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Applying for Medicare at Age 65

When you reach the age of 65, it will be time to begin applying for Medicare at age 65. Medicare is also given to some younger adults that suffer from certain disabilities, as well as those who have been diagnosed with End-Stage Renal Disease, ESRD.

There are a number of terms you may hear when applying for Medicare at age 65, including original Medicare or traditional Medicare. This refers to Medicare Parts A and B.

Hospital Insurance: Medicare Part A Coverage

Medicare Part A is commonly referred to as just hospital or inpatient insurance. This is because it will cover the care you receive in a hospital. Part A coverage will also cover the costs associated with an extended stay at a skilled nursing facility, or if you receive health care services at your home. Hospice for those who are terminally ill is also covered by Medicare Part A coverage.

Medicare Part A receives its funding from the payroll tax that is placed into the Hospital Insurance Trust Fund. The majority of people who have worked or are married to someone who has worked and paid into Social Security don’t have to worry about paying a premium for Part A Medicare coverage.

Medicare Part B: What Does it Cover?

This covers the costs of physician services, home health care that Part A does not cover, and outpatient hospital care. Other costs that Part B Medicare coverage takes care of include:

  • Laboratory and diagnostic tests, including blood, work, and X-rays
  • Mental health care
  • Orthotics and prosthetics
  • Medical equipment includes hospital beds and wheelchairs
  • Preventative care services
  • Ambulance services

Medicare Part B insurance is financed partly by the Part B premiums that are paid monthly by all Medicare beneficiaries. Additional funding for this insurance is provided by general revenues provided by the federal government.

Senior man celebrating his birthday with family after blowing out candles on birthday cake, close up
applying for Medicare at age 65, you may wonder what coverage is provided to you and the costs you will incur.

Original Medicare Coverage and Costs

When applying for Medicare at age 65, you may wonder what coverage is provided to you and the costs you will incur. Original Medicare has a number of extremely strict rules regarding what services it is able and not able to cover. For example, in the case of home health care services, this will only be covered in specific circumstances and for those who require certain, specialized therapies. Also, Original Medicare will not cover routine hearing, vision, or dental services.

In regard to Medicare Part B, there are a number of preventive services that are offered to help seniors, and other adults with certain disabilities, remain healthy. These preventative care services include:

  • Management of chronic conditions
  • Vaccines
  • Cancer screenings
  • Annual wellness visits

Anyone who receives Original Medicare benefits will have certain costs they have to cover including deductibles, copayments, and premiums. For seniors who have a limited income, they may be interested in learning about the Medicare Savings Programs. These can help to pay for the costs associated with Original Medicare coverage.

When You Should Enroll in Original Medicare

Any older adult who currently receives benefits from Railroad Retirement or Social Security will be automatically enrolled in Medicare when they turn 65. Everyone else will have to apply for Medicare with the Social Security Administration.

Those who are under the age of 65, but who suffer from a disability, will typically be enrolled automatically after 24 months of receiving benefits from Social Security. However, there are certain people with specific disabilities who will be able to receive Medicare coverage sooner.

There are several different enrollment periods for seniors to be aware of when applying for Medicare at age 65. Each person receives their own Initial Enrollment Period into the Medicare program around their 65th birthday. There are also a number of Special Enrollment Periods. One example of this would be for those who continue to work after they turn 65 and plan to maintain their employer insurance coverage. There is also a General Enrollment Period each year.

The date you will begin receiving Medicare benefits will depend on when you enroll. Any older adult who is turning 65 may have the option to delay their enrollment in Medicare if they meet certain requirements. For example, if they maintain coverage from their employer. There is a My Medicare Matters QuickCheck tool that can help you assess your circumstances and determine if you can put off your enrollment without incurring any type of penalty.

How to Enroll in Medicare

If you are reaching the right age and ready to begin applying for Medicare at age 65, there are a number of ways you can do it. You can contact the Social Security Administration by phone at 1-800-772-1213 or you can visit your local office. You can also fill out the enrollment application online. The Social Security office can also help you if you ever misplace or lose your Medicare card.

Where to Find More Information or Help

The good news is when it comes to applying for Medicare at age 65, there are a number of resources available for you to use. Some of the best resources to help you learn when and how to enroll in Original Medicare include:

  • The NCOA consumer education site called My Medicare Matters will walk you through all the parts of Medicare and let you know when and how to enroll in each one. This site also offers the Medicare QuickCheck tool that gives you advice based on your personal situation.
  • You can also find assistance from your State Health Insurance Assistance Program, or SHIP. This organization offers free and objective assistance for those with Medicare related questions. You can find the SHIP closest to you by calling 877-839-2675.

When you are trying to figure out how to apply for Medicare, having all the necessary information can be quite helpful. Be sure to do your research and reach out to the organizations listed here if you have any questions. Enrolling in Medicare is something that everyone needs to do when they reach 65 to ensure they receive the benefits they have worked for all their lives.

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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.

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