Getting Close to Retirement? Start Considering Your Medicare Benefit Choices Now

If you are approaching retirement age, currently age 65 according to the Federal government, you should know about your Medicare options and the many accompanying rules and exceptions.

Who Gets Medicare Part A and Part B Benefits

If are already getting Social Security benefits, you will automatically receive Medicare Part A and Part B benefits starting the first day you turn 65. (If you’re under 65 and have a disability, you will automatically get Part A and Part B after you receive benefits for 24 months.)

When you are automatically enrolled you will receive a red, white and blue Medicare card in the mail 3 months before your coverage begins.

If you are approaching age 65 and do not yet receive Social Security benefits, you will need to sign up for Medicare by contacting them three months before you turn 65.

What is Medicare Part A and Part B?

Part A is hospital Insurance. It helps cover inpatient care in hospitals, skilled nursing facility care, hospice care and home health care.

Part B is medical insurance. It helps cover outpatient care, home health care, durable medical equipment (such as wheelchairs, hospital beds, etc.), and many preventive services.

Part A and Part B Options

You do not pay a premium for automatic Part A coverage. Part B coverage is automatic; however, it includes a premium that is deducted from your monthly Social Security benefit. You can choose not to keep Part B coverage, but you must let Medicare know before the coverage date on your Medicare card.

If you choose not to keep Part B when you are first enrolled in Medicare but change your mind, you may have to wait to enroll and pay a penalty for as long as you have Part B.

What If You Didn’t Automatically Get Enrolled in Part A and Part B?

You won’t automatically get enrolled in premium-free Part A if you are still working and not getting Social Security. For premium-free Part A, you can enroll any time after you are first eligible for Medicare. Your Part A coverage will be retroactive six months from when you sign up, but no earlier than when you were first eligible for Medicare. You can only sign up for Part B during the enrollment periods listed below.

Remember, if you don’t sign up for Part A (If you have to buy it) and Part B when you are first eligible, your enrollment may be delayed and you may have to pay a late enrollment penalty.

Initial Enrollment Period

You can first sign up for Part A and Part B during the 7-month period that begins 3 months before the month you turn 65 and ends 3 months after you turn 65.

Special Enrollment Period

After your Initial Enrollment Period is over, you may have the chance to sign up during a Special Enrollment Period under certain conditions. If you didn’t sign up when you were first eligible because you had group health coverage based on employment (yours, your spouse’s or a family member’s – if you have a disability), you can sign up for Part A and/or Part B:

  • Any time you’re still covered by the group health plan
  • During the 8-month period that begins the month after employment ends or the coverage ends, which ever happens first

You usually do not have to pay a late enrollment penalty if you sign up during a Special Enrollment Period. Note: If you are on disability, the group health plan coverage is based on a family member’s current employment (other than a spouse), the employer offering the group health plan must have 100 or more employees for you to get a Special Employment Period.

COBRA coverage, retiree health plans, VA coverage and individual health coverage are not considered coverage based on current employment, and you are not eligible to sign up for Special Enrollment Period Medicare when that coverage ends. To avoid paying a higher premium, make sure you sign up for Medicare when you are first eligible.

General Enrollment Period

If you didn’t sign up for Part A (if you have to buy it) and/or Part B during your Initial Enrollment Period and don’t qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period between January 1 and March 31 each year. Your coverage won’t start until July 1 of that year, and you may have to pay a higher Part A and and/or Part B premium for late enrollment.

Get More Information

To learn more about enrollment periods, visit www.medicare.gov or call 1-800-633-4247. For information about signing up for Medicare contact www.mymedicare.gov or call 1-800-633-4227.

You can also get free, personalized health insurance counseling from your State Health Insurance Assistance Program (SHIP). In Minnesota, you can contact http://www.mnaging.net/ or call (651) 431-2500 or toll-free: (800) 882-6262. In Massachusetts, you contact https://www.mass.gov/health-insurance-counseling or call (800)-243-4636.

ONE MORE IMPORTANT NOTE

Once you’re enrolled in Medicare, you not done yet. There are many different ways to get coverage, including Part D Prescription coverage. To review all of your options visit www.medicare.gov. There are also insurance brokers who specialize in Medicare coverage. They can be found through a simple Google search using the term “Medicare Insurance Brokers.”