This guide provides a step-by-step process for enrolling in Medicare.
1. Determine Your Eligibility
Before you begin the enrollment process, confirm your eligibility. Generally, you are eligible for Medicare if you are:
- 65 or older
- Under 65 with certain disabilities
- Any age with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS)
2. Understand the Different Parts of Medicare
Medicare has several parts, each covering different services. Part A and Part B are considered “Original Medicare” which is a fee-for-service style health insurance. Important parts are:
- Part A (Hospital Insurance): Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
- Part B (Medical Insurance): Covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
- Part C (Medicare Advantage): An alternative to Original Medicare (Part A and Part B) offered by private companies.
- Part D (Prescription Drug Coverage): Helps cover the cost of prescription drugs.
3. When to Enroll
Your Initial Enrollment Period (IEP) is a 7-month period that includes:
- The 3 months before the month you turn 65
- The month you turn 65
- The 3 months after the month you turn 65
It is generally recommended to enroll during your IEP to avoid potential penalties.
4. Enrollment Options
You can enroll in Medicare in several ways:
- Online: Visit the Social Security Administration’s website.
- Phone: Call Social Security at 1-800-772-1213.
- In-Person: Visit your local Social Security office.
5. Continuing to work?
- Medicare eligible individuals will still sign up for Part A
- Part B can be delayed as long as your employer or other current insurance is considered creditable by CMS (Centers for Medicare and Medicaid Services). Check with your company human resources representative to confirm this. Medicare will ask them to complete a form later when you retire and enroll after age 65.
6. Gather Required Documents
To enroll, you will likely need the following information:
- Social Security number
- Date and place of birth
- Medicare card (if you already have one)
7. Avoid Late Enrollment Penalties
The minimum requirements are Part A, Part B and Part D (prescription plan).
Enroll in Medicare coverage during your Initial Enrollment Period unless you have coverage that’s similar in value to Medicare (creditable coverage).
8. Understand Costs
Medicare has various costs, including premiums, deductibles, and co-pays. These costs vary depending on the part of Medicare you choose. Utilize an independent broker for unbiased explanations on your benefits.
9. Consider Additional Coverage
Depending on your needs, you may want to consider additional coverage, such as:
- Medicare Supplement Insurance (Medigap): Helps pay some of the costs that Original Medicare doesn’t cover.
- Medicare Advantage Plans (Part C): Offers an alternative way to receive your Medicare benefits.
10. Review and Compare Plans
If you choose a Medicare Advantage Plan or a Part D plan, take the time to review and compare available plans in your area. Consider factors such as:
- Cost
- Coverage you need
- Network of providers
11. Stay Informed or Find a Broker
Medicare information can change. Stay informed about any updates or changes to your coverage and benefits. Every fall, next year plan information is released on October 1st. It is important to review for any changes that affect you each year.
You can contact Erik Roti or Tippy Sourignavong who will help you stay on top of your plan. They can advise you on the entire enrollment process, the do’s and don’t’s of preparing for Medicare, and reviewing any changes to your plan at the end of the year.
