Do I Have To Sign Up For Medicare When I Turn 65?

Some People Do And Some People Don’t.

If You Are Collecting Social Security For Medicare

Suppose you started collecting Kantime Medicare Social Security before turning 65. In that case, you will be automatically enrolled, and your Medicare will become active on the first day of the month of your birthday. If your birthday happens to be on the 1st, your Medicare will start on the 1st of the month before the month of your birthday(i.e., if your birthday is April 1, your Medicare will begin March 1).

If You Are Still Working On kantime Medicare Medicare-

If you are still employed and have insurance coverage supplied by your employer and your employer has under 20 employees, then Medicare will become your Primary Payer and your employer coverage will be Secondary and you will have to sign up for Medicare. However, if your employer has over 20 employees, then enrollment in Medicare is not necessary.

Medicare Monthly Costs Medicare-

Hospital Part A-

kantime Medicare Part A is Free for most individuals who have worked and paid in through payroll for over 40 Quarters(10 Years). Those who have worked and paid in for 39 Quarters or less will pay a Part A premium of $285.00 to $518.00 per month.

Medical Part B-

Medicare Part B comes with a minimum premium of $185.00(Income tested; some individuals will pay more IRMAA), which will automatically be deducted from your Social Security if collecting. If not collecting you will receive a bill for 3 months of premium(Monthly checking account deductions can be set up through Medicare.gov). Prior to this happening it’s a good idea to complete a comparison between your existing employer coverage and Medicare. If the employer has over 20 employees and coverage better serves you then you could delay signing up for Medicare Part B and having Part A only until retirement or when the employer insurance is no longer the better option. When that time comes the individual will complete a Medicare Part B Application(CMS-40B) and Employer Verification Form(CMS-L564/R297). This serves as proof that you had creditable coverage to avoid a Part B Late Enrollment Penalty.

Health Savings Account(HSA)-

Some individuals have a Health Savings Account(H.S.A.) through their employer. HSAs allow you to set aside pre-tax funds (and some employers even set funds aside for you) to be used for Medical expenses. Once your Medicare is active, you will no longer have the pre-tax option and could have a tax penalty if funds continue to be deposited in the H.S.A. account. Medicare recommends the HSA funding cease at least 6 months prior to your Medicare becoming active to avoid tax penalties.

When to Sign Up-

If you have not started collecting Social Security prior to becoming Medicare eligible then you will have to sign yourself up. You will have a 7-month window( 3 months prior to your birthday month, your birthday month and the 3 months following the month of your birthday month) to complete your enrollment to avoid penalties. This is called your Initial Enrollment Period. If you enrol during the 3 months prior to your birthday month, then your Medicare will be effective on the 1st of your birthday month. If you enroll after that, beginning with your birthday month, your enrollment will begin on the 1st of the next month.

How To Sign Up-

Enrollment can be completed online through the Social Security website. If you don’t have a mysocialsecurity account at ssa.gov, you will need to set one up. If you are not comfortable doing it online, you can visit the local Social Security office.

Frequently Asked Questions

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:

Original Medicare (Parts A & B): Allows you to see any doctor or
hospital that accepts Medicare but does not include prescription drug
coverage (Part D) or additional benefits.
Medicare Advantage (Part C): Offers bundled coverage with
potential extra benefits but may require using a network of providers.
Medigap (Medicare Supplement Insurance): Helps cover
out-of-pocket costs not covered by Original Medicare, such as
copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:

Initial Enrollment Period (IEP): A seven-month window starting
three months before your 65th birthday month.
General Enrollment Period (GEP): From January 1 to March 31
each year for those who missed their IEP.
Annual Election Period (AEP): From October 15 to December 7,
allowing you to switch or enroll in Medicare Advantage and Part D
plans.
Open Enrollment Period(OEP): From January 1 to March 31 for
those who missed AEP and want to make certain changes.
Special Enrollment Period(SEP): Can be used anytime during the
calendar year for those that meet certain criteria such as moving to a
new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.

By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.

Do I have to sign up for Medicare?

It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.

Does Medicare cover Prescription Medications?

No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.

I want to be able to go to any doctor/hospital, are there networks with Medicare?

There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.

Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.

Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.