Medicare Enrollment Periods at Age 65


Hi, I'm Tracy Mealer-Hernandez. I'm here with our second installment of Social Security Selected Shorts. Today we'll be talking about Medicare enrollment periods at age 65. So let's get started.

Before you blow out the candles on your 65th birthday cake, you'll need to learn the basics of Medicare and when to sign up. Because people seem to have a lot of questions about Medicare, today I want to answer some of the most frequently asked questions about when to enroll. The Centers for Medicare & Medicaid Services is the agency that administers the Medicare program, but you apply for Medicare with the Social Security Administration, and we can give you general information about Medicare.

First, let me provide a brief explanation of the Medicare program. Medicare is our country's health insurance program for people age 65 or older. Hospital insurance, or Part A, helps pay for inpatient care in a hospital or skilled nursing facility, some home healthcare, and hospice care. Usually, there is no monthly premium, because you or your spouse paid for some of the Medicare costs by paying the Medicare tax while working. Medical insurance, or Part B, helps pay for doctors' services and many other medical services and supplies that are not covered by hospital insurance. For most people, Part B has a monthly premium of $104.90 in 2013. The premium may change each year. Note some beneficiaries with higher incomes will pay a higher monthly Part B premium. Medicare advantage plans, or Part C, are available in many areas. People with Medicare Parts A and B can choose to receive all of their healthcare services through one of these provider organizations under Part C.

Prescription drug coverage, or Part D, helps pay for medications doctors prescribe for treatment. Both Medicare Part C and D are available through private companies, and premiums vary based on your plan. For more information on Medicare advantage or prescription drug plans, please visit www.medicare.gov, or call Medicare at 1-800-MEDICARE, TTY 1-877-486-2048.

For our discussion today, we will focus on Medicare Parts A and B. It's important to understand when you can enroll in Medicare Part B program and when your enrollment becomes effective. If you are already receiving Social Security retirement or disability benefits, you can relax. You will be automatically enrolled in Parts A and B, and the Medicare card will be mailed to you a few months before you're eligible. If you are not already receiving retirement benefits, you should contact us about three months before your 65th birthday to sign up for Medicare Parts A and B. If you miss signing up by your birthday, you can sign up any time with six months retroactivity.

There are three enrollment periods during which you can sign up for Medicare Part B. They are the initial, special, and general enrollment periods. Today we will be discussing these enrollment periods for Part B.

The initial enrollment period is your first opportunity to sign up for Medicare Part B. It lasts seven months and includes the three months prior to your 65th birthday, the month in which you turn 65, and three months after. You can see from this chart if you sign up in the three-month period before age 65, your Part B coverage begins the first day of the month that you turn 65. If you sign up during the month you turn 65 or during the three months after your birthday, your coverage starts later. To ensure timely enrollment at age 65, you should contact us about three months before your 65th birthday to sign up for Medicare. This chart shows you what month your Medicare Part B is effective during an initial enrollment period in or after the month you turn 65. You can find this chart at our website www.socialsecurity.gov under our Medicare tab or at the Medicare website www.medicare.gov.

If you are 65 or older and you or your spouse are working with coverage under a group health plan, you can use a special enrollment period to sign up for Part B. You can sign up for Part B any time while you are working and still covered by your group health plan or during the eight-month period that begins the month after employment ends, or the group health plan ends, whichever happens first. It is important to note that neither COBRA nor retiree health plans meet the requirements to use the special enrollment period. Signing up for Part B while you or your spouse are still working and covered under an employer group health plan based on current work or during the first full month when you are no longer enrolled in the plan offers you some choice in the month your Medicare coverage starts. For these situations, you can choose current month when you contact us or the first day of any of the following three months. If you sign up after your group health coverage has ended in the remaining seven months of the special enrollment period, your Part B coverage is always effective the month after you enroll.

If you didn't sign up for Part A or B during the initial or special enrollment period, make a note on your calendar reminding you to sign up during the general enrollment period of every year, January 1 through March 31st. Keep in mind, you may pay a higher premium, generally 10% for each 12- month period you are eligible for but did not sign up for Medicare Part B, and your coverage will start on July 1st. Remember, it is important to sign up for Medicare when you are first eligible to avoid penalties.

If you would like individualized Medicare counseling on coverage issues, please contact your State Health Insurance Counseling and Assistance Program, or SHIP. Each state has a SHIP. To find your state's resources, please visit www.medicare.gov, or call 1-800-633-4227. For more information on Medicare enrollment periods, or to apply for Medicare, even if you are not yet ready to file for retirement benefits, go to www.socialsecurity.gov. Our award winning website has applications, tools, fact sheets, and much more. We hope this information has been helpful. And thank you for joining us.