Sign Up or Delay Medicare

I’m turning 65 and want to start my Medicare Benefits as soon as possible…what do I do?

Individual who were born on the 2nd of the month through the 31st of the month can start their Medicare benefits on the 1st of their birth month.  For example, if you were born on May 15th,  you would be eligible to start Medicare on May 1st.

However if you happen to have been born on the 1st of the month, Medicare will allow you to start benefits in the month preceding your birth month.   So if July 1st  is your birthday, you can actually start your Medicare benefits on June 1st..

When do I enroll?

1. If you have already started collecting your Social Security Benefits, the government will automatically enroll you into Medicare Parts A (Hospital Benefits) & Medicare Part B (Outpatient/Doctor Benefits). No action is required on your part and will receive your card about three to four months prior to your birth month.
2. If you are not receiving your Social Security Benefits, you would need to make a manual enrollment into Medicare. Your enrollment window will start on the first of the month, three months prior to your birth month.  So if you were born of December 12th, your enrollment window would start on September 1st.

How do I enroll in Medicare? There are three primary ways to enroll:

1. Make an appointment at the Social Security office. You can locate a local office here: https://secure.ssa.gov/ICON/main.jsp
2. Call 1(800) 772-1213. Be prepared for long wait times.
3. Apply online by visiting ssa.gov/medicare – this is by far the quickest method.

When will I receive my card?

Typically your Medicare card will arrive in about a month. You will need your Medicare number which will be printed on your card to enroll in your Medicare Supplement and Medicare Part D (prescription drug plan).

If you are pressed for time and need your Medicare number as soon as possible, you can usually obtain it about a week after making your enrollment by logging into your Social Security portal https://www.ssa.gov/myaccount/  and downloading your “Benefit Verification Letter .”

What’s next?  

AFTER you have obtained your Medicare number, give us a call to review the Medicare Supplement and Medicare Part D options:  (800) 431-1946.

I’m already turned 65 (or older) and want to enroll in Medicare. Which scenario describes your situation?

1. I’ve had group health insurance from an employer sponsored plan at my employer or my spouse’s employer since I tuned 65: In this scenario you have had creditable health insurance and can sign up for Medicare when you are ready without a penalty. There are two forms which are required. The Medicare Application: https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms40b-e.pdf and also the proof of coverage form which need to be filled out by your employer: https://www.cms.gov/medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf Once both of these forms are filled out, provide them to your local Social Security office or scan and upload them to your Social Security portal at www.ssa.gov

2. I have not had health insurance from an employer sponsored plan and did not yet enroll in Medicare: In this scenario, if you are still within the three month window after your birth month you can still apply for Medicare without a penalty.  However if three months have passed since your 65th birth month , you have not yet enrolled in Medicare and you have not had creditable coverage, you are considered late and cannot enroll in Medicare until the General Enrollment Period which runs from January 1-March 31. You will also be subject to a lifetime penalty. Your coverage will not then start on July 1st.  See methods to enroll here.

3. I have had cobra coverage: Cobra coverage does not count as creditable cover to allow you defer your Medicare enrollment.  If you blew past your enrollment window, you are considered late and cannot enroll in Medicare until the General Enrollment Period which runs from January 1-March 31. Your coverage will not then start on July 1st.  You will also be subject to a lifetime penalty. See methods to enroll here.

I’m turning 65, but plan to continue to work and delay my Medicare enrollment. What do I need to do?

If this describes your situation you have options. First, you don’t have to go on Medicare unless the group plan has less than 20 participants. If the group has less than 20 participants you must sign up for Medicare to avoid a lifelong penalty.

If your group health insurance coverage has more than 20 participants, you can defer your Medicare enrollment indefinitely while you have coverage. This will save the expense of paying for Medicare Part B.  As for Medicare Part A, it is usually wise to enroll as it will provide additional hospital insurance to compliment your employer coverage and there is no cost.

NOTE:  You are not allowed to enroll in any part of Medicare if you participate in a Health Savings Account (HSA). 

I have group coverage available, but should I do Medicare instead?

Remember, if you have less than 20 participants in the plan, you don’t have a choice…you need to enroll in Parts A & B to avoid a penalty. But if you are in a large group with over 20 participants, you might find that it may be more beneficial to enroll in Medicare for a variety of reasons.

One such reason is cost. Many group plans have large monthly premiums that are deducted from your paychecks every month. If the cost of your work plan will exceed the combined costs of Medicare, your Medicare Supplement and your Part D prescription plan, it probably makes sense to go on Medicare.

Another reason it might make sense to go on Medicare is that in many cases the coverage will be better. Having Medicare Part’s A & B along with the right Medicare Supplement Plan will typically provide 100% coverage for your hospitalization costs, pay all of your outpatient costs, have no network, no-copays, no referrals required for specialists and just a minimal deductible of a couple hundred dollars. It’s almost impossible to get that good of coverage from the group market.

If you decide to go on Medicare, you can learn how above.  After you receive your Medicare card, give us a call to review the Supplemental Plan options.