Welcome to “New to Medicare!”
Welcome to Part 1 of my latest column series, “New to Medicare.” Today and the next eight weeks will be dedicated to guiding those who will soon be going on Medicare Parts, A, B, or both, through the process of initially enrolling in Original Medicare, making the choice between a Supplement or Advantage Plan, what needs to be done after one’s initial enrollment, and everything in between.
This Week’s Question
When do I need to start thinking about Medicare and my plan options? What steps need to be taken to enroll? When does Medicare Part A and B go into effect?
A Year in Advance
Although you can’t enroll in Original Medicare until three months prior to your desired effective date, I’d say about a year in advance is a good time to start actually thinking about and doing some initial research, although you can take out all the confusion and save time by using my agency’s no cost services. Over the 13 years The Health Insurance Store has been in business, we’ve developed a very easy to understand approach to explaining Medicare and one’s options in plans and companies. We’re also brokers, able to provide plans from virtually every competitive Supplement, Advantage, and Part D company on the market, which ensures unbiased advice.
The Three Scenarios
There are three scenarios regarding enrolling in Medicare Parts A and/or B for the first time. The most common and one people are familiar with is turning 65, which with only one exception is when one first becomes eligible for Medicare. Those in this category can get a Medicare effective date the first day of the month they turn 65. For example, if you were born on November 24th, 1956, your Medicare A and B effective dates can be as early as November 1st, 2021. Those who are already collecting Social Security prior to their 65th birthday don’t need to do anything. There are no forms to fill out or applications to be completed. A red, white, and blue card with both Parts A and B will be mailed to you about 100 prior to the original Medicare effective dates. It comes from Social Security in an envelope about half the size of a sheet of printer paper. To use the prior example, anyone born in November 1956 and already collecting Social Security should expect their card mid-July.
If You Postpone
Those who are going to postpone collecting Social Security until a date after their 65th birthday do have to physically apply for Medicare. The easiest way to do that is at Social Security’s website, ssa.gov. Before the application can be completed, an online account must be created but it’s a pretty simple process start to finish. You can also apply for Medicare over the phone or in person at your local Social Security office, although currently local they’re not open for face-to-face meetings.
The Last Group
The last group are those who are over age 65 and can get health insurance through their own or a spouse’s employer. I estimate 80% or more who do are best to opt out of Part B which can be done without incurring a late enrollment penalty. I will get into much more detail regarding this topic next week. It can be very confusing who should or shouldn’t opt out of Medicare Part B, who could be accessed a penalty for a late enrollment in both Parts B and D, who is exempt from penalties, and who will be forced to pay a higher monthly Part B premium than the $148.50 standard rate.
Those who opted out of Part B enroll at a later date, either upon retirement or if at some point their insurance at work becomes a lesser value than Medicare and a Supplement or Advantage Plan. Unfortunately, the application for Part B can’t be done online for those who already have Part A, which I do recommend everyone take at age 65 because it’s free and can come in really handy, especially for those with higher deductibles and MOOP. Once someone who has opted out knows when they want Part B to go into effect, they can apply up to 90 days prior, but all effective dates must be the 1st of a month, no other day.
I often hear people who are in this demographic say they were told they can only apply for Part B in January, February, or March for an effective date of July 1st. That’s not true. Only those who are going to be assessed a Part B late enrollment penalty have this restriction. Again, anyone who is getting health insurance as an active employee or is a spouse of an active employee can enroll in Part B any time during the year with an effective date of any month they so choose. However, a “Request for Employment Information” form must be filled out by the employer that states the dates the Medicare beneficiary was insured and that it is currently active or what date it ended. The completed form then needs to be submitted to Social Security. Unfortunately, due to local offices being closed for in person transactions, the process of getting it to a representative is a bit more time consuming. Hopefully they will open back up soon, but until then, I suggest starting the process of acquiring Part B as close to 90 days prior to one’s desired effective date as possible.
Our staff can provide the necessary forms and also walk you through the process upon request. Like consultations, we don’t charge any fees for this service and guidance.
Please look for copies of each column in the series on our website within a few days of them appearing in the paper. You can also access the podcast and webcast versions there as well approximately one week from publication.
And don’t forget to listen in to my radio show, Medicare A to Z, on WMBS Uniontown each first and third Monday of the month from 1:15 to 3. You can listen online at wmbs590.com.
Call one of our office locations or reach out to me directly with any Medicare related questions or to set up an appointment for a free consultation.
Erie County Area
1105 West 12th Street, Suite – A
Erie, PA 16501
Fayette/Westmoreland County Area
121 North Pittsburgh Street
Connellsville, PA. 15425
21 Yost Blvd., Forest Hills, PA 15221
Mailing Address: 128 Forest Hills Plaza, Pittsburgh, PA 15221
Albuquerque/Santa Fe, New Mexico Area
821 Coors Blvd. NW
Albuquerque, NM 87121
Serving These Areas
We proudly serve the health insurance and Medicare needs of the following Pennsylvania areas: Connellsville, Uniontown, Greensburg, Mt. Pleasant, Scottdale, Irwin, N. Huntingdon, Murrysville, Monroeville, Plum, Lower Burrell, New Kensington, Pittsburgh, Plum, Oakmont, Penn Hills, Forest Hills, Wilkinsburg, East Liberty, Lawrenceville, Bloomfield, Natrona Heights, Leechburg, Washington, Morgantown WV, Latrobe, Monnessen, Jeanette, Erie, Edinboro, Northeast, Girard, Fairview, Union City, Harborcreek, Corey, Meadville, Waterford, Ligonier, Kittaning, Somerset, Waynesburg, Fayette County, Westmoreland County, Armstrong County, Butler County, Somerset County, Erie County, Crawford County, Venango County, Allegheny Valley, Pennsylvania
We proudly serve the following New Mexico areas: Albuquerque, Rio Rancho, Sante Fe, Bernalillo, Belen, Los Lunas, Espanola, Moriarty, Corales, Tijeras, Cedar Crest, Edgewood, Soccoro, Sandoval County, Sante Fe County, Bernalillo County, Rio Arriba County, Valencia County, Soccoro County, New Mexico
Not affiliated with the U. S. government or federal Medicare program.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.