Healthcare

What You Need to Know About Obtaining Medicare Coverage

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by Alli Thomas

Jul 20, 2021

Because there are multiple parts to Medicare, there are several sets of rules on when you can enroll.

If you’re eligible for Medicare but don’t sign up, you may be subject to late enrollment penalties, so it’s important to know the rules for enrollment periods.

Here are answers to some common questions about obtaining Medicare coverage:

 

When Can I first Sign Up for Medicare?

Since people turn 65 every day, Medicare offers everyone a seven-month enrollment window around their 65th birthday for all components – Part A, Part B, Part C (Medicare Advantage), and Part D (prescription drugs).

The Initial Enrollment Period for everyone:

  • starts three months prior to the month you turn 65
  • ends three months after the month you turn 65

For example, if you turn 65 in September, you can enroll in Medicare from June to December.

There is one order-of-operations component, too. You must be enrolled in Part A and Part B before you can enroll in a Medicare Advantage plan, so don’t wait until the last month of your IEP to apply if you want more than just Parts A and B.

Note: If you already get benefits from Social Security, you don’t have to sign up as you will automatically be enrolled in Part A and Part B unless you live in Puerto Rico.

 

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Should I have enrolled in Medicare while I was still working?

Good news: If you were working until recently at an employer with over 20 employees and received health coverage, you weren’t required to sign up for Medicare Part A (which covers hospitalization, skilled nursing and some home health care) or Part B (which covers office visits, outpatient care, and medical supplies).

If you’re still working and covered by your employer’s health insurance plan when you turn 65, you can postpone applying for Medicare.

However, since Part A is free, many people sign up for it anyway when they first become eligible.

It’s a good idea to sign up for Part A even if you are still working and have employer-sponsored health insurance as it can act as secondary insurance to pick up the tab for expenses that your employer-sponsored health insurance doesn’t cover.

What if I didn’t enroll and have lost my employer-covered healthcare?

Workers over 65 that lose their employer-covered health coverage either due to retirement, loss of work, or end of benefits receive an eight-month Special Enrollment Period to sign up for Medicare.

This period starts the month after your employment or health coverage ends. For example, if your benefits end in September, your enrollment period begins in October.

 

What If I missed my Enrollment Period(s)?

If you missed your enrollment period, you have to wait until the next General Enrollment Period, which runs from January 1 to March 31. You should also contact Medicare as soon as possible.


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Alli Thomas

Alli Thomas has worked in the financial services industry for nearly 20 years, with a focus on retirement-related investing. She began her career as a FINRA-licensed participant-services call-center associate at Vanguard, and then moved to Principal Financial Group, where she worked closely with employers, assisting with retirement plan set-up and design, selecting appropriate plan investment offerings, and maximizing employee participation through targeted education campaigns and enrollment meetings. Alli has also worked as a qualified 401(k) administrator and registered investment advisor for several small investment firms. She now writes about all things investment- and finance-related, leveraging her extensive experience and passion for retirement planning to help investors make well-informed financial decisions.

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