Enrolling due to age

Medicare Benefits Solutions
May 4, 2020

If you are getting close to your 65^th birthday, now is the time to start thinking about your Medicare options. You’ll have some decisions to make.  Give yourself plenty of time to review and compare Medicare plans and find the one that’s right for you.

When can you get started? You’ll have the opportunity to enroll in Medicare during your 7-month Initial Enrollment Period. It starts three months before your birthday, lasts during your birth month, and continues for three months after your birthday.

Enrolling in Part A and Part B

When you turn 65 years old, you may automatically get premium-free Part A (hospital insurance) if you’ve worked 40 quarters and paid Medicare taxes. If you don’t meet that criteria, you may purchase Part A. Unless you are still working and continue to have creditable healthcare insurance through your employer, it is recommended that you enroll in Medicare Part B (medical insurance) at this time.

Is Part B mandatory? Although enrollment in Part B is not mandatory, most Medicare recipients enroll when they’re first eligible to avoid paying late enrollment penalties when they decide to sign up later. Part B helps pay for medically necessary services and supplies and includes coverage for doctor visits, outpatient procedures, preventive care, and durable medical equipment (DME).

Original Medicare or Medicare Advantage? The choice is yours

When you first sign up for Medicare, you can choose to get your Part A and/or Part B benefits through Original Medicare, the federal program that administers your coverage, or through Medicare Advantage.

If you choose Original Medicare, you may have the option to buy supplemental insurance. When you turn 65 and you’re enrolled in Part B, you’ll have a 6-month period to buy Medicare Supplement insurance. Medicare Supplement, or Medigap, policies help cover some of the out-of-pocket costs not included in Original Medicare, such as copayments, coinsurance, premiums, and deductibles. During your Medigap enrollment period, you can buy any policy sold in your state, regardless of whether you have a pre-existing condition.

Medicare Advantage (MA) plans, also known as Medicare Part C, are offered by private insurance companies who contract with Medicare. They’re required to give you the same coverage as Original Medicare Parts A and B, but most MA plans include additional benefits, like vision and dental care, hearing exams, fitness programs, and even prescription drug coverage.

Part D prescription drug coverage

As you turn 65, you may not have any chronic conditions that require prescription medications on a regular basis, but it’s important to consider Part D coverage. Prescription medications can be expensive, and life is unpredictable. Protect your family and finances from unexpected prescription drug costs by enrolling in Part D when you are first eligible for Medicare.

If you are getting your Part A and Part B benefits through Original Medicare, you can enroll in a stand-alone Prescription Drug Plan (PDP). Or, you can enroll in a Medicare Advantage (MA) plan that will include Part A, Part B, and Part D coverage. These drug plans are offered by private insurance companies, and although they are regulated by the Centers for Medicare & Medicaid Services, each plan can have its own formulary (list of covered drugs). If you currently take medications, check the plans you are considering to make sure your medication and dosage are offered at an affordable price. Each plan will have its own pricing, so compare your options carefully before enrolling.

Review the plans offered in your area, but don’t hesitate to ask for help if you have questions along the way. Licensed, knowledgeable sales agents are available to help you navigate your options and can help you enrol when you’ve made a decision.