Time is the element involved on how and when to sign up for Medicare. Enrolling in Medicare requires understanding the basics. This includes Part A Medicare and Part B Medicare. Moreover, the parts of Medicare and how it all works must be kept in mind.
Common Medicare mistakes can cost anyone thousands of dollars. All the answers to enrollment procedures on Medicare are here. Further, seniors will be given guidance over the choices they might need to make.
What Is Medicare? [A Review]
Medicare is a federal health insurance program. This offers for most specially seniors who are turning 65 and retired at 65 or beyond. Further, it is also for people under 65 with certain disabilities and health conditions. For instance, individuals under 65 with Amyotrophic Lateral Sclerosis automatically become eligible for Medicare. In the case of End-Stage Renal Disease, it is a permanent kidney failure that requires dialysis or transplant. Therefore, people under 65 with ESRD are also eligible for Medicare.
Once someone becomes eligible for Medicare, they may enroll in different programs. It is crucial for seniors to understand the different coverage options and Medicare quotes. Also, one must pick a program carefully. How they choose to get the benefits can affect their finances. Additionally, information on all Medicare supplement plans is discussed further.
Basically, the federal government administers this program. This is the way most seniors get their Medicare. Then, there are other coverage options offered by private insurance companies. Of course, those insurance companies must be Medicare-approved. The most important thing about Original Medicare is it automatically enrolls those eligible in Part A and Part B.
However, even when people enroll in Part A and B, Original Medicare does not cover everything. The decision on which Medicare quotes to enroll is based on the senior. This depends whether they have other health insurance in addition to Medicare. For example, a plan from their current or previous employer.
Also, Original Medicare only pays 80% of the medical or doctor bills. This is why seniors should pay attention to all Medicare supplement plans.
Part A Medicare (Hospital Insurance)
Basically, this plan covers the most necessary medical care. These are inpatient hospital stays and care in a skilled nursing facility. Further, it covers health care and hospice care. Most importantly, Part A Medicare is free for most people.
Part B Medicare (Medical Insurance)
Part B helps cover services from doctors and other health care providers. Further, the coverage includes home health care, and outpatient care. It also covers durable medical equipment and many other preventive services.
Part C Medicare (Medicare Advantage Plans)
Medicare-approved private companies offer this Medicare health plan. Also, this is not a separate benefit. Usually, this includes all benefits and services covered under Part A Medicare and Part B. Further, this plan includes Medicare prescription drug coverage or Part D.
Private companies that are Medicare-approved follow set of rules. Their plans have a yearly limit on their out-of-pocket costs for medical services. In addition, this plan includes extra benefits and services. These services aren’t usually covered by Original Medicare.
This plan incorporates all benefits covered by Part A and B. Significantly, it provides all benefits with different rules, costs and restrictions. Further, it also has extra coverage such as dental or vision. However, these may affect how and when seniors receive care.
Anyone can become automatically enrolled in Part C Medicare when they have health coverage. This coverage could be from their former or current employer. The senior may also have the option to stay with the plan. Otherwise, they may switch to Original Medicare.
Seniors may enroll in Medical Advantage Plan. However, they must consult with their current union or employer first. They may also be required to pay more or pay all of the costs. This occurs when a senior decides to use insurance outside their plans’ provided network. In addition, there are usually co-insurance or co-payments involved. Most importantly, there might be added monthly premium to the Part B premium.
Part D Medicare (Medicare Prescription Drug Plans)
Basically, this helps cover the cost of prescription drugs. This plan is added drug coverage to Medicare. Moreover, Medicare-approved private insurance companies run this program. This program helps seniors lower their prescription drug costs. Also, it helps protect them against higher costs in the future.
A senior pays an additional monthly premium to add this coverage. Again, that is apart from Part B premium. One may get Plan D through their Medical Coverage Plan. That is, if their Medicare Advantage Plan offers drug coverage. Otherwise, they may sign up for a Medicare Prescription Drug Plan. One may also get extra help for Part D.
How Do I Get Automatically Enrolled?
Now that we have reviewed the different Parts of Medicare quotes, it is time to proceed with the enrollment process. Anyone can become automatically enrolled in Part A Medicare and B Medicare coverage. These are the following conditions:
- A person turning 65 and getting Social Security or Railroad Retirement Board (RRB) benefits.
- Those under 65 and disabled. They automatically get Part A and Part B after having disability benefits.
- Patients with ALS (Amyotrophic Lateral Sclerosis) and ESRD (End-Stage Renal Disease).
It is vital to know that Part B here is optional. Those who do not wish to have Part B must follow instructions that come with the Medicare card. Also, they must send the card back.
Those who keep Part B card may have to pay monthly premiums. However important it is to keep, there are times when you don’t need to sign up right away. Deciding whether to keep Part B depends on the situations.
What Are The Common Scenarios?
Here are common scenarios when an eligible does not need to enroll in Part B.
Are you still working?
Or are you a spouse or family member of a disabled that is still working? Those who have health insurance through an employer may want to keep that coverage. However, there’s nothing to worry about. They can have a special enrollment period to sign up for Part B later. Moreover, they do not have to worry about paying a penalty.
Do You Have Tricare Coverage?
Tricare is insurance for active-duty military, military retirees and their families. They may need to take Part B to keep their Tricare coverage. Here’s how it would work:
If one is a retired service member, they must enroll in Part A and Part B when they become first eligible. This is to keep Tricare coverage. This also includes their spouse or dependent child.
However, if one is an active duty service member, they may not have to get Part B right away. This also refers to their spouse or dependent child. They can get Part B during a special enrollment period without any penalty.
What If You Don’t Have Other Health Coverage?
When the senior does not have any health coverage, they may want to keep Part B coverage. This refers to the types of services and items mentioned earlier. If they do not wish to keep Part B, here’s what will happen:
They may have to wait to sign up. Their coverage will have delays. Therefore, they may have to pay a late enrollment penalty.
When one has to pay a late enrollment penalty, their monthly premium for Part B may go up 10%. This is for each full 12 month period. However, they did not sign up for it. Also, they may have to pay this penalty for as long as they have Part B.
How and When to Sign up for Medicare
When one is not under free Part A, they may sign up for Part A once their Initial Enrollment Period begins. Their Part A coverage will begin 6 months back from the date they applied for Medicare. Also, not earlier than the first month they were eligible for Medicare. However, one can only sign up for Part B or A during the periods listed below.
Initial Enrollment Period
Seniors can first sign up for Part A and/or Part B during the 7-month period. This begins 3 months before the month they turn 65. Also, this includes the month they turn 65. Then, it ends 3 months after the month they turn 65.
In most cases, the coverage begins the first day of their birthday month. What if their birthday is on the first day of the month? Their coverage will then begin the first day of the prior month.
What if they enroll the month they turn 65? Or during the last 3 months of their Initial Enrollment Period? Well, the start date of their Medicare coverage will have delays.
Special Enrollment Period
After the Initial Enrollment Period is over, they may have another chance to sign up. This can happen during a Special Enrollment Period. They can sign up for Part A and/or Part B when:
- Anytime they still receive coverage
- During the 8-month period that begins the month after their employment ends;
- or when their coverage ends; whichever happens first
Usually, they don’t have to pay a late enrollment penalty when they sign up during this period. This period does not apply to people eligible for Medicare based on disabilities.
General Enrollment Period
Seniors can sign up between January 1-March 1 each year. This period applies to those who were not able to sign up during Initial and Special Enrollment Period. Their coverage will not start until July 1 of the same year. Also, they may have to pay a higher Part A and/or Part B premium for late enrollment.
How Does Other Insurance Work With Medicare?
There are rules involving Medicare and other Insurance. Mostly, the employer may join with other employers or unions. This is to form or sponsor a multiple-employer plan. What happens? Usually, the largest employer/union determines whether Medicare pays first or not.
Always remember these facts:
- The primary payer (one who pays first) pays up to the limits of the coverage
- The secondary payer only pays if there are costs the primary insurer doesn’t cover
- The secondary payer (usually Medicare) may not pay all of the uncovered costs
- If the employer insurance is the secondary payer, they may need to enroll in Part B before their insurance can pay
How Much Does Part A Coverage Cost?
Usually, seniors do not have to pay a monthly premium for Part A coverage. This occurs when they or their spouse have paid Medicare taxes while working. When one is not eligible for premium-free Part A, they may buy Part A.
In most cases, one may choose to buy Part A Medicare including Part B. They also have to pay monthly premiums for both.
What’s the Part A Late Enrollment Penalty?
Non-eligible for Part A may have to pay 10% more of their monthly premium. This happens when they do not buy Part A after being eligible. They may also have to pay the higher premium for twice the number of years they could have had Part A. However, they did not sign up.
How Much Does Part B Coverage Cost?
The standard monthly premium amount was $134. That was in 2017. It may be higher depending on the senior’s income. However, most people who get Social Security benefits pays less than this amount. How? The monthly Part B premium increased more than the cost-of-living increase for 2017 SS benefit. They are paying the standard premium amount or higher if:
- enrollment in Part B for the first time in 2017
- the senior does not get Social Security benefits
- They will receive direct bills for their monthly Part B premiums. This means they did not yet receive their Social Security benefits.
- They have Medicare and Medicaid. Medicaid pays their premiums.
- Their modified adjusted gross income as reported is above certain amount. This report is basing on their IRS tax return 2 years ago.
What’s The Part B Late Enrollment Penalty?
Seniors may pay a late enrollment penalty when they do not sign up for Part B. Remember, the penalty goes on as long as they have Part B. Their monthly premium for Part B may go up 10%. That is for each 12-month period they could have had Part B. When they can sign up during a Special Enrollment Period, they may not have to pay penalty.
Comprehending how and when to sign up for Medicare helps seniors buy some time. Most especially, it helps them save a lot of money. It is important not to make mistakes when signing up for Medicare. To get an estimate on premiums and late enrollment penalties, visit Medicare.gov. Anyone can use their eligibility and premium calculator. Medicare quotes are also available on their website.