| Tue, Jan 15, 2019 @ 12:54 PM

5 Tips for Enrolling in Medicare for the First Time

Posted by Medicare Made Clear

Medicare eligibility begins at age 65 for most people. (If you were born in 1954, you are next up to join the ranks of Medicare beneficiaries.) Here’s what you need to know about turning 65 and signing up for Medicare for the first time.


1. You have a set Medicare Initial Enrollment Period when you can sign up for Medicare.

Your Medicare Initial Enrollment Period (IEP) is based on your 65th birthday. It’s 7 months long and includes:

  • The 3 months before the month you turn 65
  • The month you turn 65
  • The 3 months after the month you turn 65

You are automatically enrolled in Part A and Part B at age 65 if you are receiving social security or Railroad Retirement Board benefits, but you still have your IEP when you can make coverage choices. If you’re not receiving benefits, you need to sign up for Medicare yourself online or at your local social security office. Get your IEP dates here.


2. You may be able to delay enrolling in Medicare Part B and postpone paying the premium.

Medicare Part B is medical insurance. It covers doctor visits and outpatient care, and it comes with a monthly premium. Most people get premium-free Medicare Part A (hospital insurance) based on their or their spouse’s work history.

You may be able to delay Part B and postpone paying the premium if you or your spouse will be working past 65 and covered through an employer health plan. It’s important to understand Medicare’s rules for delaying Part B. There is a penalty for late enrollment unless you qualify for a Special Enrollment Period when your employer coverage ends.


3. You can choose to get your benefits through Original Medicare or a Medicare Advantage plan.

Original Medicare (Parts A&B) is administered by the federal government. Medicare Advantage plans (Part C) are offered by private insurance companies and are approved by Medicare. These plans provide all the same benefits as Original Medicare and often include additional benefits, such as coverage for prescription drugs and for dental, vision and hearing care – all in one plan. You must be enrolled in both Part A and Part B to be eligible for a Medicare Advantage plan.


4. You may buy additional coverage to fill in for what Original Medicare doesn’t cover.

If you decide to get your benefits through Original Medicare, you can add drug coverage with a standalone Medicare prescription drug plan (Part D). These plans are offered by private insurance companies and approved by Medicare.

Some people also buy a Medicare supplement plan (Medigap) to help with some of the costs not paid by Original Medicare, such as deductibles, copays and coinsurance.


5. Your annual out-of-pockets costs are capped with a Medicare Advantage plan.

Each Medicare Advantage plan sets its own cost terms, and every plan must set an annual out-of-pocket maximum. After the maximum, the plan pays 100% for all Medicare-covered services. Plans may or may not charge a monthly premium, but you still need to pay the Part B premium to Medicare. You don’t need additional coverage with a Medicare Advantage plan in most cases, and you can’t use a Medicare supplement plan with a Medicare Advantage plan. Get info about Medicare supplement plans vs. Medicare Advantage plans here.


Turning 65 means it’s time for Medicare.

Just like your 65th birthday, Medicare enrollment can sneak up on you. Use the tips above to get a head start on learning the Medicare basics so you can make an informed decision when the time comes.


For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.