Turning 65 Soon? How to Enroll in Medicare.
What’s your situation?
- You’ll be turning 65 this year, and you plan to apply to start receiving Social Security at that time.
- You’ll be turning 65 this year, but you plan to keep working and not apply for Social Security until you can receive full benefits at age 66.
In either situation, you should enroll in Medicare within the initial enrollment period. This period is the seven months surrounding your 65th birthday (3 months before, your birth month, 3 after). Can you enroll later? Yes. But enrolling after this initial period usually means that you will pay late enrollment penalties. That typically means that premiums for applicable parts of Medicare are a little higher, in most cases for as long as you are insured.
To start, let’s look at what Medicare is.
Medicare is the federal health insurance program for people who are age 65 or older. It is also available to younger people who have certain disabilities or permanent kidney failure (called End-Stage Renal Disease) that requires dialysis or a transplant.
If you apply for Social Security at age 65, you will automatically get Medicare coverage for hospital insurance (Part A) and medical insurance (Part B). If you’ve paid Medicare payroll taxes during your working life (and most workers have), then there is no charge for Part A. But there is a small monthly premium for Part B. Premiums for part B are usually deducted directly from your monthly Social Security Payment.
If you don’t plan to apply for Social Security until you are age 66 or older, then you will need to apply separately for Medicare coverage during the seven month period around the date you turn age 65. Although you could wait until later to apply for Medicare, late enrollment penalties mean you will pay more for Part B coverage and other coverage such as a Prescription Drug Plan unless certain special circumstances apply. You will directly pay premiums for Part B (and part D or an Advantage plan) until you apply for Social Security; Medicare will bill you.
Enrolling in Medicare:
Enrolling in Medicare During the Initial Enrollment Period.
Medicare’s “initial enrollment period” is seven months long: It includes the 3 months before you turn 65 (the recommended time to enroll), the month you turn 65, and the 3 months after your birthday. If you wait until the last 4 months of the initial enrollment period, your coverage will be delayed from 1 to 3 months after you enroll.
Enrolling is easy and you can do it in a few minutes online. Just go to Medicare.gov and follow the links.
If you don’t enroll in Medicare during this initial enrollment period, then you can apply between January 1 and March 31 each year. But you usually will have to pay a higher premium for late enrollment.
Is saving money the only reason to enroll in Medicare when you are first eligible? No. That’s not necessarily the most important reason. U.S. insurance companies (and healthcare providers) expect that older Americans will enroll in Medicare and, as a result, the insurance plans and options they offer to older Americans take this expectation into account.
What Choices and Decisions Will You Need to Consider When Applying for Medicare?
Decide first between Original Medicare or a Medicare Advantage Plan
- Original Medicare includes hospital insurance (Part A) and medical insurance (part B)
- It provides direct coverage
- You can choose your doctors, hospitals, and other providers, so long as they accept Medicare
- You typically have some deductibles or co-pays but you may purchase supplemental coverage (Medigap Insurance) to cover those. Medigap insurance is provided by Medicare-approved private insurance companies and you can compare coverages and costs.
- You usually pay a monthly premium for Part B
- If you want coverage for prescription drugs, you must choose and pay a premium for Part D Prescription Drug Plans. These plans come from approved private insurance companies. Drugs covered and costs differ among available plans so you will need to compare these.
- Medicare Advantage Plans (called Part C) include hospital insurance (Part A) and medical insurance (Part B) and, usually, prescription drug coverage (Part D).
- These plans are provided by approved private insurance companies.
- In most Advantage plans, you need to use doctors, hospitals and other healthcare providers that participate in the plan or you may pay more or all of the cost.
- Advantage plans usually include a premium in addition to Part B. They may or may not cover co-pays.
- Advantage Plan coverages and costs vary among companies and plans so you need to carefully compare which meet your needs before applying.
- Prescription drugs are covered by most Advantage plans but the list of specific drugs covered (the formulary) varies among plans and companies.
- It is illegal for any insurance company or broker to try to sell you Medigap insurance if you have an Advantage Plan.
How Do You Get Started with Enrollment?
The easiest and best way is to use the online application process at www.Medicare.gov. Before you actually begin the application process, you can use the many educational resources available to learn more about Medicare options and which will help you meet your health needs and financial considerations.
We recommend two publications:
If you need to talk live to a real person, you can find contact information for both the national Medicare office and your state resources on the site.
If the big 65 year is looming in your future, take a little time soon to visit the Medicare.gov website. A little clicking through the helpful resources available there will help you plan ahead. A little effort now can help you get the health care coverage you need at the best price. That can make a difference to the future.
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