Getting Educated on The Benefits You Deserve
When and how to enroll for Medicare can be really hard and time consuming if you don’t have the proper information. You also may be asking yourself “What is Medicare?” and “Am I eligible to enroll in Medicare?”.
Medicare is health insurance provided by the US government. Medicare includes Part A (which is hospital insurance, and Part B (which is medical insurance). Medicare also offers Part D (which adds prescription drug coverage). However, Part D is not included in Original Medicare and is offered by private insurance companies.
You can sign up for Medicare:
- Up to 3 months before or after your 65th birthday
- During Annual Enrollment (October 1 – December 7)
- During Open Enrollment (January 1 – March 31)
Am I Eligible for Medicare?
You must meet at least one of the following criteria to be eligible to receive Medicare:
- Be age 65 or older and eligible for Social Security (you can sign up for Medicare up to three months before and after your 65th birthday)
- Be permanently disabled and have received disability benefits for at least two years
- Have end-stage renal disease (ESRD) (permanent kidney failure that requires dialysis treatment or a kidney transplant)
- Have Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis, or ALS)
How to Enroll in Medicare
If you aren’t automatically enrolled, you can enroll in Medicare Part A and/or Medicare Part B in the following ways:
- Online at www.SocialSecurity.gov.
- By calling Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday, from 7AM to 7PM.
- In person at your local Social Security office.
- If you worked at a railroad, contact the Railroad Retirement Board (RRB). Call 1-877-772-5772 (TTY users 1-312-751-4701), Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.
Why Are Medicare Enrollment Periods Important?
You may not have to enroll yourself in Medicare. There are a few situations where you may be automatically enrolled:
- If you are already receiving retirement benefits through the Railroad Retirement Board (RRB) or Social Security, you will automatically be enrolled in Medicare Parts A and B.
- If you live in a US territory, you will be automatically enrolled in Medicare Part A, but will have to manually enroll in Part B.
- If you are receiving disability benefits from Social Security or the RRB, you will automatically be enrolled in Medicare Parts A & B. (The exception to this is if you have ESRD, in which case you must apply for Medicare.)
Initial Enrollment Period (turning 65)
For most people, enrolling in Medicare Part A is automatic. But there are some situations where you may have to deliberately enroll in Medicare Part A and/or B, during what is known as your Initial Enrollment Period.
The Initial Enrollment Period lasts seven months: three months before your 65th birthday, the month of your birthday, and the three months after your birthday.
Here are some reasons you might have to enroll during this period:
- If you aren’t receiving retirement benefits and are close to turning 65, you can enroll in Original Medicare during this time period.
- If you do not qualify for retirement benefits from Social Security or the RRB, you can sign up for Medicare Parts A and/or B.
General Enrollment Period
If you did not enroll in Medicare during the Initial Enrollment Period when you were first eligible, you can enroll during the General Enrollment Period. This runs from January 1 through March 31 of each year.
Special Enrollment Period
If you choose not to enroll in Medicare Part B when you are first eligible because you are already covered by an employer or union, you can sign up for Medicare Part B any time you are still covered by group insurance, or during a Special Enrollment Period.
Your eight-month Special Enrollment Period begins either the month that your employment ends or when your group health coverage ends, whichever occurs first.
Note: COBRA and retiree health coverage are not considered employer coverage, and don’t qualify you for the special enrollment period.
Understanding the Medicare Plans and Options Available to You
Medicare Advantage Plans (Medicare Part C), Medicare Supplement Plans (also known as Medigap Plans) and Medicare Part D (Prescription Drug Insurance) are not included with Original Medicare. These plans must be purchased from Medicare-approved private insurance companies.
Medicare Advantage Plans combine all the benefits of Original Medicare Parts A and B, and often include prescription drug coverage. Additionally, some plans include dental, vision and hearing coverage, and other extra benefits, all for a single monthly plan premium. You must be enrolled in Original Medicare to be eligible to switch to a Medicare Advantage Plan.
All these plans are offered during different enrollment periods and have different eligibility requirements. Talk to a trusted insurance agent to walk you through the various plans available and to help determine which of these plans might be right for you. Your insurance agent can also help walk you through the enrollment process.