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What You Need to Know About Signing Up for Medicare for the First Time

Signing up for Medicare for the first time? Before you do, here’s what you need to know about the different parts of Medicare and Medicare supplemental plans. Please be advised that we strongly encourage new Medicare beneficiaries to have all the facts before signing up for Medicare for the first time. Meet with a local insurance agent or reach out to Medicare (1-800-MEDICARE or https://www.medicare.gov/).

When Can You Get Medicare?

The first time you apply for Medicare is called your “Initial Enrollment Period.” This is a 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

Is it mandatory to sign up for Medicare at age 65? No. You have the option to delay your Part B when you’re first eligible under certain circumstances (for example, when you’re still receiving health coverage from employment or if you have private insurance). However, if you do not enroll and you do not delay your Part B when you are first eligible, you may have to pay a Part B late-enrollment penalty.

Tip: Even if you do choose to delay your Part B, it’s important that you still sign up for Part A when you turn 65.

How to Sign Up for Medicare at Age 65

 When you turn 65, do you automatically get Medicare? If you’re already collecting social security when you turn 65, then yes, you should be automatically signed up and your Medicare card should be sent to you. If you haven’t received your Medicare card (or if you are not collecting Social Security by age 65), you’ll need to apply for Parts A & B before your 65th birthday (unless you are choosing to delay Medicare).

To sign up for Medicare online:

  1. Go to Medicare.gov
  2. Under the “Sign Up” tab, click “Apply for Medicare Online.” This will direct you to Social Security where you’ll be able to follow the prompts and sign up.

If you do not want to sign up for Medicare online, you can call Social Security (their contact information is on their website at ssa.gov) or make an appointment at your local social security office and sign up in person.

Notice: Everyone pays a Part B premium, although some may qualify for government assistance with this cost. This Part B premium varies depending on your income, but most will pay the standard monthly premium of $135.50 in 2019. If you’re receiving Social Security, the Part B monthly premium will be taken out of your Social Security. If not, then you’ll be responsible for paying that premium, which will be billed to you quarterly.

For more details on how your income can affect your Part B premium, click here.
 

 

What is Original Medicare and What are Medicare Supplemental Plans?

When you take out your Part A and Part B, you’re on what’s called Original Medicare. That means Medicare covers 80% of your inpatient and outpatient costs while you pay the other 20% out of pocket, in addition to the Original Medicare deductibles. For example, those on Original Medicare will not only pay 20% of all costs, but they will have be responsible for the Part A deductible of $1,364 (in 2019) each time they go to the hospital.

This is where a Medicare supplement plan comes in. What a Medicare supplemental plan does is help you cover that 20%. These plans are offered by private insurance companies and usually fall into three categories: Medicare Advantage, Medicare Supplement, and Prescription Drug.

Medicare Advantage plans (MAPD) are like an “all-in-one” plan. They combine Parts A, B, and D. Usually, members on these plans need to have a primary care doctor who they receive referrals from before seeing a specialist. The benefits of MAPD plans vary widely between insurance companies, so it’s important you talk to someone, like a Medicare Insurance Agent, who can show you the differences between the cost of plans in your area.

Medicare Supplement plans combine Parts A and B but do not include Part D. When you have a Medicare Supplement plan, you should have a separate Prescription Drug Plan (PDP) for two reasons:

  1. You will pay a penalty if you don’t take out Medicare Part D.
  2. Medicare Part D can help you with the cost of your prescription drugs.

Those on Medicare Supplement plans don’t have to see a primary care doctor in order to visit a specialist and can go to doctors in different counties and states.

Prescription Drug plans (PDP) cover your Medicare Part D. Those on Original Medicare only or those on Medicare Supplement plans should have a separate PDP per Medicare’s Part D requirement. Please know that Medicare beneficiaries can be penalized for not having a Part D plan. Again, if you have a Medicare Advantage Plan, your Part D is already embedded in the plan and you do not need an additional PDP. See a Medicare Insurance Agent to ensure you’re covered.

So You’re Signed Up with a Plan. Now What?

  • Once you get your Medicare card and your individual insurance plan cards, find a safe place in your wallet to store them. You’ll need your insurance cards for your doctor visits and for the pharmacy. Those on Medicare Supplement plans will also need their Medicare Card for doctor visits.
  • In addition to your insurance cards, you should also receive a booklet or letter listing your plan’s benefits. Keep this information someplace you can access easily so you’re able to stay up to date with your plan coverage.
  • If at any time you misplace one of your cards or can’t find information on your benefit plan, an insurance agent can help you replace this information.
  • Mark October 15 on your calendar in case you ever want to make a change to your Medicare plan. You can change your MAPD plan or your PDP plan every year between October 15 and December 7.
  • Save your insurance agent’s contact information. At any time during the year, you can reach out to them with questions about your plan, benefits, special enrollment periods, and more.
  • Take advantage of your plan benefits. Use the resources Medicare and your insurance company offer you.

 

Commonly Asked Questions

  1. Can I keep my current doctor?
    1. You may be able to, depending on the medical group they are in and the Medicare care plan you are looking at. Be sure to tell your insurance agent that you want to keep your same doctor so they can direct you to a plan that your doctor takes.
  2. If I don’t like my plan, when can I change?
    1. Each year between October 15 and December 7, there is an annual enrollment period (AEP) for Medicare beneficiaries. At this time, you can change your MAPD or PDP plans for a January 1 start date.
    2. There are other special enrollment periods that may allow you to change your plan during the rest of year. Read this article to find out more.
  3. Will my prescription drugs be covered?
    1. When signing up for a Medicare plan, be sure you tell your insurance agent the prescriptions you’re taking so they can search plan formularies and find you a plan that will cover your medications.
    2. On most plans, you will still have a copayment for non-generic drugs, but check with your agent before signing up for a PDP plan.
  4. What if I’m not ready to take out my Social Security? Can I still apply for Medicare Parts A & B?
    1. You can apply for Medicare without drawing your Social Security. A Medicare Insurance agency, like Caress Insurance Agency, Inc., can help you do this, or speak to a representative from Social Security (ssa.gov).
    2. Note that you will be responsible for the Part B monthly premium ($135.50 in 2019), which is billed quarterly if you’re not having it taken out of Social Security.
  5. Do I have to sign up for Medicare if I’m still working at 65?
    1. If you are receiving health insurance through your employer, you can choose to delay your Medicare Part B without being penalized. When your group coverage or private insurance coverage is ending, don’t forget to apply for Medicare Part B.
    2. Even if you choose to delay your Part B, we suggest you still take out your Medicare Part A when you turn 65.

Don’t be afraid to ask questions. Before signing up with a Medicare plan, you have a right to know what will be covered and what the projected cost of your health needs will be for the year. Caress Insurance Agency, Inc. has agents in San Diego County, and we work with Mercy Scripps Hospital to help answer your Medicare questions and provide you with the latest information on your Medicare Insurance Plans.

 

CATEGORIES: MedicareSeniors & Caregivers

 

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