Retirement. It’s so close you can taste it. You’re crossing days off your calendar waiting for that magical day to get here. The only thing holding you back is your health insurance. Eeek! You get sick just thinking about how much your premiums are going to be when you retire. Your backup plan is holding out for Medicare, but you don’t know if you’ll make it at your job until 65. What to do?
This is a common dilemma that many of my clients are going through. They’re ill from the outrageous amount that will be exiting their checking account each month just to pay for their health insurance; and that’s not including the rest of their monthly bills. They know they do have a backup plan in Medicare.
For those that can postpone till 65 to retire, they are in luck since they will immediately qualify for Medicare. For those that qualify, here’s what you’ll need know about signing up to receive your Medicare benefits.
Are You Eligible More Medicare?
First things first, you may be wondering if you’re eligible to receive Medicare benefits. In addition, you may be wondering what benefits that you’ll be entitled to. If you’re confused – don’t worry, you’re not the only one – a quick and easy resource is to visit Medicare.gov. From there you can click on an Initial Enrollment Package link that will walk you through a series of questions. You can see a screen shot of the first page below. You will be asked approximately 10 questions, some of which are listed here:
- Date of Birth
- Marital Status
- Tax Filing Status
- Type of Medicare Coverage
- Are You on Medicaid
- Do You Live Outside U.S.
- Household Income Range
- Are you receiving health benefits through your current employer
After you’re done answering the questions, it will compute a “Results” page informing you on what you are covered for including: General Enrollment, Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. I highly suggest you start here if you want your answers to your specific situation.
Automatic Enrollment in Medicare For Some
Anyone who has received a Social Security check or 24 months worth of Social Security Disability Insurance (SSDI) is automatically enrolled in Medicare Part A and Part B. Part A is hospital insurance; Part B is medical insurance. For example, if your 65th birthday is February 20, 2011, your Medicare effective date would be February 1, 2011.
If you’re getting Social Security checks and approaching age 65, you’ll get a Medicare card in the mail three months before your 65th birthday. Consider that your birthday card from them 🙂
Medicare benefits begin on the first day of the month in which you turn 65. If you are getting SSDI (regardless of your age), the card will arrive coincidental with your 22nd monthly payment and you are entitled to Medicare coverage with your 25th monthly payment.
Please note: you must be a U.S. citizen or a legal resident of this country for five years or longer to be eligible for Medicare.
Social Security and Medicare
If you’re coming up on 65 and not receiving Social Security benefits, SSDI or benefits from the Railroad Retirement Board, you can still apply for Medicare coverage. You can visit your local Social Security Administration office or dial (800) 772-1213 or go to www.ssa.gov to determine your eligibility.
In this case, if you are eligible you have the choice of accepting or rejecting Part B coverage. If you want Medicare Part A and Medicare Part B, then you should sign your Medicare card and keep it in your wallet. If you don’t want Part B, you put an “X” in the refusal box on the back of the Medicare card form, and send the form to the address shown right below where your signature goes. About four weeks later, you will get a new Medicare card indicating that you only have Part A coverage.
When can you change your Medicare coverage?
There are different enrollment periods that Medicare offers to the public to change (add or decrease) their benefits. Please take note of these periods for there are typically no exceptions.
- The initial enrollment period is seven months long. It starts three months before the month in which you turn 65 and ends three months after that month. You can enroll in any type of Medicare coverage within this seven-month window – Part A, Part B, Part C (Medicare Advantage Plan), and Part D (prescription drug coverage). As it happens, if you don’t sign up for some of this coverage during the initial enrollment period, it may cost you more to add it later.
- Once you are enrolled in Medicare, you can only make changes in coverage during certain periods of time. For example, the annual enrollment period for Part D is November 15-December 31, with Part D coverage starting January 1. (You can also select a health plan for the next year or drop or change Part D coverage in this period.)
- Additionally, there are also open enrollment periods between January 1 and March 31. These dates frame an open enrollment period for Part D; if you enroll in Part D in this window, coverage starts on the first day of the month after the plan receives your enrollment form. There is also an open enrollment period for Part B coverage from January 1 to March 31; if you sign up for such coverage within that period, it begins in July of that year.
What if You Can’t Afford Medicare Payments?
Each state has different programs for helping those out that can’t afford to pay for their Medicare benefits. The programs may pay some or all of Medicare’s premiums and also may pay Medicare deductibles and coinsurance. To qualify, you must have Part A (hospital insurance), a limited income, and, in most states, your resources, such as bank accounts, stocks and bonds, must not be more than $4,000 for a single person or $6,000 for a couple. You’ll need to contact your state Medicare office for more details.
Special Medical Conditions and Medicare
Individuals with end-stage kidney failure who need dialysis or a transplant may qualify for Medicare regardless of age. Upon diagnosis, they can contact the Social Security Administration. Medicare coverage usually takes effect three months after a patient begins dialysis. People with Lou Gehrig’s Disease (ALS) are automatically enrolled in Medicare as soon as they begin receiving SSDI payments.
Questions On When You Need To Sign Up For Medicare?
The Centers for Medicare & Medicaid Services (CMS) is a branch of the U.S. Department of Health and Human Services. CMS is the federal agency that administers the Medicare program and monitors the Medicaid programs offered by each state. English and Spanish-speaking Customer Service Representatives (CSRs) at 1-800-MEDICARE can answer your questions. 1-800-MEDICARE CSRs can give you information about Medicare coverage and costs, health plan options, and your Medicare claims.