Getting Started on Medicare

 

When to enroll in Medicare

When you are about to turn 65 

People—including those who started to receive Social Security or other benefits before turning 65—are automatically signed up for Medicare Parts A and B, when they turn 65.

Everyone else must enroll on their own. Enroll by visiting your local Social Security office or calling Social Security at 800-772-1213.

If you would like to sign up for Medicare Part A and/or Part B when you turn 65, you have seven months to sign up, called Initial Enrollment Period (IEP). This seven-month period includes: the three months before the month you turn 65; the month you turn 65; and the three months following.

If you miss your initial enrollment for whatever reason, you can sign up for Medicare Part A and/or Part B during the General Enrollment Period (GEP) that runs from January 1 through March 31 of every year.

You may have to pay a late enrollment penalty if you did not sign up when you were first eligible.

 

Working past age 65

If you continue working past 65 and finally decide to retire, you have eight (8) months to enroll in Medicare. This eight-month period is called Special Enrollment Period (SEP). But you have only two months to enroll into a Part D program or a Medicare Advantage plan and avoid paying a penalty.

If you have health coverage through your or your spouse’s employer, for example, because you continue to work past 65, you may be able to defer enrolling in Medicare without paying a late enrollment penalty. However, you must have a proof of creditable coverage.

Contact your employer’s HR benefits administrator for more information.

 

Get More from Medicare

Decide Between Original Medicare and Medicare Advantage

When you enroll in Medicare for the first time, if you do nothing, you’ll automatically be signed up for original Medicare. You can add drug coverage by signing up for a Part D plan.

You pay a set amount for your health care (deductible) before Medicare starts paying. Then, Medicare pays its share, and you pay your share (coinsurance or copayment) for covered services and supplies.

 

Medicare Advantage Plans

Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans must cover all of the services that Original Medicare covers.

Some plans may offer extra benefits that Original Medicare doesn’t cover, like vision, hearing and dental services. Out-of-pocket costs vary in each plan.

In addition, all Medicare Advantage plans limit out-of-pocket costs and most also include Part D drug coverage. If you get your drug coverage somewhere else, you can select a Medicare Advantage plan that doesn’t include Part D.

Medicare Advantage plans may require members to see healthcare providers in the plan’s network.

 

Sign Up for Part D Even if You Don’t Take Many Prescriptions

If you stay with original Medicare, and even if you don’t take any medications now, consider signing up for Part D (Medicare’s prescription drug plan) right from the start.

If you wait, and enroll later, you may end up having to pay a higher premium (late enrollment penalties).

 

Apply for Extra Help

If you have limited income and resources, you may qualify for the federal Extra Help program, which helps people cover their Medicare Prescription Drug Plan costs. If you’re already enrolled in Medi-Cal, Supplemental Security Income, or a Medicare Savings Program, you automatically qualify for Extra Help. If you’re not enrolled in those programs, you can apply by contacting the Social Security Administration.

 

Annual Enrollment Period

Annual Election Period (AEP) is the period each year during which you may change your Medicare coverage options for the upcoming year. Annual Election Period runs from October 15 to December 7 each year. Any plan change you make is effective January 1 of the new year.

Each year, Medicare health plans and Part D prescription drug plans allow changes to their premiums, deductibles, cost-sharing, and some benefits. You need to be aware of how your plan may change and prepare accordingly. Even if you like your current plan, it is important to review the changes and compare options to determine which plan offers the coverage you need in the new year.

 

Open Enrollment Period

There’s a Medicare Advantage Open Enrollment Period that runs from January 1 through March 31 every year. Those who selected a Medicare Advantage plan can change their option one time during this time.

Attend a Medicare education event to learn more about how Medicare works and what to do to avoid paying late enrollment penalties for the rest of your life.

Click HERE to see the list of Medicare 101 sessions in your area and reserve your spot.