How many times have you heard that Medicare is complicated or confusing? These complaints can be enough to make anyone dread dealing with it. That’s why Higginbotham is here with six inside tips to help ease your transition to Medicare.
Tip 1: You can sign up for Medicare as early as three 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 you’re eligible. Medicare’s Initial Enrollment Period (IEP) starts three months before the month of your 65th birthday and ends three months after, for a total of seven months. If you sign up for Medicare during the first three months of your IEP, coverage will usually begin on the first day of your 65th birthday month. If you sign up during the last four months of your IEP, your coverage will typically begin on the first day of the next month, which could leave you with gaps in your coverage.
For example, if your 65th birthday is in April, your IEP runs from January 1 to July 31. If you sign up for Medicare in January, February or March, your coverage will begin on April 1. However, if you sign up during the month of April, your coverage will begin on May 1. And, if you sign up in May, June or July, it’ll begin on June 1, July 1 or August 1, respectively.
If you sign up during the last four months of your IEP, the start of your coverage may be delayed, potentially leaving you with gaps in coverage.
Tip 2: Find out if you will be enrolled in Medicare automatically.
If you’re younger than age 65 and currently receive Social Security or Railroad Retirement Board benefits, you will be automatically enrolled in Original Medicare (Parts A and B) and your Medicare card will be mailed to you. This also applies if you’re eligible for Medicare due to a disability – if this is the case, your Medicare coverage will go into effect after 24 months of receiving Social Security Disability Insurance (SSDI).
Tip 3: Consider delaying Medicare Part B.
You may be able to postpone Part B and delay paying its premium if you have creditable coverage through a group medical plan. For example, if you or your spouse work past age 65 for an employer with more than 20 employees and have employer-sponsored health insurance, you may be able to delay Medicare enrollment.
Make sure to check with your group health plan’s benefits administrator before you decide to postpone your Part B enrollment. You’ll need to confirm that you have creditable coverage and ask for written proof, especially for your drug coverage, to ensure you qualify.
Tip 4: Choose a Medicare plan with benefits you need.
Once you have Medicare Part A and Part B, you’ll have to consider if you need additional coverage. Parts A and B only cover in-patient hospital care, outpatient services and preventative screenings. This means health-related items like prescriptions, glasses, contacts, hearing aids and dental care are not covered.
To address these gaps, you can either add a Medicare supplement (Medigap) with a prescription drug plan (Medicare Part D), or you can opt for a Medicare Advantage (Part C) plan, which provides the benefits of Medicare Parts A, B and D in one convenient plan. Both of these options help cover out-of-pocket expenses, such as deductibles, coinsurance and other costs, and are available through approved insurance companies. The specific benefits provided will vary depending on your plan and insurer.
You can also purchase a stand-alone plan for dental, vision and hearing care, or this coverage can be “bundled” into your Medicare Advantage plan to create more comprehensive health coverage.
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Tip 5: 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 and you do not qualify for a Special Enrollment Period. Each part of Medicare has its own rules for timing and for calculating late enrollment penalties, so it’s important to speak with your health insurance broker to understand your enrollment timeline.
Tip 6: Evaluate your coverage needs every year.
Contrary to what some may believe, you do not have to keep the same Medicare Advantage (Part C) or prescription drug plan (Part D) every year. Medicare’s annual enrollment period runs from October 15 to December 7 every year. During this time, you can join, switch or drop a Medicare Advantage or prescription drug plan. Because of this, it’s important to review your coverage needs with your insurance advisor every year prior to the annual enrollment period.
Ready to make the switch to Medicare?
Although switching to Medicare can seem daunting, focusing on what applies to your personal situation can make the transition easier. If you need help determining your Medicare or health insurance coverage needs, Higginbotham can help. Request a quote today to get in touch with one of our Medicare specialists.