If you’re approaching the age of 65, there is plenty to consider, from retirement to travel to financial planning. Getting ready for your Medicare signup is one of the more complicated, but also necessary, parts of reaching retirement age.
How to Prepare for Your Medicare Signup
Start Early
There are many choices to make with Medicare, and you’ll be able to make the best possible decision if you have plenty of time to consider Medicare itself and your own needs. Start at least six months before your enrollment period begins, and start with learning all you can about your Medicare choices.
Knowing Medicare
For most people, Medicare kicks in at age 65. You’re eligible to enroll in Medicare three months before your 65th birthday, and if you enroll during this period, you have more options and will get the best prices. If you wait, you will pay more in premium penalties.
Basic Medicare
Basic Medicare is made up of Parts A and B. Part A covers visits to the hospital and some of your fees if you need healthcare at home or from a skilled nursing facility. Part A also helps pay for hospice care.
Part B pays for the rest of healthcare, like lab tests, doctor visits, screenings, and outpatient treatments. Medicare Part B also offers a bit more coverage for home healthcare issues. Part B pays for an annual wellness visit, for orthotics and prosthetics, ambulance services, and some mental healthcare. It does not typically cover vision, hearing, or dental issues.
Enhanced Extras
If you need more coverage, you can enhance your Medicare coverage by getting Part D and Part C or by choosing a Medigap plan. Part D Medicare covers prescription drugs. Part C is also known as Medicare Advantage and may cover dental, hearing, and vision needs, depending on the type of plan you choose. A Part C plan will also cover prescriptions, so you won’t need both a Part C plan and Part D.
In place of these, you can choose a Medigap plan, which is supplemental insurance offered by private insurers. These plans cover the shortfalls of Part A and Part B, and the plans are all standardized except for those living in Massachusetts, Minnesota, and Wisconsin. If you live in one of these states, remember that much of what you’ll find online about plans will apply only to the other 47 states. You’ll need to ask your Medicare insurance specialist for a list of plans specific to your state.
For most, though, there are 11 plans to choose from. So long as you get your plan during your enrollment period, you can’t be denied coverage or charged higher rates for a preexisting condition. You can also freely change your plan during the change period a few months later. If you wait to get your plan, however, insurers can charge more and can deny coverage of preexisting conditions.
Paying and Getting Healthcare
If you worked for 10 years or more and paid into Social Security, there is no premium for Part A Medicare, but there is a deductible for each hospitalization period. Your premium for Part B will depend on your income. The more you make, the higher your premium. Part B has an annual deductible of $185.
Part D, C, and Medigap plans all have different deductibles and premiums depending on the plan you choose. These plans themselves may also cover some of your deductible for Part A. When you have Part A and Part B Medicare, you can visit any doctor or healthcare facility that accepts Medicare. Your Medigap and Medicare Advantage Plans work more like traditional insurance in that you’ll be covered when you see in-network providers and pay more if you visit providers outside the network.
Know Yourself
The next step in preparing for your Medicare signup is carefully considering your own health and income needs. For example, if you are generally in good health and take few medications, you may want to choose a Medigap plan that offers lower premiums and a higher deductible but which will cover you in the event of an unexpected, catastrophic event. If you enjoy travel, you will want to look into Medigap plans that offer coverage while you’re abroad, since Medicare Part A and B do not cover you outside the United States.
If you have preexisting conditions or take many medications, you may prefer a Medicare Advantage Plan that offers more prescription drug coverage than Medicare Part D. If you have ongoing vision or dental issues, investigate Advantage or Medigap plans that can offer some coverage in these areas. It’s also important to take stock of your medications and consider whether you would be happy using a generic version of a medication or switch pharmacies if a plan requires it.
Understand Your Options for Enrollment
Once you’ve become familiar with Medicare itself and have a good grasp of your own needs, it’s time to consider precisely when you can sign up.
Your Initial Enrollment Period
If you’re just starting out with Medicare, you’ll be free to sign up for Parts A, B, C, and D during the seven months surrounding your birthday month. If your birthday is in June, for example, your enrollment period begins March 1 and ends September 30.
Your coverage will commence depending on when in that period you enroll. If you enroll before your birthday month, coverage begins on the first day of the month you turn 65. If you wait till the third month after your birthday, coverage doesn’t begin until the beginning of the sixth month after your birthday month.
Special Enrollment
In certain situations, you can sign up using a special enrollment period. If you are still working when you turn 65 and have an employer’s coverage, or if you have coverage through a spouse who will still be working at that time, you can enroll in Medicare Parts A and B at any time while you’re still covered or in the eight months after your employment coverage ends. For Medicare C and D, your special enrollment period will be for 63 days after employment coverage ends.
Open Enrollment
If you’re signing up for the first time, enroll during your own enrollment period. This gives you plenty of time to work through the details. It also gives you time to change things up during the next Open Enrollment period if you find you’ve made a mistake. Open enrollment always runs from Oct 15th through Dec 7th, and coverage from this period always begins on January 1st. Once you’ve signed up with Medicare initially, you can always renew or change your coverage during this open enrollment period.
During this time, if you already have Parts A and B, you can switch to a Medicare Advantage (Part C) plan or vice versa. You can join, drop, or change your Part D plan. You can also change from one Medicare Part C plan to another. Finally, you can buy or drop a Medigap policy without any penalty if you find you need more or less coverage.
How to Apply
When you’ve had some time to consider how Medicare works and your own medical and financial needs, it’s time for your Medicare signup. If you’re already getting Social Security retirement benefits or disability benefits, you’ll be automatically enrolled and should receive a welcome packet and card from Medicare about three months before you turn 65. If you pass this point and haven’t received your welcome packet, be sure to contact the Social Security Administration.
Signing Up for Parts A and B
To sign up yourself, visit the Social Security website, call their national customer hotline at 1-800-772-1213, or make an appointment to visit your local Social Security office in person. This is all fairly straightforward. Where things get more complicated is in choosing and signing up for a Part C, D, or Medigap plan.
Signing Up for Parts C, D, and Medigap
There are many Part C plans and Medigap plans offered by private insurers. The method for signing up for each will depend on the insurer and the state where you live, and this is where it helps to have professional advice.
The advice of a Medicare insurance specialist is the safest way to make sure you’ve considered all your options, thoroughly understand the details of a plan, and have the right plan for your financial and medical needs. A specialist works for you and can explain exactly what Medicare Parts A and B will cover in reference to your unique situation. They can then help you understand which Medicare Advantage or Medigap plans will best fill in the gaps.
When you meet with your specialist, make sure to cover important questions like:
- Are my drugs on this plan’s drug list?
- Can I continue to use my current pharmacy with this plan?
- Will I have to switch hospitals or healthcare providers to stay in-network on this plan?
- Which doctors near me will accept my coverage?
- Will this plan cover me if I’m visiting family out of state?
- Can I use mail-order prescriptions?
- What will be my out-of-pocket expense for prescriptions on this plan?
- What are my premiums, deductibles, and copays like?
Be Ready for Your Medicare Signup
Signing up for Medicare isn’t an easy task. The process is complicated and difficult to understand easily as a layperson. When you need help choosing the right plan for your needs, contact Senior Solutions Group, and talk to a specialist. We’re here to answer your questions and get you the coverage you need at a price you can afford.
