Dear Marci,
I turn 65 this December, and I’m anxious about enrolling in Medicare on time. I do not want to miss my first chance to enroll, because I heard that you pay penalties if you don’t enroll right away. What steps should I take to make sure I don’t make Medicare enrollment mistakes?
– Lara (Baton Rouge, LA)
Dear Lara,
The steps you should take to enroll in Medicare on time will differ depending upon whether or not you already collect Social Security retirement benefits when you turn 65.
If you already receive Social Security when you turn 65, the federal government will automatically enroll you in Medicare. Your Medicare will start on the first of the month you turn 65, which is December. You do not need to sign up for Medicare.
On the other hand, if you do not receive Social Security when you turn 65, you must take action to apply for Medicare. To avoid higher costs down the line, you must enroll during your Initial Enrollment Period (IEP). Your IEP includes the three months before, the month of, and the three months following your 65th birthday. For you, your IEP will span from September 2015 to March 2016, since your 65th birthday is in December. If you enroll in Medicare during this seven month period, you will avoidlate enrollment penalties and gaps in health insurance coverage.
The date your Medicare coverage begins depends on when you enroll during your IEP. For your coverage to begin as soon as possible, it is best to enroll in the first three months of your IEP (the three months before the month you turn 65). Your Medicare coverage will then go into effect starting the first day of the month you turn 65. If you enroll during the month you turn 65, your Medicare coverage will go into effect the following month. If you enroll during the fifth month of your IEP, your Medicare coverage begins two months after you enroll. If you enroll during the sixth or seventh month of your IEP, your coverage begins three months after you enroll.
If you enroll in Medicare at any point during your IEP, your enrollment will be considered timely. You will not face any late enrollment penalties. To enroll in Medicare, you can call the Social Security Administration at 800-772-1213 or you can visit your local Social Security office.
When you enroll in Medicare (either actively during your IEP or automatically), you receive Medicare Parts A and B. Most people do not pay a premium for Part A, but almost all people owe a premium for Part B.
Understand that you will have the option to turn down Part B, but you should use great caution before declining Part B coverage. You should only consider delaying Part B if you confirm two essential things. First, you must have coverage from your or your spouse’s currentemployer. If are insured by your own or your spouse’s current employer, you have special permission, called a Special Enrollment Period, to enroll in Part B later without risking higher costs and periods without coverage. Second, you must verify that your current employer coverage will pay the same amount for your care as it did before you qualified for Medicare. In other words, ensure that your employer coverage pays first on claims before Medicare pays. Insurance that pays first on claims is called primary coverage. You should always enroll in Medicare Part B right away if your employer coverage is not primary to Medicare (meaning it pays after Medicare on insurance claims). If Medicare is supposed to pay first and you fail to enroll, the employer plan may pay little to none of your health care costs.
Keep in mind that how your current employer coverage is affected by your Medicare eligibility largely depends on the size of the employer. If you have current employer coverage, talk to your employer to find out how yourcoverage works with Medicare. Verify this information with Social Security before making any final decisions about Part B coverage.
-Marci