When you turn 65, you become eligible for the Original Medicare program. Do you need to enroll?
If you are turning 65 this year, you may want to set aside a little time to make some decisions about Medicare. Not understanding Original Medicare enrollment can result in life-long late enrollment penalties and higher premiums.
Enrolling into Original Medicare can be a simple process. It is up to you to know if you need to sign up when you turn 65 or wait and continue with other health coverage past the age of 65.
Which of the following applies to you?
Most americans should enroll in medicare part a when they are first eligible at age 65, but you may be able to delay part b.
The size of your employer will determine if you can delay Medicare Part B enrollment and not have to face a late enrollment penalty later.
If there are 20 or more employees in the company:
- Check to make sure you have group health plan coverage (as defined by the IRS). Your employer’s benefits manager is a great place to start!
- Compare Medicare’s coverage with your employer’s plan benefits.
You may be able to delay Part B enrollment with Medicare!
Follow the link below to Medicare.gov for more information.Go to Medicare.gov
If there are 20 or less employees in the company:
You should sign up for Medicare Part A and Part B when you are first eligible one of the following ways:
- Online with Medicare [click here]
- Online with Social Security [click here]
- Call Social Security at 1-800-772-1213
- Visit your local Social Security Office
After you have enrolled in Medicare Part A and B, contact a Medicare Team member to purchase a Medicare Supplement, Prescription Drug (PDP) or Medicare Advantage Plan.Contact a team member
I have enrolled into Original Medicare Part A and Part B, now what?
Once your Medicare Part B becomes effective, the enrollment clock for a Medicare plan begins. It is important to understand these deadlines to avoid paying unwanted late enrollment penalties, enrollment delays or a gap in health coverage.
Work with a local and trusted resource to review your plan options.
The health coverage benefits for Original Medicare Part A and Part B are the same for all Americans. Original Medicare is the “easy” portion of the process. A local advisor provides tremendous value in helping you select a coverage plan that works with Medicare. Many supplemental overages are county specific and there are drastic differences between coverage options.
Working with a local resource that specializes in Medicare can help you discover the Medicare insurance options available in your area. You may see a television commercial advertising great benefits with their Medicare insurance plan. A Medicare Specialist near you can explain if all the advertised benefits are offered in your specific county.
Do you need a Medicare Advantage plan or a MEDIGAP (Supplement) plan and drug coverage (Part D)?
The available Medicare insurance plan options can be confusing. Are you going to enroll with a Medicare Advantage plan that includes prescription drug coverage? Perhaps a MEDIGAP (Medicare Supplement) plan would fit your needs better? Will you still need drug coverage in addition to your plan choice? Taking some time to explore the different plan options can simplify this decision. Visit with a local Medicare Specialist to review the options available in your area.
How will you use your Medicare insurance?
Your lifestyle and hobbies can play a big part in your Medicare insurance decision. Are you the type of person that stays home and barely travels? Do you spend time and reside in several different states?
It is important to understand your benefits with Original Medicare Part A and Part B and how they work with your Medicare insurance plan.
MEDIGAP (Medicare Supplement) plans are offered through private insurance companies. They may come with a more expensive monthly premium and do not offer prescription drug (Part D) coverage. You may need to purchase a stand-alone prescription drug (Part D) plan in addition.
MEDIGAP (Medicare Supplement) plans may offer a few advantages should you choose this type of Medicare insurance. Your Medicare supplement (MEDIGAP) plan will cover you in any hospital or physician office in the U.S. that accept Original Medicare. This Medicare insurance option may favor those who travel around the U.S. or have specific physicians and facilities they prefer to use.
Medicare Advantage plans (Part C) are available through private insurance companies that contract with Original Medicare. A Medicare Advantage plan may also offer prescription drug (Part D) coverage included as part of the benefits. Most Medicare Advantage plans will have a lower monthly premium compared to a MEDIGAP plan. Some plans even offer a $0 monthly premium.
Medicare Advantage plans provide coverage for physician visits and hospital stays. Some plans also include services not covered by Original Medicare like routine vision and dental. Coverage may not be available if you are out of network. Review the Medicare Advantage plan options with a local Medicare specialist to understand the plan benefits available in your county.
What enrollment period applies to you?
When you are ready to enroll with Original Medicare and the Medicare insurance plan of your choice, you are entering an enrollment period. There are several different enrollment periods when you are eligible or enrolled with Original Medicare and a Medicare insurance plan. Which one fits you?
Initial Enrollment Period
Unless you qualify for automatic enrollment, you will need to sign up for Original Medicare Part A and Part B during your Initial Enrollment Period (IEP). Your IEP begins three months before you turn 65 and end three month after your month of eligibility.
If you are turning 65 and already receiving Social Security or Railroad Retirement Benefits, you will be automatically enrolled into Medicare Part A and Part B beginning the first day of your birthday month. If you are not receiving Social Security or Railroad Retirement Benefits when you turn 65, you will need to sign up for Original Medicare and choose a Medicare insurance plan.
General Enrollment Period
If you did not enroll in Original Medicare during your Initial Enrollment Period, you can still apply and enroll during the General Enrollment Period. The General Enrollment Period runs from January 1 to March 31 each year. If you use this enrollment period, your coverage will begin on July 1st of that year. It is possible that you will face a late-enrollment penalty if you miss the IEP.
Special Enrollment Period
Many Americans find themselves needing to enroll with Original Medicare outside of a regular enrollment period. This is known as a Special Election Period (SEP). If you qualify for a SEP, you will be able to enroll with Original Medicare or a Medicare insurance plan outside of your Initial Enrollment Period or the General Enrollment Period. Visit with your local Medicare Specialist to see if a Special Enrollment Period will apply to you.
Annual Enrollment Period
Every year from October 15 through December 7, the Medicare Annual Enrollment Period (AEP) begins. This is your time to review your Medicare insurance plan coverage and compare options available to you.
You may also sign up for a Medicare Advantage or Stand-alone Prescription Drug plan at his time if you did not enroll during your Initial Election Period.
During the Annual Enrollment Period (AEP) you can change to a Medicare Advantage plan and disenroll with your Medicare Supplement (MEDIGAP) plan and stand-alone prescription drug (PDP – Part D) plan. You can change from a Medicare Advantage plan to another Medicare Advantage plan that is available in your specific area.
This is also your time to disenroll from a Medicare Advantage plan and revert to Original Medicare Part A and Part B.
You can enroll into a Medicare Part D prescription drug plan or change from one to another during the Annual Enrollment Period. You may also opt out of Medicare prescription drug coverage completely during this time.
Any changes you make during the Annual Enrollment Period will take effect January 1st of the following year.