Enrolling in Medicare can almost be as tricky as navigating Medicare coverage options. Here’s everything you need to know about enrolling in Medicare.
When Can I Enroll?
Initial Enrollment Period
Your first chance to enroll in Medicare is called your Initial Enrollment Period (IEP). This 7 month enrollment period is different for each person, beginning 3 months before your 65th birthday and ending 3 months after your 65th birthday. For example, if your birthday is June 15, your IEP would begin on March 1 and end on September 30th.
If you are already receiving Social Security benefits at the time your IEP begins, you will automatically receive a Medicare enrollment package in the mail from the Social Security Administration. This package will include your Medicare Card in it.
If you have not yet started drawing Social Security, you’ll need to contact the Social Security Administration to enroll in Medicare. You may contact them via phone or enroll on the SSA.gov website. Our consultants understand this process very well and can walk you through it, if you need any assistance. About two weeks after you sign up you can expect to receive the same Medicare enrollment package.
The Medicare enrollment package will include important information that you will want to read before making important Medicare decisions. The main decisions you’ll need to consider are:
Do you want to sign up for Medicare Part B?
This is an important decision to get right as there may be penalties for delaying enrollment in Part B. If you do want to sign up for Part B coverage, do you want to receive your benefits through Original Medicare or a Medicare Advantage Plan? Even if you decide that you want a Medicare Advantage plan, you will still have to enroll in Original Medicare (Part A and Part B)
Signing up for Original Medicare is fairly simple, as the benefits are the same for everyone. However, the Plan B monthly premium is based on your income, and premiums can change on an annual basis.
Original Medicare will cover approximately 80% of your medical costs. You will likely want to cover the remaining 20% with a Medicare Advantage (also known as Part C) Plan or a Medicare Supplement (also known as Medigap) Plan.
If you do want to sign up for Part B coverage, do you want to receive your benefits through Original Medicare or a Medicare Advantage Plan?
Enrolling in a Medicare Advantage Plan or a Medicare Supplement Plan can be a little more difficult because you will choose a plan through a private insurance company in your service area. Many Medicare Advantage Plans also include Part D, which is Prescription Drug Coverage, and extra benefits. If you choose to enroll in Original Medicare however, you will still want to consider signing up for a Medigap (also known as a Medicare supplement) plan and a Part D plan. Medicare Supplement Plans are optional, but if you are not enrolling in Part C, you will want to consider another option that will limit your out-of-pocket medical costs. Original Medicare doesn’t have a limit to your cost responsibility. Also, if you do not enroll in Part D, you may be subject to penalties.
For most people, this amount of information and making a decision can be overwhelming. If you are comparing Medicare plan options, it might be a good idea to discuss your options with a Licensed Insurance Consultant. Our consultants can help you understand the differences between plans and make the right enrollment decisions for your needs, now and in the future.
General Enrollment Period
If you decided to delay Medicare Part B enrollment during your Initial Enrollment Period, you will still be able to enroll during the Annual Election Period which is October 15 to December 7 each year. Choosing to enroll during this period will activate your Medicare Part B for the following January 1. You may also activate your Medicare Part B during the Medicare General Enrollment Period (GEP). The General Enrollment Period occurs annually from January 1 through March 31 and if you choose to activate your Medicare using this election period, your Medicare will become effective the following July 1st. Be aware that you may be subject to penalties for delaying enrollment in Part B.
Special Enrollment Periods
If you previously delayed Medicare Part B enrollment because you were receiving group health insurance through your or your spouse’s employer, you may qualify for a Special Enrollment Period (SEP). A SEP is the only way to sign up for Medicare outside of the IEP and GEP windows.
There are many situations that may qualify you for a SEP, like your coverage or employment ending. Like other enrollment periods, a SEP is only available for a limited amount of time after your qualifying event. We recommend speaking with a Licensed Insurance Consultant who can discuss all of these opportunities with you and help you figure out the proper path you should consider.
Now that you know when to apply for Medicare we can focus on how.
How Do I Enroll?
If you are enrolling in Original Medicare you will need to go through the Social Security Administration. You can apply online, over the phone, or by visiting your local Social Security office. Some common documents you might need during the application process are your birth certificate, proof of U.S. citizenship, a copy of your most recent W-2, and your bank account and routing information. There may be additional forms required based on your situation.
For Medicare Advantage Plans, Medicare Supplement Plans and Prescription Drug Plans, you’re enrolling through a private insurance carrier. There are many ways to process an enrollment. This can be done online, on the phone or by mailing/faxing in an application. We strongly suggest reaching out to a Licensed Insurance Consultant for guidance to help you enroll in a plan that best suits your needs.
Our Licensed Insurance Consultants can help you through every step
By now you’ve likely realized that enrolling in Medicare is time sensitive and can be complex. One of our Licensed Insurance Consultants can help make sure you don’t miss your opportunity to enroll in a Medicare plan. There are never any fees for any of our services.