If you live in the USA, you’ll know that medical expenses can pile up, especially as age-related afflictions start to occur more frequently.
The average hospital stay can cost over $ 3,500 per day. Fortunately, Medicare’s available to all citizens over the age of 65, to help cover the expenses related to healthcare for seniors.
Nobody’s immune to disease or injury at any age, but we’re particularly vulnerable when we reach our Golden Years.
So, if you qualify for Medicare, it’s a good idea to sign up, so you can enjoy your retirement, without having to worry about excessive medical expenses.
Here’s what you need to know about Medicare enrollment.
Automatic Medicare Enrollment
Medicare covers most major medical costs, as follows:
- Part A covers in-hospital care, some home health care, and care in a nursing facility
- Part B pays for medical supplies, outpatient care, preventive care, and doctors’ services
- Part C comprises private health insurance i.e. Medicare Advantage
- Part D is an optional policy that pays for prescription drugs and vaccines
If you’re like most people in the USA, you would have paid towards Medicare throughout your working life. That means the government will automatically enroll you into Medicare Part A and B when you turn 65.
People who receive social security, are automatically enrolled in Medicare Parts A and B at this time too.
If you want to forego Part B, you can do so. yet, you’ll have to pay a penalty if you decide to sign up for Part B at a later stage though.
This penalty amounts to a 10% increase on your premium for every 12 months you delay enrolling in Part B. You’ll have to pay this elevated premium for as long as you’re covered by Medicare.
You’ll know you’re enrolled when you receive your membership card in the post.
When Do You Have to Enroll in Medicare Manually?
In the following circumstances, you’ll have to enroll yourself in Medicare during the IEP (Initial Enrollment Period):
- If you’re not receiving retirement benefits
- If you’ve decided to delay your Social Security retirement benefits or Railroad Retirement Benefits
- If you don’t qualify for retirement benefits
All US citizens over the age of 65 are eligible to receive Medicare senior healthcare, so you’re entitled to apply during the IEP regardless of your circumstances.
If you don’t receive automatic enrollment, you will have to pay premiums based on how long you’ve paid into the Medicare fund while employed.
Initial Enrollment Period for Medicare
There’s no fixed date that signifies when the IEP starts and ends, it’s unique to each individual.
When you turn 65, you have seven months to enroll with Medicare. This enrolment period runs from the three months before you turn 65 until three months after the month of your birthday.
During this enrolment period, you can sign up for the following Medicare programs:
- Parts A and B of Medicare
- A Medicare Advantage Part C Plan
- Medicare Part D prescription drug plans
If you don’t make use of the initial enrolment period, you may have to pay penalties if you have pre-existing medical conditions or a late enrolment fee.
You must have Medicare Part A and B to sign up for an Advantage Plan. So, if you opt-out of Part B initially, you can still sign up for Medicare Advantage once you’ve added Part B to your coverage.
The deadlines for this are three months before you have Original Medicate until the later of these two dates:
- The last day of your Initial Enrollment Period
- The last day of the month before you have Medicare Part A and B
Do you need some more clarity on all these different dates? Medicare On Video offers a simplified explanation, courtesy of a Medicare specialist.
How to Sign Up for Medicare During the IEP
Although there are other times you can sign up for Medicare, the easiest way to get the Medicare coverage you need is during the IEP. Here’s how to sign up manually for Medicare at this time:
- Visit your nearest Social Security office
- Call Social Security Administration at 1 (800) 772-1213
- Mail a dated and signed letter with all your details to the Social Security Administration office.
- Apply online at www.ssa.gov
If you’re eligible for Railroad Retirement benefits, you can enroll in Medicare by contacting the RRB or your local RRB field office telephonically.
Keep proof of all your correspondence, so you can avoid penalties if your application goes astray.
Should you miss the IEP for any reason, you can still apply for Medicare during the annual General Enrolment Period.
Medicare General Enrollment Period
The general enrolment period runs from January 1st to 31 March every year. If you’re already signed up for Medicare, you can switch to a Medicare part C plan and add a Medicare supplement plan at this time too.
If you didn’t sign up during the Initial Enrollment Period, this is your chance to do so. You might still have to pay penalties though.
Medicare Special Enrollment Periods
If you’re still covered by a group health insurance plan during your IEP and you prefer not to sign up for Medicare right away, you can do so later.
Should you lose your group insurance, or decide you prefer Medicare, you can sign up anytime before you lose your coverage or during a Special Enrollment Period.
Your SEP lasts eight months after the date your employment or group coverage ends. You don’t usually have to pay a late enrolment penalty if you sign up during this time.
It’s important to note that you can’t sign up during the SEP if you’re eligible for Medicare because of End-Stage Renal Disease.
Also, some healthcare policies aren’t eligible for this benefit. These are
- A COBRA policy that extends your employer’s lapsed health insurance
- ACA health insurance policies
- TRICARE for retired military members
- Other retiree health coverage
If you have any of the above health insurance, you don’t qualify for a SEP and you must sign up for Medicare during your IEP.
Medicare Advantage Open Enrollment
If you didn’t sign up for an Advantage plan during the IEP, you can do so between October 15 and December 7 every year.
At this time, you can make the following changes without penalties:
- Add a Medicare Part D plan to your coverage
- Change or cancel your Part D plan
- Switch from Original Medicare to a Medicare Advantage Plan
- Change insurers if you want to
- Swap your standard Advantage Plan for one with prescription drug coverage
Regardless of when you make these changes during Open Enrollment, your coverage only commences on 1 January of the following year.
Medicare Supplement Enrollment Periods
Medicare supplement plans and Medigap plans cover all your out-of-pocket costs subject to different terms and conditions. There are currently 10 different types of supplement plans, all labeled according to a letter of the alphabet.
Medicare Supplement Special Enrollment Period
As long as you have Original Medicare you can sign up for Medicare supplement plans any time of the year. However, it’s best to join during one of the Special Enrollment periods.
Special enrollment periods include the following instances:
- Within six months of enrolling in Medicare Part B
- Within 63 days of your employer’s health insurance ending
- When you lose your Medicare Advantage plan due to moving out of range
- If your insurer discontinues your Medicare Advantage plan
- If you cancel your Medicare Advantage plan within a year of enrolling in Medicare Part A
You can also enroll in Medigap plans A, D, E, or F if :
- You canceled your Medicare Advantage Plan due to a fault on the part of your insurer
- You cancel your supplement plan in favor of an Advantage plan but change your mind within a year
- Your insurer goes bankrupt
During these times, known as guaranteed-issue periods, no insurer can refuse you coverage or impose penalties or waiting periods for pre-existing conditions.
Take Good Care of Yourself
Making a note of the Medicare enrollment period that applies to you and signing up in good time is the first step toward making sure you enjoy peace of mind during your retirement.
Health insurance is only the first step toward ensuring good health in later life though. There are things you can do every day to help you stay healthy, no matter what age you are now.
Keep browsing the health section of our blog for more tips and guidelines to help you stay in great shape.