Applying for Medicare is simple: contact Social Security. Choosing the right plan for you is the troublesome part. For guidance, contact Healthcare Solutions Direct.
Turning 65
When you are getting close to turning 65, you should start thinking about your plans for coverage. You will first get the opportunity to sign up for Medicare three months before the month of your 65th birthday. This marks the beginning of your initial enrollment period, which lasts for seven months.
To sign up for Medicare, you can schedule an appointment with your local Social Security office, apply online at Medicare’s website, or call Social Security.
What Are You Signing Up For?
During the initial enrollment period, you enroll in Medicare Part A and Part B. You can choose to purchase Part A on its own, but if you want Part B coverage, you need to purchase both Part A and Part B.
Medicare Part A is hospital insurance, covering your inpatient care in a hospital or skilled nursing facility. Medicare Part B covers preventive services and medically necessary care, which can include things like clinical research, ambulance services, durable medical equipment (DME), mental health care, and limited outpatient prescription drugs.
Many people receive Part A without having to pay premiums. This premium-free Part A is available for people who have worked long enough while paying taxes to Social Security. Social Security pays attention to your earnings every year. Each year you have the opportunity to earn a maximum of four work credits through your earnings. To be eligible for premium-free Part A, you or your spouse must have earned at least 40 work credits, or the equivalent of 10 years of working.
Why Sign Up For Medicare?
Premium-free Part A is the reason why most seniors should sign up for Medicare. Even if you have secondary insurance coverage through your work or union, you will receive hospital coverage for added security.
The other major reason to sign up for Medicare as soon as you are able is because of the late enrollment fees. Part B late enrollment fees last for the lifetime of the policy, as long as you hold coverage. They add up to 10% of the standard Part B premium to your monthly premium rate for every 12 months you went without signing up after you became eligible for Medicare coverage.
You don’t have to sign up for Medicare Part B right away if you are still working and have health insurance through your employer. This and other circumstances qualify you for a special enrollment period. Once you are no longer covered by the group health insurance, either because you stop working there or lose coverage, your special enrollment period to sign up for Medicare starts. You will have eight months to sign up without having to pay late enrollment fees.
What Should You Sign Up For?
Odds are, you have probably already been receiving targeted mail and offers for health insurance plans, giving you a glimpse of the coverage choices you will need to be making. You already know that there are multiple options when it comes to Medicare plans. Once you sign up for Part A and Part B, you can choose to add a Part D prescription drug plan, add a Medicare Supplement plan, or switch to a Medicare Advantage plan.
If you regularly take medications, you should sign up for a Part D prescription drug plan during your initial enrollment period or as soon as you lose creditable drug coverage. Part D has a late enrollment penalty that charges 1% of the national base premium for every full month you went without creditable drug coverage.
If you are thinking about signing up for a Medicare Supplement plan, you should do so during the six months before you first enroll in Medicare Part B. This marks the beginning of your Medicare Supplement (also called Medigap) Open Enrollment. You have twelve months to sign up for a Medicare Supplement plan without having to go through medical underwriting.
The good thing about these decisions is that you can make changes to your Medicare Advantage and Part D coverage every year. During the Annual Enrollment Period in the fall, from October 15 to December 7, Medicare beneficiaries have the chance to sign up for either of these plans, switch to a different plan, drop the plan or return to Original Medicare.
People with Medicare Supplements typically keep the same plan, as the opportunity to enroll happens during the initial six months and afterward only opens up for special circumstances that give you guaranteed issue rights. If you choose not to enroll in a Medicare Supplement during the first six months, you can enroll if you lose coverage or otherwise qualify.
End Stage Renal Disease (ESRD)
If you have End Stage Renal Disease (ESRD), you can sign up for Medicare once you qualify for coverage. Specific to this condition, you are eligible for Medicare coverage once you start your fourth month of a regular course of dialysis treatments. You can alternatively be trained to perform at-home dialysis treatments with your doctor’s approval and if you are trained at a Medicare-certified training facility. With at-home dialysis, your Medicare coverage can begin in the first month of your dialysis treatments.
Not every ESRD patient signs up when they first become eligible for Medicare coverage. Medicare coverage for ESRD can be retroactive for up to 12 months, starting when you first became eligible.
Automatic Enrollment
Some people under Medicare are signed up automatically for benefits and don’t have to apply for themselves. Social Security does this for the following people:
- People who are already receiving Social Security or Railroad Retirement Board retirement benefits at least four months prior to turning 65;
- People who have been receiving Social Security disability benefits for at least 24 months;
- People with Amyotrophic Lateral Sclerosis who have applied for disability benefits.
If you don’t have to sign up for Medicare, you will receive your red, white, and blue Medicare card in the mail shortly before your coverage begins.
Call Us Today For All Your Medicare Questions
Do you have additional questions about the process of signing up for Medicare or learning about your coverage options? Contact Healthcare Solutions Direct today.
