For many people, the idea of turning 65 and Medicare enrollment and the corresponding requirements and timelines can be quite overwhelming. After all, this is a new milestone in their life. The good news is, getting to know a little about the Medicare program, how it works, and when you are eligible will help you know when and how to enroll.
Do You have to apply for Medicare or will You be Enrolled Automatically?
If you are currently receiving benefits from Social Security – this can be disability benefits or retirement benefits – when you are determined to be eligible for Medicare, you will be enrolled automatically into Part A and Part B coverage. You are considered eligible for Medicare services when you reach the age of 65 or if you have been collecting disability benefits for a period of 24 months.
If you are currently not collecting benefits from Social Security when you are determined to be eligible for Medicare, then you will have to enroll through the Social Security Administration. You have the ability to do this online, you can call the office or you can do it in person at the local Social Security office. The number you should call to sign up for Parts A and B Medicare coverage is 800-772-1213.
If you are interested in enrolling in prescription drug coverage, this is Medicare Part D, then you have to enroll in this yourself. This will be true regardless of if you are enrolled in Medicare automatically or if you have had to enroll manually on your own.
- Important note: Those who suffer from End-Stage Renal Disease or Lou Gehrig’s disease do not have to receive Social Security benefits for a period of 24 months prior to being eligible for Medicare.
Will You Have to Pay for Medicare?
Part A Medicare coverage will be provided at no charge to you if you or you have a spouse who has worked and paid taxes into the Medicare program for 40 quarters or 10 years. If you don’t have enough working quarters, then you will have to pay a premium for Part A coverage. Part B Medicare coverage will always have a premium that you have to pay.
If you have Part D or Medigap insurance, you may also have a monthly premium to pay for these, too. Remember, Medicare Advantage plans will have different costs than what is associated with Original Medicare. If you have a lower income, you may be qualified for programs that will help you pay for your Medicare premiums, as well as additional costs you may have incurred.
Do You Need Both Part A and Part B Coverage?
When you are turning 65 and Medicare enrollment is present, you may wonder if you need both Part A and Part B coverage. This will depend on if Medicare is going to be your primary insurance or your secondary coverage. Part A is your hospital insurance and Part B will cover your medical costs, such as doctor’s appointments. If you are currently employed and the insurance provided by your employer is primary, then you don’t need Part A or Part B coverage. However, the majority of people will choose to take Part A simply because it is free. If you have Medicare coverage that is considered primary, because you have COBRA coverage or retiree insurance, then you will need to enroll in both Part A and Part B coverage.
When Are You Eligible to Apply for Medicare?
You will be eligible to apply for Medicare during your IEP or Initial Enrollment Period. The IEP is the seven-month period around your 65th birthday. It will include three months prior to your birthday month, the actual birthday month and then three months after you have turned 65. If you still have active, employer insurance coverage, you can sign up while you remain working. You will also have as much as eight months after you lose the coverage or after you stop working. This period of time is referred to as the Special Enrollment Period for Part B coverage.
If you fail to enroll in coverage during these times, then you can enroll during the yearly General Enrollment Period. This lasts from January 1st to March 31st each year. Your actual coverage will start on July 1st of the year when you enroll. Keep in mind, if you don’t enroll when you were originally eligible, you may face a penalty fee.
Will You Receive Notification of Medicare Coverage when You Turn 65?
For those who currently receive Social Security benefits, you will receive information in the mail about Medicare approximately three months prior to your 65th birthday. If you don’t receive Social Security benefits, then you have to manually enroll in Medicare on your own by contacting the Social Security Administration. You won’t receive any type of notice in the mail that lets you know that you are eligible for Medicare coverage.
Will You Face a Penalty if You Wait to Enroll in Part B Coverage?
If you don’t sign up for Part B Medicare coverage when you are first eligible, then you will have to pay a monthly late enrollment penalty. If you have insurance from your employer, then you have to enroll within a period of eight months prior to your retirement or you will be required to pay a penalty fee.
When it comes to turning 65 and Medicare enrollment there is no question that it can be a bit confusing at first. However, when you take the time to learn about the details, you will find that it is easier than you thought. You can easily enroll online, on the phone, or by visiting the local social security office. Taking the time to enroll when you are initially eligible is a must; however, if you want to avoid having to pay a penalty for enrolling late. When it comes to learning how to apply for Medicare, you should not wait. Turning 65 and Medicare Enrollment can be confusing. We know this, so feel free to give us a call and let us hold your hand through the process. Our services are free and our clients get lifetime claims support.
Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.
