Medicare | FAQ

How do I apply for Medicare?

If you are turning 65 and already collecting Social Security, then you will be automatically enrolled in Medicare Part B. If you are not collecting Social Security by your 65th birthday, you will need to enroll in Medicare Part B. Please go to https://www.ssa.gov/benefits/medicare/ to enroll.

Parts of Medicare

Medicare Part A (hospital insurance) helps pay for inpatient care in a hospital or limited time at a skilled nursing facility (following a hospital stay). Part A also pays for some home health care and hospice care.

Medicare Part B (medical insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services.

Medicare Advantage Plan (Part C) includes all benefits and services covered under Part A and Part B bundled together and are provided with additional services. These plans are run by private insurance companies that follow Medicare’s rules.

Medicare Prescription Drug Plans (Part D) help cover the cost of prescription drugs. These plans are run by private insurance companies that follow Medicare’s rules.

Medicare Supplemental Policies (Medigap) help pay Medicare out-of-pocket copayment , coinsurance, and deductible expenses.

Am I Eligible for Medicare?

Most people age 65 or older are eligible for free Medicare hospital insurance (Part A) if they have worked and paid Medicare taxes long enough. You can enroll in Medicare medical insurance (Part B) by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B Premium.

When Am I Eligible to Enroll in Medicare?

If you’re eligible at age 65. Your initial enrollment period begins three months before the month of your 65th birthday, includes the month you turn 65, and ends three months after your birthday. During this period you are guaranteed acceptable.

What if I Do Not Enroll at Age 65?

If you choose to not enroll in Medicare Part B and then decide to do so later, your coverage could be delayed and you may have to pay a higher monthly premium for as long as you have Part B. Your monthly premiums will go up 10% for each 12-month period you were eligible for Part B, but did not sign up for it, unless you qualify for a Special Enrollment Period. If you did not enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a “general enrollment period” from January 1 through March 31. Your coverage begins on July 1 of the year you enroll.

Important Dates

Open Enrollment Period – October 15 – December 7th, changes are effective January 1 of the following year. You can change or enroll in Medicare Advantage Plans or Prescription Drug Plans.

General Enrollment Period – January 1 – March 31. If you did not enroll in Medicare you can sign up for Part B. Part B will become effective July 1 of the same year.

Medicare Advantage Open Enrollment Period – January 1 – March 31. You can make changes only if you have a Medicare Advantage Plan. You can switch to a different Medicare Advantage Plan or Original medicare, with or without drug coverage. You cannot make any changes if you are not already enrolled in a Medicare Advantage Plan.

Special Enrollment Period  – All year long, but need to meet special requirements to make plan changes. Effective the next month after application is received.

Currently Employed through Group Health Insurance

If you have medical insurance coverage under a group health plan based on your or your spouse’s current employment, you may not need to apply for Medicare Part B at age 65. You may qualify for a Special Enrollment Period (SEP) that will let you sign up for Part B during:

• • Any month you remain covered under the group health plan and you, or our spouse’s, employer continues.
  • The 8-month period that begins with the month after your group health plan coverage or the employment it is based on ends, whichever comes first.