plans contract with Medicare changes or ends
The money you pay as Medicare tax goes into one of two Medicare trust funds. The Hospital Insurance Trust Fund pays for hospital, hospice and skilled nursing facility costs of people currently on Medicare.
A second trust fund the Supplementary Medical Insurance Trust Fund receives money from Congress and interest on the funds investments. It pays for Medicare Part B costs.
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Contact Social Security To Sign Up For Medicare
You can either:
Know when to sign up for Part BYou can only sign up for Part B at certain times. If you dont sign up for Part B when you turn 65, you might have to wait to sign up and pay a monthly late enrollment penalty. Find out when you can sign up. How much is the Part B late enrollment penalty?
How Financial Advisers Can Help With Medicare Open Enrollment
For clients who are retired and who are eligible for Medicare, this governmental program is a key tool to manage and cover their healthcare costs. Once they enroll initially, they still need to stay on top of both what Medicare covers and their own changing healthcare needs.
Each year from Nov. 7 through Dec. 15, there is an open enrollment period when current Medicare users can change their coverage. This generally cannot be done throughout the rest of the year. Retirees and others who are eligible can certainly benefit from their advisers help and guidance as they review their coverage against their anticipated needs for 2021. Here are some ways advisers can help clients prepare for the upcoming open enrollment period.
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Assisting An Eligible Parent Family Member Or Friend
Do you have a Medicare-eligible parent, family member, friend, or other person who is considering a Medicare Advantage plan but needs help enrolling? If so, you may need to understand the enrollment process, and CarePlus is here to help you!
In most cases, Medicare Advantage plan coverage starts on the first day of the next month after CarePlus receives the completed enrollment form. For people who enroll in a Medicare Advantage plan during Medicare’s Annual Enrollment Period , coverage becomes effective on January 1 of the following year.
Your goal is to help evaluate plan options, decide on coverage needs, choose the right plan for the beneficiary, and aid your parent or loved one in the enrollment process. Allow adequate time to make the right coverage decision. Be patient and flexible as you go through the process.
If you would like to complete an application on behalf of someone else, we are required to verify that you are certified under state law with a Durable Power of Attorney for Health Care,Healthcare Power of Attorney, or other legal authority to act on behalf of the person interested in enrolling.
How To Enroll In A Medicare Part D Plan
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Sign Up: Within 8 Months After You Or Your Spouse Stop Working
- Most people dont have to pay a premium for Part A . So, you may want to sign up for Part A when you turn 65, even if you or your spouse are still working.
- Youll pay a monthly premium for Part B , so you may want to wait to sign up for Part B.
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 for as long as you have Part B. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?
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- Going from original Medicare plus a drug plan to a Medicare Advantage plan that includes prescription drug coverage
- Moving from a Medicare Advantage plan back to original Medicare
- Changing Medicare Advantage plans due to coverage issues and/or perhaps to take advantage of the better features of a new plan
- Changing Part D prescription drug plan providers for coverage or features issues
There are other adjustments in their plans or coverages that clients might make going into the new year based on their circumstances.
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Centers For Medicare & Medicaid Services
This federal agency, which is part of the Department of Health and Human Services, runs the Medicare program. Its website offers information about how Medicare works, what it covers, when to enroll and how to buy private insurance policies that can fill in coverage gaps.
The Medicare website can tell you how original Medicare works. And its Medicare plan finder is the best way to learn about the Part D, Medicare Advantage and Medigap plans available in your area.
If you have questions about Medicare rules, coverage and claims, call Medicares help line at 800-633-4227 or use the Live Chat function available by clicking Talk to Someone | Chat Now. Information is available in dozens of languages, including English and Spanish. If you speak a language that is not available, ask for an interpreter.
The Medicare & You handbook, updated annually, explains what Medicare covers, how it works, when you need to sign up and any changes to the rules.
Signing Up For Medicare Online Step
Signing up for Medicare online through the Social Security Administration is the fastest way to apply.
Enrollment takes less than 10 minutes online, according to the Social Security Administration.
How to Apply for Medicare Online
You will be asked to provide your current health insurance information or, if you receive Medicaid benefits, your Medicaid number.
You may be required to provide additional documentation if you are:
- Not a U.S. citizen
- Applying under your spouseâs work record
- Over age 65 and transitioning from your employerâs health coverage
After youâre enrolled, CMS will send you a welcome packet in the mail along with your Medicare card.
If you sign up for Medicare on your own, the packet should arrive about two weeks after you sign up.
You will also receive a âMedicare & Youâ handbook, which includes important information about your coverage.
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Enrolling Your Newborn Baby
You can enrol your newborn baby by using the Newborn Child Declaration. Youll get the declaration from the hospital. Find out how to enrol your baby.
If youve adopted a child or your child was born overseas, youll need to give us extra documents. Read more about what to do:
Tn Ship: Tennesseans’ Medicare Resource
The Tennessee State Health Insurance Assistance Program is a federally funded program that provides free, unbiased counseling and assistance to Tennessee’s Medicare-eligible individuals, their families, and caregivers. We do not promote any insurance agency, and we maintain confidentiality with all of our clients. Whether you are new to Medicare or a seasoned beneficiary, our trained counselors can assist you with all of your Medicare questions.
Contact us at 1-877-801-0044 or email us at [email protected]!
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Circumstances That Allow For Early Enrollment
There are three circumstances that allow people to receive Medicare before they turn 65. These include having a disability, End-Stage Renal Disease or ALS .
Medicare Eligibility for People Under 65
- Disability
- If you qualify for Social Security Disability Insurance , you will be automatically enrolled in Medicare after receiving 24 monthly SSDI checks. Medicare coverage begins upon receipt of your 25th check.
- End-Stage Renal Disease
- If you are diagnosed with ESRD, you qualify for Medicare on the first day of your fourth month of dialysis . You can also qualify for Medicare when you are first hospitalized for a kidney transplant.Starting in 2023, Medicare will cover the costs of immunosuppressants for the lifetime of transplant patients. Medicare only covered 36 months of the drugs in the past.
- Amyotrophic Lateral Sclerosis
- If you are diagnosed with ALS and approved for SSDI benefits, you will immediately qualify for Medicare. There is no SSDI 24-month waiting period for ALS patients, but it may take up to five months for Medicare to approve your enrollment and issue your Medicare card.
Social Security, not Medicare, determines when people are eligible for SSDI coverage.
Those insured through the Railroad Retirement Board should also contact Social Security rather than Medicare to find out if they are eligible.
You Automatically Get Medicare
- You should already have Part A and Part B , because you have ALS and youre already getting disability benefits.
- We mailed you a welcome package with your Medicare card.
Sign up for Part B if you live in Puerto Rico or outside the U.S.
- Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.
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 and pay a monthly late enrollment penalty.
- Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.
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 of turning 65, you might have to wait to sign up and pay a monthly late enrollment penalty.
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Should I Sign Up For Medical Insurance
With our online application, you can sign up for Medicare Part A and Part B. Because you must pay a premium for Part B coverage, you can turn it down.
If youre eligible at age 65, your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.
Note: Important Upcoming Change Rules for 2023 and later: If you accept the automatic enrollment in Medicare Part B or if you sign up during the first three months of your IEP, your coverage will start the month youre first eligible. Beginning January 1, 2023, if you sign up during the month you turn 65 or during the last three months of your IEP, your coverage starts the first day of the month after you sign up.
The following chart shows when your Medicare Part B becomes effective in 2022:
| In 2022, if you sign up during this month of your IEP | Your Part B Medicare coverage starts |
|---|---|
| One to three months before you reach age 65 | The month you turn age 65. |
| The month you reach age 65 | One month after the month you turn age 65. |
| One month after you reach age 65 | Two months after the month of enrollment. |
| Two or three months after you reach age 65 | Three months after the month of enrollment. |
The following chart shows when your Medicare Part B becomes effective in 2023:
What Can I Do Next
Generally, youre first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65.
Because the company has less than 20 employees, your job-based coverage might not pay for health services if you dont have both Part A and Part B.
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The Parts Of Medicare
Social Security enrolls you in Original Medicare .
- Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
- Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.
Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.
- Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
- Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
- Medicare Part D helps cover the cost of prescription drugs.
Most people age 65 or older are eligible for free Medicare hospital insurance if they have worked and paid Medicare taxes long enough. You can sign up for Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .
How Well Do You Understand Medicare Enrollment
When you enroll in Medicare or when you have the chance to change Medicare plans can have lasting effects on how much you have to pay and the quality of coverage you receive.
Most people who switch Medicare plans are beneficiaries who are now using more health care and looking for plans that can provide them even more coverage, according to multiple studies from Deft Research, a market research firm that specializes in older adult consumers.
But finding the best Medicare plan can be complicated. There are a dizzying number of plans and options to choose from beyond Original Medicare. You have to do your homework to make sure youre getting the best care for your money.
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Signing Up For A Medigap Policy
To purchase a Medigap supplement insurance policy, you must first enroll in Medicare Part A and Part B.
Medigap policies are not required but enrolling in one can help you pay out-of-pocket costs, including deductibles, coinsurance and copayments.
The best time to enroll in a Medigap plan is when you are first eligible.
This is a six-month enrollment period that begins the month youâre 65 and enrolled in Medicare Part B.
If you apply for Medigap coverage after this six-month window, private insurance companies may not sell you a policy if youâre in poor health.
You can find a Medigap policy by using an online tool on the Medicare website, contacting your local SHIP or calling your State Insurance Department.
How to Sign Up for a Medigap Policy Online
