Turning 65 does not automatically mean you must enroll in Medicare. Medicare rules state that if you are 65 and covered by a group health plan from active employment at a company with more than 20 employees, you may delay enrolling. No worries—when you retire, you will be granted a Special Enrollment Period (SEP) to enroll without penalty. This also holds true if you aren’t working but you’re covered by your spouse’s medical plan.
“But, I’m on an Affordable Care Act Plan. Can I remain on that?” Yes, you may. However, after 65 you’ll lose any tax credit/subsidy that may be in place, meaning you’ll pay full price, which may be dramatically more expensive. They do allow you to keep your ACA plan while having Original Medicare too, but you’ll pay full price for that plan and you must report to your ACA carrier that you’ve enrolled in Medicare to avoid having to repay subsidies.
Not Working or Not Covered by Active Employment? Then it’s time to take action. Enrollment is completed at the Social Security Administration. You can do so online, or make an appointment at your local Social Security Office. Your Initial Enrollment Period begins three months before your 65th birthday month and ends three months after that month. During this time, you may need to enroll in Original Medicare, which includes: Part A (Hospital Insurance) and Part B (Medical Insurance). You will also need to decide how you want to receive your Medicare coverage—and yes, you have options.
Some individuals are automatically enrolled in Original Medicare. If you are already receiving Social Security retirement benefits, you will be enrolled in Medicare Parts A and B three months before the month you turn 65.
You should receive your Medicare card about 30 days after enrolling. From there, it’s time to make decisions about how you want your Medicare coverage to work for you. After you’ve received your card, you can call us to help educate you on how Medicare works and to assist you with your options. Understand that Original Medicare covers 80% of inpatient hospitalization and outpatient medical costs. It does not include prescription coverage. At a minimum, you must add a Part D prescription plan, even if you don’t currently take any prescription medications. Don’t worry, there are numerous prescription plans with no monthly premium. You simply need to have one in place.
Not receiving Social Security yet? No problem, but if you don’t have creditable, employer-provided insurance you must take action. Some people decide to wait until a later date to begin collecting Social Security Benefits, but you must still have Medicare in place. In that instance, Medicare will invoice you for your Original Medicare premium(s).
Avoid Costly Mistakes. Medicare enrollment rules and timelines can be confusing. Missing or misunderstanding your Initial Enrollment Period could result in lifetime premium penalties. If you miss your initial enrollment period, you’ll need to wait until the following January to enroll. That’s why it’s important to seek free, accurate, and unbiased information from your local SHIP agency. SHIP counselors are specially trained in Medicare policies and do not benefit financially from your decisions.
They can:
Explain how Medicare works
Review your coverage options: Supplemental (Medigap), Medicare Advantage and Prescription plan.
Screen for financial assistance programs to help make Medicare more affordable
SHIP (State Health Insurance Program), formerly known as MMAP, has offices in every Michigan county. Call today! 800-803-7174