Understanding Your Options Before 65
Medicare can be a complicated, intimidating issue to research. If you’re approaching 65, and starting to look into Medicare, rest assured that you are not alone if you feel like it’s a lot to tackle. With 10,000 baby boomers turning 65 every day there are a lot of people out there in the same boat as you, looking for information and trying to determine the best path forward.
We are here to help. As a local, family-owned agency located in southern Maine, our goal is to provide you with information so that you are able to make informed decisions about the plans that will meet your needs and assist with your enrollment. Let’s start at the beginning – enrollment.
Enrollment if you are collecting Social Security
If you are collecting Social Security benefits you will be automatically enrolled in Medicare when you turn 65. Medicare Parts A and B will start the first day of the month that you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the previous month.
You will receive an “Initial Enrollment Package” that welcomes you to Medicare. This is mailed to you four months before your 65th birthday month and will include your new Medicare card. If you don’t want Medicare Part B at this time, follow the instructions on the back of the card. Otherwise, Medicare coverage will automatically begin the first day of the month of eligibility.
Enrollment if you’re not collecting Social Security
Full retirement age for Social Security benefits is 66 and 8 months for those born in 1958, so many people will continue to work past age 65. If you work past age 65 and have creditable coverage through an employer, you do not have to enroll in Medicare and you will not be penalized later.
In January of 2024:
Full retirement age for Social Security benefits will be 66 and 10 months for those born in 1959, so many people will continue to work past age 65. If you work past age 65 and have creditable coverage through an employer, you do not have to enroll in Medicare and you will not be penalized later.
In January of 2025 and beyond:
Full retirement age for Social Security benefits will be 67 for those born in 1960 and after, so many people will continue to work past age 65. If you work past age 65 and have creditable coverage through an employer, you do not have to enroll in Medicare and you will not be penalized later.
However, even if you do have creditable coverage through an employer, Medicare is still worth looking into. Employer plans often have high deductibles, so you may be able to get better, more affordable, coverage through Medicare.
If you lose employer coverage and do not have other credible coverage, you must sign up in the first eight months of eligibility to avoid a 10% annual penalty on your part B premium.
If you are not collecting Social Security, but want to enroll in Medicare you must do so yourself. There are three ways that you can enroll:
- Social Security website (Tip: This is the quickest way to enroll)
- Visit local Social Security office in person (Tip: Arrive early to avoid long wait times)
- Call Social Security to arrange a telephone interview (Tip: It can take 6 weeks to get an appointment – call well in advance of when you will need Medicare coverage)
If you enroll online or in person at the Social Security office, you should receive your Medicare card within 3-4 weeks.
What happens once I’m enrolled?
Your initial enrollment period (IEP) lasts for seven months: the three months before your 65th birthday month, the month of your 65th birthday, and the three months after your 65th birthday month. During your IEP you may pick up any Medicare supplement plan, Medicare advantage plan, or prescription drug plan with no medical underwriting and no pre-existing conditions clauses. This is called a guaranteed issue period.
If you are enrolling in a Medicare supplement you have an additional two months to enroll. If you wait longer, you may have to go through an underwriting process.
The choices you make during your IEP do not lock you in permanently. Medicare supplements can be changed any time of year. For Medicare Advantage Plans and Part D Prescription Drug Plans (PDPs) you will have an opportunity each year during the Annual Enrollment Period (AEP) to make changes unless to have a Special Election Period.
Handling All The Options
Whether you’ve been automatically enrolled in Medicare, or enrolled yourself, you’re going to notice that your mailbox is filling up with solicitations from every insurance company in the country. You have a choice to make – do you try to sort through this pile and call all the different companies across the country asking each all of your questions, or should you make one call and talk to someone local who works with all these different companies to answer your questions?