Some people get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) automatically, and some have to sign up for it.
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Original Medicare (Parts A and B) makes it easy to sign up. All you have to do is open your mail and put your Medicare card in your wallet. For some plans, you'll have to do a little more to sign up, but it's important to learn as much as you can about your choices before signing up.
If you want to sign up for Original Medicare, it might be easy. If you already get Social Security or Railroad Retirement Board benefits and you live in the U.S., the government will sign you up for both Medicare Part A and Medicare Part B when you turn 65. Your Medicare card and instructions will be sent to you in the mail three months before you turn 65.
At this point, you can choose not to sign up for Medicare Part B, which has a monthly fee of $170.10/month for most enrollees in 2022. Medicare Part A, on the other hand, does not have a monthly fee for most enrollees. But you probably won't want to do that unless you or your spouse already have health insurance through an employer with at least 20 workers. That's a good reason to wait to sign up for Medicare Part B.
If you decide not to sign up for Part B but want to later, you may have to pay a higher premium – 10 percent more for each year you could have signed up but didn't. The penalty doesn't apply, though, if you didn't sign up for Part B coverage at first because you already had health insurance through your (or your spouse's) current employer. This includes TRICARE if you are currently working for the military.
Original Medicare won't sign you up automatically if you turn 65 but aren't yet getting Social Security or railroad retirement benefits. You will be able to sign up instead during a seven-month open enrollment period that starts three months before the month you turn 65 and goes through the month you turn 65 and the three months after that. So, if your 65th birthday is July 14, you can sign up for Medicare in April, May, June, July, August, September, and October.
If you are eligible for Social Security but haven't signed up yet and want to start getting benefits, you can sign up online or at a Social Security office near you. Make sure you understand how your benefits change based on how old you are when you start getting them. There is no right or wrong time to start getting your benefits.
If you'll be eligible for railroad retirement benefits, you can sign up by calling the field office of the Railroad Retirement Board.
Beneficiaries who qualify for a Medicare Savings Program (MSP) because of their income and assets are automatically signed up for Medicare Part B.
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You can get Medicare coverage through a private insurance company instead of directly from the federal government if you have Medicare Advantage. When you get medical care, instead of a regular Medicare ID card, you'll just use the insurance card that your private Medicare Advantage insurer gives you.
To join a Medicare Advantage plan, you must have Original Medicare (Parts A and B) or be eligible for them. You must also live in an area where an Advantage Plan is available. (A plan may be available in a state, but not in every county in that state.) In some rural parts of the U.S., there are no Medicare Advantage plans at all, even though they are available in most of the country.
You also can't join a Medicare Advantage plan at any time you want. When you first become eligible for Medicare, you can sign up. If you have Social Security Disability Insurance, you can sign up in the 25th month of your disability or in the three months before or after that month. During the annual open enrollment period, which runs from October 15 to December 7, you can change to a different Medicare Advantage plan or switch from Original Medicare to a Medicare Advantage plan. Your new plan will start on January 1.
Medicare Advantage plans must cover all of the services that Medicare Parts A and B would cover, but the out-of-pocket costs are different. Most Advantage plans also cover Part D prescription drugs, making the plan a one-stop shop for Medicare (as opposed to needing to purchase a Part D plan and a Medigap plan if you have Original Medicare). But either way, there are pros and cons.
You should know that Original Medicare and Medicare Advantage don't cover long-term custodial care, so you'll still need long-term care insurance to cover future costs.
Note that even though your Medicare Advantage plan combines Medicare Parts A and B into one private plan, you'll still have to pay your Medicare Part B premium in addition to your Medicare Advantage premium. Most enrollees have their Part B premiums taken out of their Social Security checks, but if you don't get Social Security, you'll have to pay it directly. In 2022, the Part B premium for most enrollees will be $170.10/month. Some Medicare Advantage plans offer a "giveback" rebate that pays a portion of the Part B premium, but this isn't very common.
We can assist you on signing up, call us at (908) 460-8836.
From October 15 to December 7 each year is the fall open enrollment period. During this time, you can switch to a different Medicare Advantage plan or to Original Medicare if you think it would be better for you.
If you already have a Medicare Advantage plan, you can switch to a different Advantage plan or back to Original Medicare during the annual Medicare Advantage open enrollment period. This is true even if you just signed up during the last annual enrollment period and your coverage didn't start until January 1. This window has been open since 2019 and is open from January 1 to March 31. It only applies to people who already have Medicare Advantage plans. During this time, a person with Original Medicare can't switch to a Medicare Advantage plan. Instead, the person would have to wait until the annual enrollment period in the fall.
If you already have a Medicare Advantage plan and want to switch to a different Advantage plan during general open enrollment or the Medicare Advantage open enrollment period, your current plan will drop you without a break in coverage. During general open enrollment, any changes you make will take effect on January 1. During the Medicare Advantage open enrollment period, if you make a change, it will take effect on the first of the next month.
If you are under 65 and qualify for Medicare because of a disability, most states have at least some kind of guaranteed issue period during which you can buy a Medigap plan. However, the protections for consumers vary greatly from one state to the next. In most states that make sure people under 65 can get Medigap plans, insurers are allowed to charge extra premiums for people under 65. If you click on a state on this map, you can find out how that state regulates Medigap plans.
If you miss your first chance to sign up for Medigap, you may still be able to buy a policy, but the insurance company may charge you more. Or, even worse, a company could refuse to give out any Medigap policies at all. But some states have consumer protections that say at least some Medigap plans must be given to everyone who wants them.
In New York and Connecticut, Medigap plans are not based on a person's health, no matter when they sign up.
Every year, from February 1 to March 31, people in Massachusetts can sign up for guaranteed-issue Medigap coverage.
Maine requires that each Medigap insurer set aside one month each year when all applicants are guaranteed to get at least Medigap Plan A.
Missouri has a "anniversary rule" that lets Medigap enrollees switch to the same letter plan from a different Medigap insurer 30 days before the policy anniversary. This is called "guaranteed issue."
Medigap enrollees in California and Oregon have 30 days after their birthdays each year to switch to any other Medigap plan with the same or less benefits without having to go through a medical exam.
People who are already enrolled in a Medigap plan in Washington state can switch to another Medigap plan at any time (guaranteed-issue) as long as they've had coverage for at least 90 days. People who have Medigap Plan A can only change to another Plan A. People who have Medigap Plans B through N, on the other hand, can change to any other Plan B through N.
As of March 2022, Idaho will have a "birthday rule" plan change window. In 2021, the state passed a law that told the insurance department to set up a time each year when a person with Medigap could switch to a different Medigap plan without having to go through a medical underwriting. The state has confirmed that plan changes will only be made to plans with the same or less benefits. For more information, see the state's bulletin for insurers.