| Tue, May 22, 2018 @ 09:00 AM

7 Inside Tips to Help You Make a Smooth Move to Medicare

Posted by Medicare Made Clear

Couple reading medicare enrollment pamphletsHow many times have you heard that Medicare is “complicated” or “confusing”? It’s enough to make anyone dread dealing with it, right?

Well here are some inside tips that just might help clear a path to Medicare enrollment for you.

1. You can sign up for Medicare up to 3 months before you turn 65.

Medicare eligibility begins at age 65, but you can sign up earlier to make sure your coverage starts as soon as possible. You will have a 7-month Initial Enrollment Period (IEP) that starts 3 months before your birthday. If you sign up during these first 3 months, your Medicare coverage will kick in on the first day of your birthday month. Your coverage could be delayed if you sign up during your birthday month or later. Get your personal IEP dates using this Enrollment Date Calculator.

2. You might be enrolled in Medicare automatically.

Medicare will mail your Medicare card to you automatically if you currently receive social security or Railroad Retirement Board benefits. This applies if you are eligible for Medicare due to age or disability. You will be enrolled in Original Medicare (Parts A & B). Your coverage will go into effect on the first day of your 65th birthday month or the month of your 25th disability check. You still have your IEP during which you may make other coverage choices.

3. You may want to delay taking Medicare Part B.

Medicare Part B helps pay for doctor visits and outpatient care. You pay a monthly premium for it. Part A helps pay for hospital and inpatient care. Most people get Part A for no premium.

You could postpone Part B – and have to pay the premium – if you have other coverage. You might be working past 65 and have employer-sponsored health insurance, for example. Or maybe you have retiree or union coverage.

Check with your plan benefits manager before deciding to postpone your Part B enrollment. Ask for proof that your current insurance will allow you to qualify for a Special Enrollment Period when you leave or lose your current coverage. You could face late enrollment penalties if it doesn’t. (See #6 below.)

4. You get to choose how you want to get your Medicare benefits.

Once you sign up for both Part A and Part B, you have two options for getting your Medicare benefits:

  • Keep government-sponsored Original Medicare (Parts A & B), which provides coverage for hospital and medical services.
  • Choose a private Medicare Advantage plan (Part C), which typically includes coverage for hospital and medical services, prescription drugs and other benefits all in one plan.

Identifying your health and budget needs can help you decide which option may work best for you.

5. You can add coverage to government-sponsored Original Medicare.

If you choose Original Medicare, it’s important to know that it doesn’t cover everything. Many people add a Medicare Part D plan, a Medicare supplement plan or both. Plans are offered by private insurance companies.

Coverage Combinations with Original Medicare

Chart featuring Medicare coverage combinations

There are important considerations when deciding whether to add coverage to Original Medicare or choose a Medicare Advantage plan instead. Doctor choice and costs are two of the key ones.

6. You need to enroll on time to avoid late enrollment penalties.

Medicare Part B and Part D may add penalties to your premium payments if you enroll after your IEP ends. Each part has its own rules for timing and for calculating the penalty.

  • Part B: You can delay enrolling in Part B without penalty if you plan ahead for it. (See #3 above.) Otherwise, you’ll be charged an additional 10% of the premium amount for each full 12-month period you could have had Part B and didn’t. The penalty is charged every month for as long as you have Part B.
  • Part D: The timing and penalty for Part D enrollment is based on having creditable drug coverage. Basically, you are charged a penalty if you go more than 63 days without drug coverage “at least as good” as Part D provides. The penalty is an additional 1% of the average Part D premium for each month you delay enrollment. The penalty amount may change each year along with annual Part D premiums. It’s charged every month for as long as you’re enrolled in Part D.

Medicare supplement plans may also penalize late enrollment. Your Medicare supplement open enrollment period begins once you are 65 or older and enrolled in Part B. You have six months from that date to enroll in a plan and be guaranteed coverage. After that, plans may charge you more or deny you coverage altogether based on your health history.

People who pay a premium for Part A (most don’t) may be charged a penalty for late enrollment. The penalty is an additional 10% of the premium amount and is charged every month for twice the number of years enrollment was delayed.

7. You can change your coverage later if you decide to.

Medicare Open Enrollment is October 15 to December 7 every year. During this time, you can join, switch or drop a Medicare Advantage plan or a prescription drug plan. It’s a good idea to review your Medicare coverage every year to make sure it still serves your needs.

You will automatically go back to Original Medicare if you drop a Medicare Advantage plan during open enrollment, and you will lose drug coverage if it was included with your plan. You may replace drug coverage with a stand-alone prescription drug plan at this time without penalty. A penalty may apply if you drop drug coverage and more than 63 days pass before you get it again.

Conclusion

It may feel like Medicare is a vast and overwhelming maze. Partly that’s because Medicare serves millions and millions of people, each with his or her own set of circumstances, and the program must anticipate and accommodate them all. Focus in on what applies to your personal situation, and your path to Medicare may become clear.

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.

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