Do I Need to Apply for Medicare?
“Do I need to apply for Medicare?” This question comes up just about everyday for us. Whether it is someone who comes to an event or educational class, or a phone call from someone searching the web for answers, we are bound to get this question at least once a day. Unfortunately, there is not one answer for everyone. The answer is ‘it depends on your situation.’
Who qualifies for Medicare?
Generally, Medicare is for people 65 or older. You may be able to get Medicare earlier if you have a disability, End-Stage Renal Disease or ALS. U.S. citizens and lawful U.S. residents who have resided in the U.S. for 5 continuous years at the time of application will be eligible at age 65. In this article we will focus on those turning 65. If you are eligible for Medicare after 24 month of continuous Social Security disability benefits, the transition will be automatic and there is no need to apply.
Should I apply for Medicare?
For some, it will start automatically. For those receiving Social Security benefits at least 4 month before age 65, Medicare will start automatically. If your date of birth is any day of the month between the 2nd-31st, your Medicare will start on the first day of your birth month. If your birthday is on the first of the month, your Medicare will start the first day of the prior month. You should expect to receive your Medicare card in the mail in those first three months. If you have not received your you can order one through your MySSA account. In this situation it is possible to refuse Part B, but not Part A. If you decide to refuse Part B you must be aware that there is a penalty for delaying Medicare without Creditable Coverage.
Full retirement age is getting later, and because of that many new Medicare beneficiaries have not started receiving Social Security benefits at the time they turn 65. In this situation you must apply for Medicare. You can apply in the 3 months before your first Medicare eligible month, the month your eligibility starts, and the 3 months following.
The next question is should I apply? If you are already retired the short answer is ‘yes.’ Delaying Medicare may produce a lifetime late enrollment penalty. If you are still working at 65 and covered under a qualifying group health plan, the choice is up to you. A good way to start is compare the costs of Medicare to your current plan premium, then compare out of pocket costs like deductibles and copays. Once you retire you have a Special Enrollment Period of 8 months. This allows you to enroll in Medicare no matter what time of year it is.
Will I get a penalty for delaying Medicare?
If you are actively employed and covered under a group health plan with more than 20 employee members, you may be able to delay your Medicare coverage with no penalty. Ask your insurance provider if your coverage is employer group health plan coverage, if it is not, you must enroll into Medicare to avoid a Late Enrollment Penalty. We have seen instances of both misinformation and deception causing these issues for Medicare beneficiaries.
Some insurance agents have led clients to believe there were no repercussions in delaying Medicare in order to keep the client on their plan. Some have listened to the advice of family, friends, or neighbors who have good intentions, but bad information. If you have a health insurance plan through any market other than an employer and you are eligible for Medicare, you need to apply. This must be with active employment, either you or your spouse. COBRA is not creditable coverage. Obamacare is not creditable coverage, and private health insurance plans are not either. Many of these plans will send notice to individuals when they are turning 65, that they are no longer eligible and should apply for Medicare. But not always.
Check out Medicare.gov for more!
Retired but not yet 65?
It is important to prepare if retiring before 65. The monthly cost for health insurance plans goes up greatly as we get older but COBRA is not always the best option. Depending on your health and budget there are several coverage options to bridge the gap between early retirement and Medicare. At age 63 the number of options goes down. If you are planning to retire or are already retired looking for health insurance coverage until you age into Medicare, give us a call! This is what we do everyday. We will show you your current options and make sure you are prepared when Medicare enrollment time comes!