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When Do I Have To Take Medicare?

Intro | Should I Take Medicare Now?

|How To Signup For Medicare | Medicare Secondary Options |

I'm Turning 65 But My Spouse Is Not |

Medicare Disability | Medicaid

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His explanations of a very complicated health care system is clear, easy to understand and concise. 

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Part 1: Signing Up for Medicare at 65

When turning 65, you can sign up for Medicare starting 3 months before your 65th birthday month. You will begin Medicare on the 1st of your 65th birthday month to avoid any gaps in coverage. The exception to this rule is if your birthday is on the 1st of the month. In this case, you start Medicare on the 1st of the month before your 65th birthday month. You can sign up 3 months before this date.

Understanding the timeline for Medicare enrollment is crucial. If you sign up for Medicare in any of the 3 months before your 65th birthday month, your coverage will start on the 1st of your 65th birthday month. If you apply for Medicare during your birthday month or any of the 3 months after, your coverage will start on the 1st of the month after your application. However, if you wait until after these 3 months, you will need to demonstrate that you had creditable coverage to start Medicare Part B in a timely manner. Forgetting to sign up could result in waiting until the General Enrollment Period and potentially facing penalties.

Medicare enrollment can take anywhere from 2 weeks to several months, so we recommend starting this process as soon as possible. This will hopefully give Social Security ample time to process your application and help you avoid any delays.

Before we dive into the active ways to sign up for Medicare, let's discuss a passive option. If you have elected Social Security before turning 65, you will be automatically enrolled in Medicare when you become eligible. This could be when you turn 65 or if you qualify for Medicare disability. However, it's important to note that this automatic enrollment only applies if you take Social Security before 65. If you take Social Security after 65, you will not be automatically enrolled in Medicare.

Let’s say you took Social Security at age 62. A few months before you turn 65, you will automatically be sent your Medicare card in the mail. You don’t have to do anything proactively.

In this scenario, you will be automatically enrolled in Medicare Parts A and B. But if you have creditable work coverage, you can return Medicare Part B. Many people who have elected Social Security may have creditable work coverage through their employment or their spouses. In either case, if you have creditable work coverage, you can delay Medicare Part B until you are ready.

As you approach Medicare eligibility, talk to the brokers at NJ Life and Health to learn all your options. We’ll help you pick the right Medicare plan for your needs or delay Medicare until you are ready.

Signing Up Online

You can sign up for Medicare online through your www.ssa.gov portal. Social Security is the agency that oversees Medicare, and many Medicare-related activities are conducted through it.

The first step is to create an online Social Security account. This process can be tedious because of all the security measures Social Security takes to protect your identity. We appreciate all the layers of identity verification Social Security has implemented, but it can be time-consuming to get started. If you need any help, give us a call.

After you have created an account, start over at www.ssa.gov. The home page has a “Sign Up For Medicare” button. Click this link to start the process.

Once you have started the application, you will have to log in to Social Security again and fill out the Medicare application online. The process takes about 15-20 minutes. It can be confusing, and we’d be happy to help you through it if you get stuck.

Once you complete the application, your Social Security online portal will display an application tracker. This tracker will show you where your application is being processed and let you know when you’ve been approved.

On average, you will receive your Medicare card in the mail about 4-6 weeks after submitting your application. You may also get a letter with your Medicare information before your card arrives at your house. There is a large amount of variability in how long applications take to process, so the earlier you start, the better. In our experience, online is the most efficient and consistent method when you are turning 65.

Note: You have the option to sign up for both Social Security Income benefits and Medicare at the same time online using the same application. Based on our own experience with clients, we do not recommend doing so. We have found that doing both in the same application leads to significant delays. We recommend signing up for Medicare first and then signing up for Social Security after your Medicare benefits have been processed. Your experience may vary.

Applying Over the Phone

Many of our clients have tried applying for Medicare over the phone. This is the least efficient method, and we do not recommend it.

When you try to apply for Medicare over the phone, they will most likely not sign you up on the spot. They will give you an appointment date in 1 to 3 months. This signup date could be after your 65th birthday, and they may not even call you at the time they scheduled. It will also take a few weeks or months after this call for your Medicare benefits to be processed.

Choosing this option can lead to confusion and serious delays in your Medicare benefits. We recommend applying over the phone only as a last resort.

Local Social Security Office

You can also apply for Medicare at 65 at your local Social Security office. How you go about this is highly dependent on where you live. Some Social Security offices require a pre-scheduled appointment, and others allow walk-ins. Some Social Security offices are incredibly helpful and will help you with your Medicare application; others will tell you to leave.

This option is effective but potentially unreliable. If you can apply for Medicare in person, the turnaround time is usually quick. However, the quality of local Social Security offices is highly variable, so we can’t say if it is a viable option for everyone.

We recommend getting to your local Social Security office as early as possible to see if they will accept you as a walk-in or schedule a future appointment. In New Jersey, for example, walk-ins are typically accepted in the morning. But if it is too busy, they may turn you away.

Note: When you Google your local Social Security office online or use the ssa.gov office finder, you will not get the phone number of your local Social Security office. Instead, you will get the national Social Security hotline number. As we detailed earlier, this is not a great method for signing up for Medicare.

Part 2: Applying for Medicare After 65

If you have creditable work insurance at age 65, you can delay your Medicare Part B benefit until you are ready. When you are about to lose that coverage, you can apply for Medicare Part B. This process differs from applying at 65, so the methods vary slightly.

To apply for Medicare Part B after 65, you have to gather 2 forms: CMS-40B and CMS L564.

CMS-40B is your Medicare Part B application. On this application, you list your contact information and Medicare number and when you would like your Medicare Part B to start.

CMS L564 is a form your or your spouse's employer must fill out, depending on which company provided you insurance. The form lets Medicare know you have had creditable work coverage the entire time you have been eligible for Medicare, allowing you to avoid penalties.

Whether you are losing your work insurance due to retirement or termination, we recommend sending all this paperwork a month or two before your target Part B start date. If you have creditable work insurance, you can start Part B at any time of the year. You are given a Special Enrollment Period for losing work coverage, which offers flexible enrollment.

Social Security Office In-Person

You can drop your Medicare paperwork off at your local Social Security office. Many prefer this method to faxing because it confirms that someone has received everything necessary. As we mentioned above, the effectiveness of your local Social Security office can vary greatly depending on the location. This may be an option, or they may tell you to do it using another method.

Remember, you should get to your local Social Security office as early in the day as possible. This way, you are far more likely to see someone or schedule a future appointment. If you can talk to a local Social Security worker, you should be able to apply for Medicare on the spot.

After you give the office your documents, your application status should appear in your Social Security online portal tracker.

Faxing To Your Local Social Security Office

In our experience, faxing your paperwork to your local Social Security office is suitable for applying for Medicare after 65. But be warned: We have seen local offices occasionally lose documents or not process them promptly. Although it generally works out well, we would recommend dropping your paperwork off in person whenever possible.

You can find the fax number for your local Social Security office by typing your zip code into this website: https://secure.ssa.gov/ICON/main.jsp. This website will tell you where your local Social Security office is located and its fax number. When you fax your applications in, be sure to keep the fax transmission receipt.

Once the application starts processing, it should appear in your ssa.gov portal in the application tracker.

Applying Online

You can apply for Medicare Part B online using the same application you used to apply for Medicare before you turn 65. The application has a “Remarks” section where you can specify your Part B start date, just like on CMS 40B.

The biggest hurdle for this method used to be that you still had to submit your Employer Information Form (CL564) to Social Security separately. Social Security recently added a document upload function, which may be a great option going forward.

Medicare Disability

If you are under the age of 65 and have been receiving SSDI for 24 consecutive months or have ALS or ESRD, you will be enrolled in Medicare Parts A & B. This is sometimes referred to as "Medicare Disability". Medicare Disability functions the same as 

Conclusion

Signing up for Medicare can be incredibly difficult and confusing. There are many avenues for Medicare Enrollment, and the best method depends on your situation. We here at NJ Life and Health have helped thousands of people with their Medicare and would love to help you! We can make the Medicare enrollment process as pain-free as possible and give you our expert guidance.

Contact us at www.njlifeandhealth.com or call our Toms River, NJ office at 848-226-6897 to schedule a free Medicare education today.

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