How do I apply for Medicare is a common question among seniors who realize they are about to turn 65 and they are not enrolled in the Medicare Insurance program. Should you wait to enroll after 65, you run the risk of paying a penalty. Deciding which Medicare plan is best for you can be a daunting task. That is why the team at Senior Solutions Group analyzes your healthcare coverage and financial need to propose the most suitable plan for you. Here is a comprehensive guide to help you navigate through the Medicare signup process.
Everything You Should Know About Medicare Insurance
What Is Medicare?
Medicare is a federal health insurance program meant for Americans aged 65 years or more. It also covers younger people who have certain disabilities or illnesses, such as end-stage renal disease.
Different Medicare Parts
The Medicare insurance program is categorized into four parts – Part A, B, C, and D.
Part A, also known as hospital insurance, is a free premium cover. If you qualify for this category, you are not required to pay monthly premiums. This option covers inpatient hospital care, hospice care, home health care, inpatient care if you are in a nursing facility, and skilled nursing facility care services.
Part B, also referred to as medical insurance, is a coverage plan for outpatient services and supplies that you may need during your diagnosis, treatment, drug administration, or even preventive care. Signing up for the hospital insurance will require you to get Part B Medicare. Some common services under this cover include costs for dialysis, chemotherapy, medical equipment, ambulance rides, and mental health services among others.
The Part C category is the Private Medicare Advantage Plan. This plan is a combination of Part A and B insurance coverage available through private companies. The Medicare Advantage Plan covers vision, dental, hearing, and wellness packages.
Part D is a Medicare insurance plan that covers your prescription drugs. Private insurers offer this kind of coverage, and in most cases, you will pay varying premiums and other associated costs depending on specific insurers.
How Do I Apply for Medicare Insurance?
Medicare enrollment differs for each available four parts. You will be automatically enrolled in parts A and B if you are already entitled to Social Security benefits. However, at times you may be required to make the application yourself. The best time to enroll in Medicare is three months before your 65th birthday. Late enrollment may attract a penalty, although this might depend on your circumstances.
Automatic Enrollment: Who’s Eligible
Various people are eligible for automatic enrollment in original Medicare, but how do you know that you are in this category? If you are 65 years and above and you receive Railroad Retirement Board (RRB) or Social Security benefits, you will be automatically enrolled. You can also benefit from automatic enrollment if you are below 65 years but are entitled to federal disability benefits.
In case of automatic enrollment, you will be notified and a Medicare card provided. Usually, a welcome packet is available three months before the start of your coverage and includes additional guidelines about the cover. Some individuals choose to delay their federal retirement benefits. If you fall under this category, you will be required to apply for Medicare at the Society Security Administration.
How Do I Apply for Medicare Online?
The Centers for Medicare and Medicaid Services (CMS) run the Medicare program, but you can enroll for coverage online from the Social Security Administration (SSA) website. Follow the steps below to apply for Medicare online.
- Head over to the SSA website and choose the Medicare benefits section
- You will see the Apply for Medicare Only button in blue color; click it to start the application
- After you have started the application process, you will be provided with a re-entry number that you can use to log in back in case you want to take a break and still find your information saved
- Remember to check your information before submitting the application
- Once done, you will see a receipt on the screen of your computer showing the application number that you will use to track your application’s status.
After you have completed the application, SSA officials will review it and contact you should there be a need to provide more documents or information. If your application is successful, a decision letter will be mailed to you together with your Medicare card.
When to Apply for Medicare
You can only apply for Medicare during the set enrollment periods. The choice of the period depends on the Medicare part you intend to apply for and the insurance coverage you have. If you are a newly eligible Medicare beneficiary, you will have a seven-month initial enrolment period that starts three months before your 65th birthday. If you successfully enroll within the provided period, your cover will be active after you turn 65 years.
Here is a summary of the enrolment periods:
This period is for newly eligible beneficiaries. The period stretches from 3 months before your 65th birthday to another 3 months after you are 65 years of age.
The open enrollment, also known as the annual election period, is for current Medicare beneficiaries, and it is the period between October 15 and December 7 each year. This period allows you to change your existing Medicare plans. The changes take effect from 1 January of the following year.
In case you missed the initial enrollment, you can apply for coverage during the general enrollment period – January 1 to March 31, each year. A fine for late enrollment may apply. If you are successful in your application, the coverage starts on July 1 of that year.
Medicare Advantage Disenrollment
The Medicare advantage disenrollment period is for Medicare Part C beneficiaries. This period, open between January 1 and February 14 each year, allows you to move from Part C coverage to Part A and B or buy Part D coverage. The changes take effect on the first day of the following year.
The special enrolment period varies and it is open for specific individuals to enroll in Medicare with no penalty. The coverage for this cage starts one month after enrollment. However, you will need to show proof of a major qualifying event when applying under the special enrolment period.
How Do I Apply for Different Medicare Parts?
Different Medicare Parts require varying application procedures. Here is an overview of how to apply for any of the four parts:
Applying for Medicare Part A
You are eligible to apply for Medicare Part A during the initial enrollment, special enrollment, and the general enrollment periods. It is important that you apply for this cover when you are first eligible because any late application will attract a penalty unless you are eligible for special enrollment.
Applying for Medicare Part B
When applying for Medicare, you will have to decide if you are going for Part B. This category, which covers preventive care services, doctors’ office visits, and outpatient care, involves monthly premiums. You may not need Medicare Part B if you are still in employment and you have another health plan.
Applying for Medicare Part C
Medicare Part C is an alternative to Parts A and B. You need to be enrolled in Original Medicare for you to apply for a Part C plan. You can apply for this plan during the open enrollment, special enrollment, or the initial enrollment period. In case you need to return to either Part A or B, you will have to wait for the Medicare Advantage Disenrollment period to drop your Part C plan.
Applying for Medicare Part D
You can apply for Medicare Part D during the initial enrolment period or when enrolling for Part B during the general enrollment period. In addition, the open enrollment period, usually in fall, is a perfect time to apply for the prescription drugs plan.
Applying for Medigap (Supplement Insurance)
A Medigap plan is additional insurance coverage available to original Medicare beneficiaries to care for out-of-pocket costs. You can apply for such plans from government-approved insurance companies within six months after enrolling in Medicare Part B.
How Do I Apply for Medicare: Get Professional Help Today
Enrolling to the basic Medicare parts is a simple process, but it is highly challenging to decide which cover is the best for you. If you still find yourself stuck with the question how do I apply for Medicare even after going through this guide, it is time you engaged professionals to help you. Get in touch with us today at Senior Solutions Group for guidance and advice on the perfect combination of Medicare plans that matches your health coverage and financial needs.