How Do I Go About Enrolling in Medicare Part A and B?
If Medicare is going to be your primary health insurance in the near future, you want to know how the enrollment process works. Common questions I’m asked regarding Medicare are “when do I enroll?”, “how do I enroll?”, “where do I enroll”, and “what will it cost me to be on Medicare?”. This article will look at answers to these questions.
When Do I Enroll in Medicare?
Most of us are first be eligible to enroll in Medicare when we turn 65. In addition to being 65, you must also be a legal U.S. resident who has lived in the United States for at least 5 years in a row, including the last 5 years before applying for Medicare.
You may also be eligible for Medicare before turning 65 under certain circumstances. For instance, if you have a qualifying disability, you’re eligible to enroll after 24 months of receiving Social Security Disability Income benefits. If you’re diagnosed with End-Stage Renal Failure Disease, you’re also eligible to enroll prior to turning 65. Exactly when your Medicare benefits start with ESRD depends on what kind of care your need (dialysis or a kidney transplant).
Here are circumstances where you’ll want to enroll in Medicare Part A, B and D when turning 65.
· If you’re turning 65 and will no longer have employer or union healthcare insurance.
· If you’re turning 65 and will continue working for an employer with 20 or fewer employers.
· If you’re turning 65, are self-employed or a 1099 worker and currently getting your healthcare insurance from www.Healthcare.gov
You can delay your Medicare Part B enrollment since it comes with a monthly premium. Medicare Part B covers out-patient medical treatment and has a $148.50 monthly premium (high income earners will pay an IRMMA upcharge for their Part B coverage). You probably want to delay Medicare Part B if when turning 65 you’ll have health insurance through your employer, union or spouse. Medicare Part B, when coupled with another health insurance plan, becomes the secondary payer. There’s little value in paying a $148.50 month premium for Part B when it isn’t the primary payer of your medical bills.
If you plan on working past age 65, you may be able to stay on your employer’s health insurance plan. Have a talk with the health insurance administrator regarding the rules and cost of staying on their plan. Often, the overall out-of-pocket cost of staying on your employer’s plan is lower than the cost of Medicare. Medicare will not impose a late-enrollment penalty on you as long as your employer health and prescription plan is deemed “Credible Coverage” by Medicare.
If you do decided to start Medicare when you turn 65, start your research about 4 months prior to your birth month. Medicare will begin on the first day of the month you turn 65. My birthday is on October 21, so my Medicare will start on October 1. The exception to this rule is if your birthday is on the 1st day of a month. If your birthday is on the first day of the month, then your Medicare will start on the 1st day of the preceding month. If I was born on October 1, my Medicare would start on September 1st.
Where and How Do I Enroll in Medicare?
You should automatically be enrolled in Medicare Parts A & B if you’re already collecting Social Security benefits prior to age 65. If you elected to start drawing your Social Security early, your Medicare Card will be mailed to you. This red, white and blue care will have your Medicare Beneficiary Identifier (MBI) and show an Effective Date of coverage for Part A (Hospitalization / In-Patient Services) and Part B (Out-Patient Services).
If you’re not collecting Social Security or Disability benefits, your enrollment starts by contacting the Social Security Administration. Prior to Covid-19, you usually went to the closest Social Security field office, asked your questions, and had them enroll you. Currently, Social Security field offices are closed due to the Covid-19 pandemic.
Therefore, over the last year, your enrollment options doing it by phone or going online. The “hold time” when calling your local state level Social Security field office is much shorter than the waiting time when calling the 800-772-1213 Social Security Administration customer service number.
Online enrollment is done at www.SSA.gov . Setting up your User Name, Password and then answering the security questions is the challenge when enrolling online. Once you get past the registration and security questions, the process is straightforward and takes about 10 minutes.
What Will It Cost to Be on Medicare?
Your cost will vary depending on your age, Medicare plan choice, and income. If you’re turning 65, here’s a rough estimate.
· Medicare Part A premium is $0 for most eligible US citizens.
· Medicare Part B premium in 2021 is $148.50 month. Higher income individuals and couples filing joint tax returns will pay more than the $148.50 base rate, based on their modified adjusted gross income.
· Medicare Part D premium national average is around $34 month. Your premium can be below or above this amount, depending on the prescriptions you are on.
· Medicare Part C, or Medicare Advantage plans, bundle your Part A and Part B Medicare benefit administration and typically include Part D prescription drug plan. Medicare Advantage plans require you to continue paying your Part B premium ($148.50) and the additional Part C premium. Many areas of the country have $0 premium Medicare Advantage plans.
· Medicare Supplement premiums are set by the private insurance company offering them. In 2021, a Medicare Supplement plan G at age 65 averages around $120 for a female and $130 for a male. (Those enrolling in Medicare Part C / Medicare Advantage can’t also enroll in a Medicare Supplement plan.)
The information I’ve written here provides only a general overview of “when do I enroll?”, “how do I enroll?”, “where do I enroll”, and “what will it cost me to be on Medicare?”. This is only a starting point in educating yourself on Medicare. You will want to speak with an experienced Medicare agent / broker or go to Medicare.gov or CMS.gov for a deeper dive into Medicare. I’m available and happy to assist you with your Medicare questions or enrollment assistance.