You may already know that you are eligible for Medicare when you turn 65. But that doesn’t mean you are automatically enrolled. To receive Medicare benefits you will need to take the necessary steps to enroll, unless you are already receiving Social Security benefits, in which case you are automatically enrolled.
If your 65th birthday is coming up, you may have some questions about Medicare and what you should do. Here are some of the most common questions that come up regarding Medicare enrollment.
Do I Have to Sign up for Medicare When I Turn 65?
You become eligible for Medicare at the age of 65, but you are not obligated to enroll. As stated above, you can delay your Medicare enrollment if you have employer coverage, but be careful putting it off if you have private insurance. If you are already receiving Social Security benefits, you are automatically enrolled and you won’t need to do anything to sign up for coverage.
Do I Have to Sign up for Medicare If I Have Private Insurance?
You are under no obligation to sign up for Medicare at any time. However, it is important to be aware that there are some disadvantages to forgoing your Medicare benefits. If you do not sign up for Medicare Part B when you are eligible, you may be subject to penalties if you decide to sign up later on. One such penalty is that your premium may go up by 10% for each 12 month period of time you chose not to enroll in Medicare Part B when you were eligible. There are exceptions to this penalty if you have insurance through your employer or your spouse’s employer. But if you have private insurance, there is no exception to the penalty.
Is Medicare Better Than Private Insurance?
Not necessarily. There are advantages and disadvantages to both Medicare and private insurance. In general, private insurance may come with a higher premium than Medicare, but it often covers things that Medicare doesn’t. Private insurance often includes prescription coverage, where Medicare doesn’t unless you opt to add Medicare Part D for an additional cost.
Many people can benefit from a Medicare supplement plan to help cover any gaps in coverage. Medicare Advantage plans are offered by private insurance insurance companies to provide additional coverage for those that need it.
Can I Have Medicare and Private Insurance?
Yes, you can have both Medicare and private insurance coverage at the same time. If you are still eligible for benefits through your employer or COBRA, you can elect to keep that coverage and add Medicare. There are specific guidelines that determine which coverage pays first and which coverage pays second, depending on the situation.
Do I Have to Sign up for Medicare at 65 If I’m Still Working?
You do not have to sign up for Medicare if you are 65 and still working, as long as your employer has at least 20 employees and offers group insurance coverage. However, you can sign up for Medicare Plan A while you are still covered under an employer-provided insurance plan. It won’t cost you anything to enroll and it may cover some things your other insurance plan doesn’t cover. The only reason not to would be if your current plan has a high deductible with an HSA (Health Savings Account). You cannot continue to contribute to an HSA when you are enrolled in Medicare. While you are covered under your employer’s plan, you can forgo Medicare Plan B without penalty.
So, When Do I Have to Sign up for Medicare?
You become eligible to enroll in Medicare 3 months before your 65th birthday. In many cases you will receive information about Medicare through the mail about 3 months before your birthday. You may also receive emails and other communications informing you about your options as your birthday approaches. There are two basic time periods when you can enroll in Medicare:
- Within the 7 month period around your 65th birthday. You have 3 months before your birthday, the month of your birthday, and 3 months after your 65th birthday to complete your enrollment in Medicare.
- Open enrollment (October 15 – December 7). Each year there is an open enrollment time period from October 15-December 7 where anyone who is eligible can sign up for Medicare.
- Within the 8 month period following the termination of your employer’s coverage. If you leave your job or your employer ends your benefits for any reason, you then have 8 months to enroll in Medicare. This special enrollment period begins the month after your employer’s health insurance coverage ends.
Which Medicare Coverage Plan Is Right for Me?
With so many Medicare plans it can seem difficult to determine which plan is right for you. For most people, a combination of plans is the best option to ensure you don’t have gaps in your coverage and end up paying too much out of pocket.
- Medicare Part A: This portion covers hospitalization, including nursing facilities and hospice.
- Medicare Part B: This is your medical insurance coverage for expenses unrelated to hospital stays, such as doctor’s appointments.
- Medicare Part C: This includes Medicare Advantage plans for those who need coverage for a specific health condition or need.
- Medicare Part D: This is your prescription coverage for medications. It covers most, but not all, prescription medications.
Many people can have their healthcare needs met by a combination of Part A, B, and D. Some will benefit from Part C to cover additional costs. There is often no cost associated with Part A, but you will need to pay a premium for Part B, C, and D.
What About Medicare Supplemental Insurance?
To ensure you have the full coverage you need, you may want to consider a Medicare supplement plan. This helps to cover medical expenses that the other parts of Medicare do not, such as copays, coinsurance, and deductibles. Medicare Part D offers prescription coverage, but may not cover every medication you need. A Medicare supplement plan may cover what Part D doesn’t. Part C, Medicare Advantage plans, will also cover additional healthcare costs. It can help to look over what is covered under each plan to determine what coverage you need.
Need Help With Medicare Enrollment? Ask the Experts at Norgard Insurance Group
Medicare, because anyone 65 or older is eligible, may seem simple. But enrollment isn’t always as easy as it seems. There are different plan options under Medicare and specific rules that apply to private and employer provided insurance. There are also Medicare supplement plans that can help you get the most coverage and keep your out of pocket expenses low. Norgard Insurance Group specializes in Medicare coverage and offers a range of supplemental plans that can help you cover all your bases.