Medicare is a federally financed healthcare program for adults 65 and older and those with specific disabilities. It helps cover medical care costs, including doctor visits, hospital stays, prescription drugs, etc. Enrollment in Medicare is mandatory at age 65, but there are some circumstances where you may need to enroll earlier or later. This article will go through when you should sign up for Medicare.
What is Medicare, and what does it cover?
Medicare is a government-funded healthcare program for people over 65, individuals younger than 65 with specific disabilities, and those of any age battling End-Stage Renal Disease (ESRD) or Lou Gehrig’s disease. Medicare consists of four parts: Part A, Part B, Part C, and Part D.
- Part A: Covers hospital stays, skilled nursing facility care, hospice care, and home health care.
- Part B: Covers doctor’s visits, outpatient care, medical equipment, and preventive services.
- Part C: It is also referred to as Medicare Advantage. It is a private health insurance plan that covers everything that Parts A and B cover.
- Part D: Covers prescription drugs. If you are 65 or older, have a disability, or have ESRD or Lou Gehrig’s disease, you are eligible for Medicare.
How can I find out if I qualify for Medicare?
If you are 65 or older, you can enroll in Medicare three months before turning 65, in the month of turning 65, and three months after turning 65. If you have a disability and are under 65, you can enroll in Medicare 25 months after you begin collecting Social Security Disability Insurance (SSDI) benefits. If you have ESRD or Lou Gehrig’s disease, you are eligible for Medicare enrollment the first month you are on dialysis or the third month after receiving a kidney transplant.
What is the late-enrollment penalty?
If you do not enroll in Medicare when you are first eligible, you may have to pay a late-enrollment penalty. The late-enrollment penalty is an increase in your Part B and Part D premiums that you will have to pay for as long as you have Medicare. The late-enrollment penalty is 10% for every 12 months that you could have had Part B or Part D but did not enroll.
For example, if you are eligible for Medicare and do not enroll in Part B when you reach the age of 65, you are required to pay a 10% late-enrollment penalty for every 12 months you might have had Part B but did not.
If you do not enroll in Part D when you are first eligible, you will have to pay a late-enrollment penalty of 1% of the national average premium for every month that you could have had Part D but did not enroll. The late-enrollment penalty is permanent and will not go away even if you later decide to enroll in Part B or Part D.
There are various methods for applying for Medicare:
- You can apply online at www.socialsecurity.gov/medicareonly.
- You can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and make an appointment to apply in person.
- You can also submit an application at a Social Security office in your area.
You will automatically be enrolled in Part A and B if you are already receiving Social Security benefits. You must sign up for Part C or Part D if you want coverage for those services.
What if I am still working when I turn 65?
If a group health plan covers you through an employer or union, you can delay enrolling in Part B without paying a late-enrollment penalty. You can enroll in Part B any time during or after your eight-month particular enrollment period, which begins the month after your employment ends or your group health coverage ends, whichever comes first. You should enroll in Part A as soon as you are eligible, even if you’re still working and have group health coverage. There is no late-enrollment penalty for Part A.
How do I choose the best plan for my needs and budget?
There are a few things to consider when choosing a Medicare plan.
First, you must decide if you want Original Medicare (Parts A and B) or a Medicare Advantage Plan (Part C). If you choose Original Medicare, you can also sign up for a stand-alone Part D prescription drug plan.
Next, you must select whether you wish to purchase a Medicare Supplement Insurance Plan to cover out-of-pocket charges not covered by Original Medicare.
Finally, you need to compare plans and find one that fits your needs and budget.
You can use the Medicare Plan Finder tool on www.medicare.gov to compare plans and find one that fits your needs.
Specific aspects must be considered when determining when to enroll for Medicare. You need to decide if you want Original Medicare or a Medicare Advantage Plan and if you want a Medicare Supplement Insurance Plan. You also need to compare plans and find one that fits your needs and budget. Use the Medicare Plan Finder tool on www.medicare.gov to help you choose the best plan for your needs.