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Tips for Enrolling in Medicare
Vicky Warren · September 12, 2019 · 4 min read
Most U.S. seniors are eligible for Medicare when they turn 65. If you’re looking forward to your 65th birthday, it’s time to consider how you’ll enroll in Medicare, as there are several options you can choose from.
Here are a few things to consider when it’s time to sign up:
1. Begin Researching Medicare Early
You’ll want to begin researching your Medicare options at least three months before signing up. Having a grasp on the terminology, plan types and options will help you understand what you’ll receive when it’s time to enroll.
Medicare has four “parts” and each covers different aspects of your healthcare.
Medicare Part A: covers hospitalization and some other facilities like hospice care and home health care.
Medicare Part B: covers preventive services, medically necessary services, clinical research, and ambulance services.
Medicare Part C: Medicare Advantage plans, similar to private insurance plans offering an alternative to Part A and B plans.
Medicare Part D: covers prescription drugs
There are many ways to learn about Medicare. The official Medicare site is a good place to start.
2. There is a set Medicare Initial Enrollment Period to sign up for Medicare
The Medicare Initial Enrollment Period (IEP) is based on your 65th birthday. It’s seven months long and covers:
3 months prior to your 65th birthday
The month you turn 65
3 months after you turn 65
If you are receiving social security or Railroad Retirement benefits before turning 65, you will be automatically enrolled in Part A and Part B when you turn 65. Your IEP still applies, so that you can make additional coverage choices.
If you’re not receiving the benefits mentioned above, you’ll need to sign up for Medicare online or at your local social security office.
Your local social security office is the place to go with any questions you may have as well as where you can register in person for Medicare.
3. You can choose Original Medicare or Medicare Advantage Plans
Medicare Parts A & B are considered Original Medicare and are administered by the Federal Government.
Medicare Part C, known as Medicare Advantage plans, are offered by private insurance companies and approved by Medicare. These plans have the same benefits as Original Medicare plans, and typically include extra benefits like prescription drug coverage, dental, vision, and hearing – in one plan.
To be eligible for a Medicare Advantage plan, you must be enrolled in Medicare Part A&B.
4. You can get additional coverage to fill the gaps Original Medicare doesn’t cover
If you choose Original Medicare, you can add Medicare Part D, for stand-alone prescription drug coverage, offered by private insurance companies and approved by Medicare.
In addition, you can purchase a Medicare Supplement Plan, known as Medigap to pay for some of the costs Original Medicare doesn’t cover like deductibles, copays, and coinsurance.
To note, you cannot have a Medicare Supplement Plan and a Medicare Advantage Plan together. If you want to utilize a Medigap plan, you must have Original Medicare.
5. Annual out-of-pocket expenses are capped with Medicare Advantage Plans
Medicare Advantage plans have terms and must set an annual out-of-pocket maximum. Once you’ve reached the max out-of-pocket, plans pay 100% of Medicare-covered services.
Medicare Advantage plans may have a monthly premium. Whether they do or not, you still have to pay the Part B Medicare premium.
With many Medicare Advantage plans, you won’t need additional coverage.
6. Call Social Security with any questions
You can sign up for Medicare through the Social Security Administration.
There are several options to choose from when signing up. You’ll want to have a firm understanding of each plan so you can select the best options. If you have any questions, or anything is unclear, reach out and ask questions. Head to the Medicare.gov site and enter your state information in the handy search function under, “Find someone to talk to,” to find help.
You may consider reaching out to a trusted friend or relative to help you navigate the process.
When it comes to Medicare, knowledge is power. Gather as much information as you can to choose the best Medicare plan for you!
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