The Ins and Outs of Medicare Enrollment
Can you give me a brief rundown of Medicare's enrollment choices along with when and how to sign-up?
The rules and timetables for Medicare enrollment can be confusing to many new retirees, so it is wise to plan ahead. Here is a simplified rundown of what to know.
First, a quick review. Remember that original Medicare has two parts: Part A provides hospital coverage and is free for most people. Part B covers doctor's visits and other medical services, and costs $170.10 per month for most enrollees in 2021.
Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later.
You can enroll any time during the "initial enrollment period," which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. It is best to enroll three months before your birth month to ensure your coverage starts when you turn 65.
If you happen to miss the seven-month sign-up window for Medicare Part B, you will have to wait until the next "general enrollment period" which runs from January 1 to March 31 with benefits beginning the following July 1. You will also incur a 10 % penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium. You can sign up for premium-free Part A, at any time with no penalty.
Special rules apply if you are eligible for Medicare and still working. If you have health insurance coverage through your employer or your spouse's employer, and the company has 20 or more employees, you have a "special enrollment period" during which you may sign up. This means that you can delay enrolling in Medicare Part B and will not be subject to the 10 % late-enrollment penalty, so long as you sign up within eight months of losing that coverage.
Be aware that original Medicare does not cover prescription medications. If you do not have creditable drug coverage from an employer or union, you will need to buy a Part D drug plan from a private insurance company (see Medicare.gov/plan-compare) during your initial enrollment if you want coverage. If you enroll later, you will incur a premium penalty – 1% of the average national premium ($33 in 2022) for every month you do not have coverage.
If you choose original Medicare, it is also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B in order to help pay for items that are not covered by Medicare such as copayments, coinsurance and deductibles. See Medicare.gov/medigap-supplemental-insurance-plans to shop and compare policies.
Instead of getting original Medicare, plus a Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan that covers everything in one plan (see Medicare.gov/plan-compare). Nearly half of all new Medicare enrollees are signing up for Advantage plans.
These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper premiums. However, the deductibles and co-pays are usually higher. Many of these plans also provide coverage for extra services not offered by original Medicare such as dental, hearing and vision coverage along with gym/fitness memberships. Most plans also include prescription drug coverage.
If you are already receiving your Social Security benefits before age 65, you will automatically be enrolled in Part A and Part B. You will receive your Medicare card about three months before your 65th birthday. It will also include instructions on how to return it if you have work coverage that qualifies you for late enrollment.
If you are not receiving Social Security, you will need to enroll either online at SSA.gov/medicare or over the phone at 800-772-1213.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.
The rules and timetables for Medicare enrollment can be confusing to many new retirees, so it is wise to plan ahead. Here is a simplified rundown of what to know.
First, a quick review. Remember that original Medicare has two parts: Part A provides hospital coverage and is free for most people. Part B covers doctor's visits and other medical services, and costs $170.10 per month for most enrollees in 2021.
When to Enroll
Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later.
You can enroll any time during the "initial enrollment period," which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. It is best to enroll three months before your birth month to ensure your coverage starts when you turn 65.
If you happen to miss the seven-month sign-up window for Medicare Part B, you will have to wait until the next "general enrollment period" which runs from January 1 to March 31 with benefits beginning the following July 1. You will also incur a 10 % penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium. You can sign up for premium-free Part A, at any time with no penalty.
Working Exceptions
Special rules apply if you are eligible for Medicare and still working. If you have health insurance coverage through your employer or your spouse's employer, and the company has 20 or more employees, you have a "special enrollment period" during which you may sign up. This means that you can delay enrolling in Medicare Part B and will not be subject to the 10 % late-enrollment penalty, so long as you sign up within eight months of losing that coverage.
Drug Coverage
Be aware that original Medicare does not cover prescription medications. If you do not have creditable drug coverage from an employer or union, you will need to buy a Part D drug plan from a private insurance company (see Medicare.gov/plan-compare) during your initial enrollment if you want coverage. If you enroll later, you will incur a premium penalty – 1% of the average national premium ($33 in 2022) for every month you do not have coverage.
Supplemental Coverage
If you choose original Medicare, it is also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B in order to help pay for items that are not covered by Medicare such as copayments, coinsurance and deductibles. See Medicare.gov/medigap-supplemental-insurance-plans to shop and compare policies.
All-In-One Plans
Instead of getting original Medicare, plus a Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan that covers everything in one plan (see Medicare.gov/plan-compare). Nearly half of all new Medicare enrollees are signing up for Advantage plans.
These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper premiums. However, the deductibles and co-pays are usually higher. Many of these plans also provide coverage for extra services not offered by original Medicare such as dental, hearing and vision coverage along with gym/fitness memberships. Most plans also include prescription drug coverage.
How to Enroll
If you are already receiving your Social Security benefits before age 65, you will automatically be enrolled in Part A and Part B. You will receive your Medicare card about three months before your 65th birthday. It will also include instructions on how to return it if you have work coverage that qualifies you for late enrollment.
If you are not receiving Social Security, you will need to enroll either online at SSA.gov/medicare or over the phone at 800-772-1213.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.
Published February 18, 2022
