Signing up for Medicare may look hard, but it is actually easy. We help thousands every year with it.
If you are almost 65, you can start applying 3 months before your 65th birthday. It is good to start early so you have your Medicare card when you need it. When you first get Medicare, you can sign up for both Part A and Part B. This is also the time to think about Part D for prescription drugs, which is not covered by regular Medicare.
Medicare Part A covers your hospital stays, offering cost effective inpatient care. But what exactly does inpatient mean? We explain it to our clients as having room and board in a hospital. That means a semi private room with a bed for you and all your meals during your stay. It also covers medications provided by the hospital, along with any required lab services or medical supplies.
Medicare Part B covers a range of outpatient medical services, including preventive care like flu shots and screenings, doctor visits, lab tests, ambulance, and more. It also covers certain hospital services like surgeries, chemotherapy, and medical equipment. While Part B is optional, it is essential if Medicare is your primary insurance, and it is required for Medigap supplemental coverage.
Medicare Part C, known as Medicare Advantage, is an alternative to traditional Medicare offered by private companies. These plans combine Part A, Part B, and usually Part D into one. Similar to group insurance from past jobs, Medicare Advantage plans often have a local network of providers and involve copays for services like doctor visits and hospital stays. While optional, these plans are a choice for those seeking a bundled Medicare option.
Medicare Part D is a federal program offering affordable copays for prescription drugs that you pick up from retail pharmacies. It is a voluntary option that helps make medications more affordable and protects against extremely high drug costs. Enrollment in Part D is not through Social Security. Instead, you select a plan from a private insurance company available in your state.
Who is qualified to receive Medicare, and at what point does someone become eligible? Generally, Medicare eligibility starts at 65 years of age. Individuals who have received Social Security disability benefits for a minimum of 24 months are also eligible.
Medicare does not have a designated retirement age. The standard age for eligibility is 65, whether or not someone has retired. Eligibility at 65 or older is granted to United States citizens or permanent residents who have continuously lived in the country for at least five years. People under 65 can also qualify in the following situations:
The Initial Enrollment Period spans 7 months, allowing first time enrollment in Parts A and B when turning 65. It includes the 3 months before, the month of, and the 3 months after your 65th birthday. Enrolling in the 3 months following your birth month delays coverage. This same 7 month window applies for enrolling in Medicare Advantage or Part D plans.
The Annual Enrollment Period runs from October 15th to December 7th each year. During this time, those with Medicare Part A and B can enroll in, switch, or opt out of a Part D or Medicare Advantage plan.
The General Enrollment Period is for enrolling in Medicare Part A or Part B if you did not sign up during your Initial Enrollment Period and are not eligible for a Special Enrollment Period. It runs January 1 through March 31 each year, with coverage starting on day 1 of the month following your application.
This period lets beneficiaries with a Medicare Advantage plan make changes. From January 1 to March 31, you can switch to a different Medicare Advantage plan, or move to Original Medicare and add a Part D plan.
A Special Enrollment Period is available to beneficiaries experiencing a qualifying event. For instance, if you postponed Medicare enrollment past age 65 because of creditable coverage from active employment, you can use this period to sign up for Parts A and B. There are also Special Election Periods for Medicare Advantage and Part D plans, which give you a 2 month window to enroll after a qualifying situation.
When you first sign up for Medicare Part B, there is a 12 month window centered on your Part B effective date, extending 6 months before and 6 months after, during which you can join a Medigap plan without health screening. If you miss this window and do not have a qualifying event, you may be required to answer health questions to enroll in a Medigap plan.
Signing up for Part B or Part D after your first window closes can add a charge to your premium every month, usually for life. Answer a few questions to see an estimate.
There are exceptions that remove or lower a penalty, like help paying costs or a job plan you forgot about. A call at no cost takes a few minutes.
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