You are first eligible for Medicare when you turn age 65. You can sign up during a 7-month period that:
- Starts 3 months before the month you turn age 65
- Includes the month you turn age 65
- Ends 3 months after the month you turn age 65
There are a few situations that most people fall into when starting Medicare.
- You are signed up to receive Social Security, are turning age 65, and wish to start Medicare at this time.
- You are turning age 65 and wish to start Medicare, however you are not signed up to receive Social Security – perhaps, you wish to defer receiving Social Security until a later date.
- You are turning age 65 and are covered by an employer health plan, which you have the option to continue.
- You are over age 65 and have been covered through an employer health plan, however your situation is changing, and you would like to sign up for Medicare now.
Each of these situations are explained in greater detail below.
1) You are signed up to receive Social Security, are turning age 65, and wish to start Medicare at this time.
If you are signed up to receive Social Security, you will be automatically enrolled into Medicare (provided that you paid into Medicare from taxes or were married to someone who did for at least 10 years). In this situation, you will receive your red, white, and blue card in the mail within 3 months of starting Medicare – just make sure Social Security has your address correct.
Medicare will start on the first day of the month when you turn age 65. If your birth date is on the first of the month, Medicare will start the first of the month prior.
When you receive your Medicare card you will see Medicare Part A and Medicare Part B are on the card, which is normal. Be sure to learn about the other parts to Medicare to determine which could be a good fit for you. There is no charge to carry Medicare Part A. There is a charge to carry Part B, which is automatically deducted from your Social Security check. To see the current monthly cost for Part B see www.SeniorSavingsServices.com/Medicare-Options.
2) You are turning age 65 and wish to start Medicare, however you are not signed up to receive Social Security – perhaps, you wish to defer receiving Social Security until a later date.
Many people choose to start receiving Social Security income at a later date.
In this situation, you will want to contact Social Security to sign up for Medicare. It will not happen automatically. To sign up for Medicare you can do one of three things:
You can call the Social Security Administration at 1-800-772-1213, or
apply online at https://www.ssa.gov/benefits/medicare/, or visit a local Social Security office to enroll. (TIP: If you choose to visit a Social Security location, you will typically find it easiest to get in and out first thing in the morning. There can be long lines to wait otherwise.) I recommend applying online.
You are able to apply for Medicare starting 3 months before turning age 65, the month you turn age 65, and 3 months after. TIP: If you sign up for Medicare the month you turn age 65 or 3 months after, the start date for your Medicare will be delayed – see https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/when-will-my-coverage-start.
To pay the Medicare Part B premium, Medicare will send you a bill in the mail to pay. If you would like, you could sign up for Medicare Easy Pay (https://www.medicare.gov/your-medicare-costs/ways-to-pay-part-a-part-b-premiums/medicare-easy-pay), which is a service that will deduct from your checking or savings account monthly.
You will want to be sure you pay the bill for Medicare Part B or you will lose your Medicare coverage and will have to reapply during the General Enrollment Period, which is January 1st thru March 31st each year. If you would have to apply using the General Enrollment Period, Part B would not start until July 1st. Further, you will have to pay a higher premium to carry Part B.
3) You are turning age 65 and are covered by an employer health plan, which you have the option to continue.
If you have decided to continue working past age 65 and your employer has more than 20 employees, you can choose to stay on your employer health insurance for as long as you are able. Alternatively, if you are married to someone and are able to carry coverage on their plan, you can keep it. In this situation, the employer plan pays first, and Medicare pays second. You may want to compare your current health coverage to that of Medicare to determine which would be a better fit for you. See related article, How Does Medicare Compare to My Employer Health Plan? (www.SeniorSavingsServices.com/compare- medicare-to-employer-coverage)
If you have decided to keep your employer health plan, you can take Medicare Part A at this time and enroll in Part B when you decide to stop working or lose that coverage. (It is best to confirm with your benefits manager before doing so.) You will NOT pay a penalty for delaying Medicare – you have within 8 months after employment ends or coverage ends (whichever happens first) to enroll into Medicare.
Also note that for COBRA coverage does not count as a creditable health coverage, for Medicare purposes, to delay signing up for Medicare. If you choose to receive COBRA coverage, you must sign up for Medicare Part B when you are eligible, in order to avoid a penalty.
If your employer has fewer than 20 employees, Medicare pays before your other employer health coverage. In this situation you should sign up for Medicare Part A and Part B when you are first eligible for Medicare.
Do know that if your employer health plan is a high deductible health plan AND you have a Health Savings Account (HSA) that you contribute to, you should not take Medicare Part A at this time. Once you enroll into any part of Medicare, you are not able to contribute to your HSA. (Reference: https://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Employers-and- Unions/FS3-Enroll-in-Part-A-and-B.pdf )
4) You are over age 65 and have been covered through an employer health plan, however your situation is changing, and you would like to sign up for Medicare now.
If you do not have Medicare Part A and/or Part B already, you will want to be sure to sign up before your employer coverage ends (I recommend within 60 days). You can sign up for Medicare online.
To sign up for Part B, you will need to have form CMS L-564 (https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf) completed by your employer. You will also need to complete form CMS 40-B (https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf). Once completed, take these forms to the Social Security office or apply online at https://www.ssa.gov/benefits/medicare/.
Medicare does allow you to start Part B up to 8 months after your employment ends or coverage ends (whichever happens first). It is important to know that you are not able to sign up for a Medicare Supplement plan or a Medicare Advantage plan if you don’t have Part B.
Late Enrollment Penalties
It is important to take the action as explained above, depending on your situation. If you do not sign up for Medicare within the specified time allowed, you could be faced with late enrollment penalties (which will stay with you for your lifetime). Additionally, you may be limited to when you can get Medicare.
Further, there is a late enrollment penalty assessed any time there is a lapse of 63 or more days when you do not have a Part D Prescription Drug Plan or other creditable drug coverage.
Creditable drug coverage can include, but not limited to, current or former employer health plan, union plan, TRICARE, Veteran’s Benefits, or Indian Health Services.
What else should I know?
It is good to be aware that when you enroll in Part B it starts your enrollment period of when you can get other coverage including a Medicare Supplement plan or Medicare Advantage plan.
You get one Medicare Supplement Open Enrollment Period, which is a 6-month period of time where you cannot be asked any medical questions. After this enrollment period, you can be asked medical questions to obtain a Medicare Supplement plan. A knowledgeable insurance broker can explain which companies and options you will have based on answers to some medical questions.
While this article is meant to cover some common situations, it may not have covered yours. Do you have a different situation and want answers to what you should do? Please don’t hesitate to call me directly.