Signing up for Medicare can be stressful. There are many different enrollment periods for varying circumstances. And it doesn’t help you are constantly getting bombarded with mail from insurance companies saying you will be penalized if you don’t enroll for Medicare properly. Most of this mail is purposely doom and gloom to get you to pick up the phone. But the confusion associated with signing up for Medicare is still real.
In this article we’ll talk about what enrolling for Medicare entails. We will also cover the different situations that will help you decide when you should sign up.
Part 1: Medicare Enrollment Basics
What Does Enrolling in Medicare mean?
Enrolling in Medicare means signing up for Medicare Parts A and/or B to gain insurance benefits through the government at or after the age of 65. You can also enroll under the age of 65 if you are disabled for more than 24 months, or have End Stage Renal Disease. Medicare Part A is considered your hospital coverage (typically just room and board), and Medicare Part B is considered your medical coverage (your true medical coverage inside and outside the hospital).
To receive your Medicare card, you must be enrolled in at least Medicare Part A (Hospital Coverage). To be fully enrolled in Medicare, you must also have Medicare Part B. Unlike Part A, Part B is optional in many circumstances. However, having Part B will allow you to get the full benefits of your Medicare, including the ability to join a Medicare Supplement or Medicare Advantage Plan.
How Do I Enroll in Medicare?
The enrollment process for Part A and/or Part B is done through the Social Security department. If you are enrolling in Medicare upon turning 65, you can do so 3 months before, the month of, or 3 months after the month of your 65th birthday. This can be done for Part A and/or Part B. The easiest way to do this is to enroll online through SSA.gov; it is the fastest and most efficient method for enrolling in Medicare. You also can call Social Security to enroll over the phone. Note that when you try to enroll over the phone, they may set up an enrollment appointment up to a month or more after your initial call. You can also enroll in person at a Social Security office. Unfortunately, all these offices are closed for in-person appointments due to COVID as of early 2022. Hopefully, they will re-open soon.
If you are already claiming social security retirement payments before the age of 65, disabled for more than 24 months, or been diagnosed with end Stage renal Disease, this enrollment will be done automatically for you for both parts of Medicare. You will receive a card in the mail about 3 months prior to your start date. We will discuss this in more detail below.
Can I Keep My Current Health Insurance While on Medicare?
For most people, no. When you first become eligible for Medicare; things are likely to change. If you are currently receiving assistance from a national or state level marketplace, they will pull your subsidies and force your hand towards Medicare when you become eligible. If you are retired and still on your old work insurance, they may switch you to retiree benefits.
The exception to this situation is if you are still working. You will be able to stay on your work insurance if the company you work for has over 20 employees and provides credible insurance. If the company has under 20 employees, your employer has the right to force you on to Medicare.
Speak to your broker to see what healthcare changes you can expect when you become eligible for Medicare.
Situations Where You Are Automatically Enrolled in Medicare
You Took Social Security Prior to 65
If you took Social Security payments prior to turning 65, you will automatically get Medicare Parts A & B starting the month of your 65th birthday. Medicare will pull your Part B premiums directly from your Social Security payments, so expect a reduction.
Your Medicare card should be sent in the mail about 3 months prior to your 65th birthday. Talk to your broker before your 65th birthday month to make sure you have proper Medicare Supplemental & Prescription coverage for this transition. During the 3 months leading up to your Medicare eligibility and the 3 months after you are given an “Initial Enrollment Period”. This window allows you to go onto any Medicare plan with no health questions asked. Any
time after this they will ask health questions to join.
You Took Social Security Due to Disability
If you are under 65 but have been receiving Social Security disability checks or railroad disability insurance for 24 consecutive months, you will be automatically enrolled in Medicare on the 25th month. During this time, you have access to many of the same Medicare Supplement, Medicare Advantage and Medicare Prescription Plans people turning 65 have.
Talk to your Medicare broker before you enroll in Medicare due to disability to ensure you have proper coverage when it happens. During the 3 months leading up to your Medicare eligibility and the 3 months after you are given an “Initial Enrollment Period”. This window allows you to go onto any Medicare plan with no health questions asked. Any time after this they will ask you health questions, and most people on disability are denied with a few exceptions. Don’t miss your chance to get the best health coverage you can.
If you missed your Initial Enrollment Period when you first went on disability don’t fret. You will be given another one once you turn 65. This will allow you to choose a more comprehensive plan if you missed out the first time.
Situations When You Have to Enroll Yourself in Medicare
You Did Not Take Social Security Prior to Turning 65
You can apply for Medicare up to 3 months before your 65th birthday month. As we said above, this can be done online, by phone, or in-person. After applying for Medicare, you should get your Medicare card 4-6 weeks after the application date. The earlier in the process you start, the more time you give yourself to avoid any issues with Social Security.
You Only Received Part A Benefits on Your First Medicare Card
There is a chance that when you receive your Medicare card you will only have your Part A benefits. This is great if you don’t plan to start Medicare at 65. But if you do, there is an extra step you must take.
You must enroll yourself in Part B by letting Social Security know you want your benefits. Doing this allows you to take on your Medical insurance and allows you to avoid any penalties. The easiest way to do this is through SSA.gov. You can also call Social Security or visit a Social Security office in person (when available) to enroll. You can sign up for Part B as early as 3 months before the month of your 65th birthday. We recommend signing up for Part B as early as possible to avoid any trouble.
You Are Working and Plan on Keeping Your Work Insurance at 65
This path has a few more variables.
If you are still working at 65 and plan to for a few years, it can make sense to keep your work insurance. Talk to your broker and compare your current work insurance with Medicare. Many people are shocked to find Medicare can be the more cost-effective option. But if you have solid work health insurance and want to stay on it until you retire, this section is for you.
The first thing to do is talk to your HR or benefits department and see how your insurance works with Medicare. Ask them if your current insurance stays primary or becomes secondary to Medicare after 65. Your primary insurance is the insurance that will be billed first and pays the majority of your bills. Your secondary will help fill any gaps. Knowing this distinction will help you and your broker make the best decision about staying on your work insurance.
Also check to see if your work even offers credible insurance after you turn 65. If you do not have credible employer insurance (insurance from an employer with over 20 employees) upon turning 65, you must enroll in Medicare part B at 65 years old to avoid penalty. If you do have credible employer insurance, you may wait to enroll in part B until you leave said insurance; you will be given an 8-month special election period to enroll upon leaving or losing insurance. Any conversation about Medicare vs. your current work insurance starts with a trip to HR.
If after all this you decide to stay on your work insurance, there may be a few steps to take. If you receive a Medicare card with Part A and B on it, the first step is to proactively tell Medicare you will not be accepting your Part B benefits at 65. To do this, simply sign the back of the card and send it back to Medicare. This will let them know they should not charge you for Part B services.
If you did not receive a Medicare card, you may enroll in Medicare Part A only using the options discussed earlier. When you decide it is time to retire, you must tell Social Security you want your Part B benefits. You can do this online, via phone, or in-person (when available). But the best way to sign up for Medicare after 65 is to fax your Part B paperwork to your local Social Security office. To make sure this goes smoothly, talk to your broker to help submit the paperwork properly and avoid any penalties.
Enrolling in Medicare is in theory easy but can be complex in practice. There are a multitude of variables to consider when making the decision of if and how you will apply. It is always best to have a trusted broker at your side to guide you along the way. They have seen it all and can guarantee a smooth transition to Medicare for you. Talk to the brokers at NJ Life & Health to ensure that you won’t have any headaches when it comes to Medicare Enrollment. Visit our website at https://www.njlifeandhealth.com/request-an-appointment or call 848-226-6897.