Before I get started let me quickly note that this blog is intended to be general in nature. Medicare has evolved significantly over the years and if one tries hard enough, an exception can be found to almost everything presented concerning Medicare.
The first step in obtaining Medicare coverage is getting signed up for Original Medicare Parts A (Hospital) and B (Medical). If you have worked (and contributed to the system) the requisite number of quarters (40 or 10 years) Medicare Part A has no charge. Part B does come with a premium. In 2023 it is $164.90/month. The premium amount is set by the government. That number can change from year to year.
Medicare Parts A and B cover roughly 8o% of your health care costs and do not cover other ancillary benefits such as dental, vision, hearing or prescription drug coverage. If you are like most people, you will want to cover that remaining 20% or as close to as possible. This can be accomplished through a private insurance company. Whether utilizing a Medicare Supplement, a Medicare Advantage Plan commonly referred to as Part C, or Prescription Drug coverage, itwill be obtained through a private insurance company. (Differences in coverage and costs will be discussed in later issues)
In most cases people “age in” to Medicare at age 65. Generally, Medicare is for people 65 or older. You may be able to get Medicare earlier if you have a disability, End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant), or ALS (also called Lou Gehrig’s disease).
Initial Enrollment Period for Part A and Part B: This is the initial opportunity for most people to enroll in Medicare. It starts three months before your 65th birthday, includes your birth month, and continues for three months afterward, totaling a seven-month period.
If you have employer coverage: If you or your spouse are still working and have employer-sponsored health insurance, you may be eligible for a Special Enrollment Period. You can enroll in Medicare Part A and/or Part B anytime while you or your spouse is still working and covered by the employer’s health insurance. You generally have eight months after your employment or employer coverage ends to sign up for Medicare without incurring penalties.
Note: if you wish to continue your employer coverage you do not need to sign up for A & B and pay two premiums. You can delay signing Up for A & B till your employer coverage ends. I recommend getting started about 3 months before your employer coverage end date to avoid any gaps in coverage.
To sign up for Medicare Part A and Part B, you can follow these steps:
1. Automatic Enrollment: If you are already receiving Social Security benefits or Railroad Retirement Board (RRB) benefits when you turn 65, you will typically be automatically enrolled in both Medicare Part A and Part B. You will receive your Medicare card in the mail about three months before your 65th birthday. (Note: if you are still covered by an employer plan and receiving Social Security benefits you can still delay signing up for Part B after automatically enrolled. Follow the instructions in the letter you receive from Social Security when you receive your card.)
2. Online Enrollment: You can visit the official Medicare website (www.medicare.gov) to apply online for Medicare. The online application is a straightforward process.
• Go to the SSA website and create an online account if you don’t already have one.
• Log in to your account.
• Select “Apply for Medicare” and follow the on-screen instructions to complete the application.
3. Social Security Office: You can also apply for Medicare at your local Social Security office. You can find the nearest office on the Social Security Administration website.
4. Phone Enrollment: Contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or you can also call your local office to apply over the phone.
Remember that late enrollment in Medicare Part B may result in a late enrollment penalty, which can increase your premiums, so it’s important to enroll during the appropriate enrollment period. It’s advisable to start the enrollment process a few months before your 65th birthday to ensure seamless coverage when you become eligible.