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Are You Close to Turning 65? Have You Applied for Medicare?

| April 10, 2019

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Are you close to turning 65? Did you just turn 65? If the answer is yes to either of those questions, and you haven’t considered your requirement to sign-up for Medicare, you could be in for some pain later. Unless you are covered by an employer plan at the time you turn 65, it’s important to realize you are required to enroll in Medicare. Or else…

There is a 7 month enrollment period for Medicare. You can enroll up to 3 months before the month you turn 65, or 3 months following the month you turn 65. You want to ensure you enroll in this period, or there will be penalties. To be safe, enroll before your birthday to ensure you are covered starting at your birthday, without a lapse in coverage (assuming your employer was covering you before). There is a stiff 10% per month penalty for every full 12-month period that you are not enrolled. If you miss the 7 month window, you can’t enroll again until the General Enrollment Period, which is from Jan 1 to March 31st.

To enroll in Medicare, you’ll do so by going to the following link: https://www.ssa.gov/planners/retire/justmedicare.html. If you’ll be signing up for Social Security for the first time, you can sign up for Medicare at the same time, by going here: https://www.ssa.gov/retire.

If you aren’t currently employed or covered by an employer sponsored plan, you’ll want to at minimum sign up for Part A, B and D. Part A covers hospital stays, B covers physicians, and D covers prescriptions. Given the gaps in coverage, you’ll likely want to purchase a Medicare Advantage plan (Part C), which is private insurance that basically gives you Part A and B coverage and covers the rest of the expenses that regular Part A and B don’t cover (deductitbles, co-pays, etc.). You obtain Part A and B coverage by enrolling in with Social Security department directly. Part C and D you purchase separately from an insurance company.

Below are a few good published article links to get you primed on Medicare with a brief summary of each article. Each one provides some nuance in different aspects of the coverage:

The first article is from a Medicare private insurance company that walks you through when and how to apply for Medicare online, over the phone, or in-person. It also answers some common questions. We aren’t necessarily recommending them, just had some good info. They will also direct you to some of their Medicare Advantage and Prescription plans, if desired: https://boomerbenefits.com/new-to-medicare/apply-for-medicare/.

The next article is a general outline of the four parts of Medicare, Part A, B, C and D. It also includes links to more detailed information on each Part’s coverage. It’s helpful, in outlining when you need to enroll in Medicare (7 month window around your 65th birthday). It also has some other useful links you can connect to: https://www.elderlawanswers.com/turning-65-what-you-need-to-know-about-signing-up-for-medicare–8968.

This article is very useful and highlights several overlooked items. First it touches on the misconception that COBRA coverage exempts people from having to enroll in Medicare. If you are covered by a COBRA, you still have to enroll in Medicare during your allotted time period, or face stiff penalties. It also highlights the fact that small employers of 20 or fewer employees, will ultimately result in the requirement that their employees enroll in Medicare at age 65, during the enrollment window. Employers of 20+ employees, will often have plans that allow their employees to defer Medicare enrollment until they are no longer employed and covered by the employer plan. It also outlines the fact that private insurance bought under the Affordable Care Act isn’t Medicare. You must switch to Medicare at 65, if covered by these plans: https://www.nytimes.com/2019/01/31/business/medicare-enrollment-how-to-sign-up.html.

Having health coverage is important. When it comes to Medicare, it’s required.