Is Medicare enrollment as complicated as it sounds? Not with some help from Norgard Insurance Group.

Medicare enrollment is incredibly important, but it can seem complicated and overwhelming. Having the right information and a great team to support and guide you, you can get the right plan without feeling stressed. With some help from Norgard Insurance Group, it can be easier than signing up for private insurance. Let’s take a look at everything you need to know before you enroll.

Who Qualifies for Medicare?

Before we look at the enrollment process, let’s take a look at who qualifies for Medicare coverage. The largest group of recipients of this health insurance program are people who are 65 years old or older. It’s a type of retirement benefit provided by the federal government, funded in part by taxes you paid into the program during your time of employment throughout your life. But seniors aren’t the only people eligible for Medicare coverage. It also extends to individuals of any age who are on Social Security Disability Insurance, as well as people of any age who suffer from End-Stage Renal Disease (ESRD). ESRD is kidney failure and this disease qualifies individuals for coverage for their care that includes dialysis or a kidney transplant.

Qualification Specifics for Part A

While anyone age 65 or older is entitled to Medicare, to receive premium-free Part A coverage, the following requirements must be met:

  1. You or your spouse must have paid Medicare taxes for at least ten years while employed. Your employer withholds these taxes from your paycheck.
  2. You currently receive or are eligible for Railroad Retirement Board retirement benefits
  3. You currently receive or are eligible for Social Security retirement benefits
  4. You or your spouse were government employees and were covered by Medicare during that time

If you are under the age of 65, there are three requirements you must meet to receive premium-free Part A benefits. These requirements are:

  1. You currently receive or are eligible for Railroad Retirement Board retirement benefits
  2. You currently receive or are eligible for Social Security retirement benefits
  3. You are on kidney dialysis or are a kidney transplant patient

If you or your spouse did not pay Medicare taxes, you can buy Part A coverage if you are age 65 or older and are a United States citizen or permanent resident. However, the majority of Americans who are old enough to enroll in the program do not need to pay Part A premiums.

What are Part A premiums? Part A is the hospital insurance portion of the program. If you have Part A premium-free coverage, this means you won’t pay a premium in the event you need inpatient care in a hospital.

Part B premiums are separate from Part A. Part B is the medical insurance portion of your program. A monthly premium is required of all individuals for Part B coverage. These premiums are deducted from your retirement payments from either your Railroad Retirement, Civil Service, or Social Security retirement benefits. If you don’t receive benefits from any of these organizations, you will get a quarterly bill for the Part B premiums you owe.

How to Enroll in Medicare

Enrolling is much easier than it sounds. At Norgard Insurance Group, we can help you through every step of the process. Here’s what it looks like for most people.

  • Are you receiving Social Security benefits?
    • Yes – if you receive benefits before you turn 65, Medicare enrollment happens automatically. You will receive a welcome letter three months before you turn 65.
    • No – If you are not receiving Social Security benefits before you turn 65, you will need to sign up.
  • Signing up:
    • If you are not receiving Social Security benefits and you are approaching your 65th birthday, you will need to sign up for Social Security benefits as well as Medicare coverage. You can do both through your local Social Security office.

When to Enroll

You can enroll in both Social Security and Medicare benefits within the three months before or the three months after you turn 65. This seven-month timeframe is called the Initial Enrollment Period. You can enroll for free Part A coverage any time during or after your Initial Enrollment Period starts. The start date of your coverage is determined by your enrollment date. Keep in mind – if you sign up for Part B after your Initial Enrollment Period, you may have to pay a late enrollment penalty, and your monthly premium will go up. Late enrollment could also cause a gap in your health insurance coverage.

For individuals who must purchase Part A or Part B, enrollment is available during a specific period. This is generally between January 1st and March 31st of each year. This enrollment period is available to you if:

  • You did not sign up during the Initial Enrollment Period when you were first eligible
  • You are not eligible for the Special Enrollment Period

What is the Special Enrollment Period? This is an enrollment window for individuals who may have missed the opportunity to sign up during their Initial Enrollment Period. The requirements for being eligible for this include:

  • You’re covered by a group health plan through your current employer
  • You or your spouse are currently working
  • If you are disabled, you or a family member are currently working

The Special Enrollment Period runs for eight months starting the month after your employment ends or the month after your group health plan coverage through your employer ends, whichever occurs first. Usually, late enrollment penalties do not apply to individuals who sign up during the Special Enrollment Period.

Count on Norgard Insurance Group for Enrollment Assistance

Understanding Medicare enrollment can be confusing, especially if you’re trying to transition from a group health plan to Medicare, or if you’re unsure of how the enrollment periods work. The good news is, Norgard Insurance Group has extensive experience with all aspects of Medicare coverage, including enrollment, and we can help. Please take a look at information regarding updates to open enrollment in 2020, and then contact our team today for help walking through the process. We’re here to help with your Medicare enrollment when the time comes.