If you are less than six months away from turning 65, you need to start thinking about enrolling in Medicare.  Sorting through your options can take some time depending on what your current medical coverage is, when you are thinking of retiring, your health status, and other considerations. Planning ahead for Medicare now can benefit you for years to come.

When should I enroll in Medicare?

You can sign up for Medicare during the three months before you turn 65, during the month you turn 65, and three months after you turn 65.

Most people are automatically enrolled in Medicare Part A, which helps pay for inpatient hospital care, skilled nursing facilities, home health care and hospice care.   

If you signed up to receive Social Security or Railroad Retirement Benefits when you turn 65, you will start receiving benefits on the first day of the month that you turn 65.  (If you will not get Social Security benefits at 65, contact your local Social Security office to ask about your Medicare benefits.) 

Medicare Part B, which helps cover doctor’s bills and outpatient care, is optional and has a monthly premium.  You can sign up for Medicare Part B when you first begin receiving Medicare, or you can turn down coverage or opt to begin at another time.  Be aware, however, that you may be penalized when and if you do sign up later for Part B.  Be sure to weigh the costs of delaying enrollment for your individual situation. 

Understand that Medicare was never meant to cover all costs.  Deductibles, coinsurances and limitations apply. 


What are the types of Medicare?

Medicare Part A is hospital insurance that helps pay for your inpatient hospital care.  In certain cases it also covers skilled nursing facility care, hospice and home health care.

Medicare Part B is medical insurance that helps pay for doctors’ services and outpatient care.

Medicare Part C or Medicare Advantage plans combine Part A and Part B. Medicare Advantage plans are another way for you to receive your Medicare benefits.  They are offered by private insurance companies that have been approved by the federal Medicare program.  They must cover all Medicare benefits and may also provide additional benefits, such as eyeglasses, vision care and hearing exams.  It’s up to you to compare Medicare Advantage plans to find the one that is right for you.

Medicare Part D or Medicare Prescription Drug Coverage helps cover your drug costs.  This optional insurance is available to all people with Medicare through private companies like health plans and insurance companies.  Many Medicare Advantage plans include Medicare Part D in their plans.

If a Medicare Advantage plan is not for you right now, consider a Medicare Supplement (or “Medigap”) plan.  These plans have standardized benefits that help fill the financial gaps of Original Medicare.  While plan benefits are the same from company to company, experience and service help make it easier to get the health care you need.

Ask the right questions

Karen Wintringham, Vice President Medicare and Public Sector Programs for Health Alliance Plan, suggests asking these four questions when considering Medicare enrollment:

1 – Do I need to sign up for Medicare?

2 –Do I need Medicare Part B?

3 – Do I need prescription drug coverage?

4– Will Medicare benefits provide enough coverage to meet my needs?

Answers to these questions may lead you to identify areas where there are potential gaps in your insurance coverage, at which point you may want to look into additional coverage through Medicare Advantage plans and Medicare Supplement (or “Medigap”) plans.

Once you have gathered all of the information – which can take some investigation and time, depending on your individual situation – then you can start applying for coverage.  Just remember—the first step is making sure that if you want Medicare coverage, you get enrolled before the deadline!

Additional resources:

Medicare
www.medicare.gov

Medicare Rights Center
http://www.medicarerights.org/

Medicare Interactive Counselor:
http://www.medicareinteractive.org/page2.php?topic=counselor

Center for Medicare Advocacy
http://www.medicareadvocacy.org/default.htm