If you are turning 65 years old soon, it’s time to get ready for Medicare! Medicare is health insurance provided by the federal government for those 65 years and older and those who qualify earlier because of a disability. Medicare can be overwhelming once you start learning about the different Medicare parts and plans, so you should learn about Medicare before you apply. Here is what you need to know about signing up for Medicare.
Avoid late enrollment penalties
There is a specific time you will want to enroll in Medicare. Most people enroll in Medicare Part A and Part B during their Initial Enrollment Period (IEP). The IEP begins three months before your 65th birthday month and ends three months after your birthday month. Therefore, you have seven months to enroll in Medicare.
For example, if you turn 65 on July 13, 2022, your IEP begins on April 1 and ends on October 31, 2022. You will enroll in Medicare through the Social Security office during this time. If you fail to enroll in Medicare during your IEP, you will be charged with a lifelong late enrollment penalty once you do enroll in Medicare. You would pay this penalty for as long as you are enrolled in Medicare, and you will pay this additional charge along with your Medicare premiums.
How you can delay Medicare
Many senior citizens work past age 65 and can delay Medicare due to health coverage from their large employer. Suppose you work for a large employer with 20+ employees and are covered by their group health plan. In that case, you can delay enrolling in both Medicare Part A and Part B. If you were to enroll in Medicare while having insurance through your large employer, your work insurance would be primary, and Medicare would pay as secondary.
If your employer has less than 20 employees or you are retired and covered by retiree insurance, you will need to enroll in Medicare during your Initial Enrollment Period. If you fail to do so, you will be charged a late enrollment penalty.
Understand how Medicare provides coverage
As briefly mentioned above, the Medicare parts you will enroll in during your Initial Enrollment Period are Medicare Part A and Part B. It would be helpful to know what type of coverage these parts will provide you before signing up for Medicare.
Medicare Part A provides inpatient hospital coverage whenever you are admitted to the hospital. Part A covers:
- Semi-private room
- Three meals a day
- Medications you are administered during your stay
- Lab services
- Home health care
- Hospice care
- Skilled nursing
Medicare Part B covers outpatient services. Therefore, Part B will not cover services you receive as an inpatient at the hospital. Part B provides coverage for:
- Ambulance rides
- Durable medical equipment
- Doctor office visits
- Certain vaccinations
- Home health care
- And more
Without Medicare Part A or Part B, you would pay the total cost for your inpatient and outpatient services.
Become aware of your coverage options
Original Medicare Part A and Part B do not cover every healthcare service 100%. You will have out-of-pocket costs for many services, which is why it’s beneficial to become aware of your additional coverage options to help you with out-of-pocket expenses. There are two plans to consider: a Medigap or Medicare Advantage plan. These plans are sold by private insurance carriers or Medicare brokerage.
Medigap plans, also known as a Medicare Supplement, work alongside Original Medicare and pay as secondary insurance whenever you receive Medicare-approved services. Since Medicare does not have network restrictions, neither does a Medigap plan. You can travel and visit any doctor in America that accepts Medicare. If the doctor accepts Medicare as insurance, they must take a Medigap plan, no matter the carrier or plan type.
Whenever you enroll in a Medicare Advantage plan, you will opt to get your Medicare Parts A and B benefits through the private insurance carrier you purchase your plan through. You would no longer get your benefits through the U.S. government.
Since you will receive all your benefits through your carrier, the company will set the cost-sharing amounts for your services, as well as a network of doctors and pharmacies where you can receive your healthcare services from. Medicare Advantage plans can include additional benefits Original Medicare does not typically cover, such as a routine dental, vision, or hearing exam.
It’s never too early to learn about Medicare’s different parts or plans. Before you sign up for Medicare, join a free Medicare webinar or reach out to a reputable Medicare brokerage to ensure you are going in the right direction during your Medicare enrollment