To Medicare or Not to Medicare – That is the Question



If you are turning 65 soon, then it’s time to think about Medicare. In most cases, your Medicare Eligibility Date is the 1st day of the month you turn 65. If your birthday is the 1st day of the month, then your Medicare Eligibility Date is the 1st day of the month before you turn 65. Delaying your enrollment can result in penalties, so it is important to act immediately.

If you’re currently receiving Social Security benefits you will be enrolled into Medicare Parts A & B automatically. Medicare enrollment begins three months before your Medicare Eligibility Date and lasts for 7 months. This is known as your Initial Enrollment Period (or IEP.)

Examples:

  • If your birthday is 12/16/1952, then your Medicare Eligibility Date will be December 1st. Your Initial Enrollment Period will start September 1st.
  • If your birthday is 11/01/1952, then your Medicare Eligibility Date will be October 1st (because your birthday is the 1st of the month, it starts a month prior) and your Initial Enrollment Period began on July 1st.

If you’re not automatically enrolled because you have Social Security Benefits, you’ll need to sign up for Medicare. You can do this one of three ways;

  • Online: Login to http://www.socialsecurity.gov/medicareonly/
  • Phone: Call the Social Security Administration at (800) 772-1213
  • In Person: Call your local Social Security office and schedule an appointment. In some cases, you may be required to sign up in person. For example, if you have to furnish documented proof that you are a legal resident.

But Jack! Should I Even Enroll in Medicare Part B?!

This is likely the question everyone has and the answer can be a bit tricky.

If you are still working past age 65, it may be advantageous to stay on your plan through work. However, you want to make sure of a few things to ensure that you don’t get penalized later on.

  1. You have to be actively working and receiving coverage through your employer or union. Retiree benefits, COBRA coverage and VA Benefits doesn’t qualify you to Defer your Medicare Part B without incurring a penalty.
  2. Your employer coverage would have to be primary to Medicare. Speak to your Human Resources to make sure. Some employers’ plans might be secondary plans to Medicare and don’t qualify to allow you to defer your Part B without a penalty. If your Human Resources doesn’t know, call your Insurance Carrier.
  3. Just because you can defer your Part B doesn’t mean you should. Even if your employer’s plan allows you to defer Medicare Part B without incurring a penalty, a lot of individuals can get better coverage at lower costs by enrolling in Medicare with a Medigap policy. You should look at all your options before just assuming that staying on your employer plan is best. The best way to do this is by speaking to a licensed agent.

Important: If you don’t enroll in Part B right away without credible coverage, your Part B premium may go up 10 percent for each 12-month period that you could have had coverage though Part B but did not take it. You’ll also have to wait for the Annual Enrollment Period in January to enroll. If you need some help knowing if you can defer your Part B, please contact me and I’d be happy to walk you through it.

What is a Medigap Plan and Why Do I Want one?

With the deductibles, copayments and coinsurance, Medicare doesn’t pay for all of your medical costs. Much of the balance that is not covered by Medicare can be covered by purchasing a “Medicare Supplement” or a “Medicare Advantage Plan” from a private insurer. There are several plans to choose from that are offered my several different companies. You should speak to a licensed agent to help choose the plan that best fits your needs and budget.

Also, there are Prescription Drug Plans, sometimes referred to as “Part D.” Some Medicare Advantage Plans have coverage for prescriptions and some don’t, so you’ll probably want to make sure you have some coverage. Medicare Supplements do not have coverage for prescriptions.

For more help with the decisions involved in signing up for Medicare Insurance Plans, please contact me or request information.

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