Enrolling in Medicare

Unlike Social Security, the age for Medicare eligibility is the same for everyone: 65 years old, no matter what year you were born. If you have already filed for Social Security benefits by age 65, you will be automatically enrolled for Medicare. If not, your initial enrollment window begins three months before your 65th birthday month and extends for another three months — for a total of seven months. If you are receiving Social Security Disability Insurance or have end-stage renal disease, you may also be eligible for Medicare, even if you are under age 65.

Part A

Medicare Part A covers hospital care, post-discharge skilled nursing facility care and some home health and hospice care. If you (or your spouse) paid Medicare taxes for at least 10 years, Medicare Part A is free. You may purchase it if you do not meet this eligibility requirement.

Part B

Medicare Part B covers physician and specialist care, some preventive services, outpatient care and medical equipment. It is optional and can be purchased for a fee. In 2018, most retirees will pay $134 a month — the standard premium amount — if they enroll during their initial window. This amount can change every year. Part B can purchased after the initial enrollment period, but it will permanently cost more, and the extra fee will be based on how long you wait past initial eligibility. If you are automatically enrolled at age 65 because of your Social Security benefits, you can opt out of Part B if you don’t want to pay for it.1

Medigap

Medigap is a colloquial term that describes another optional policy you can buy to cover copays, deductibles and coinsurance expenses associated with your Medicare plan. If you sign up for a Medigap policy within the first six months of turning age 65, your coverage is guaranteed. After that, you may have to meet medical underwriting requirements, and you might be denied coverage or charged higher premiums.2 Also, it is important to evaluate your options carefully during your first enrollment period. If you decide to switch to a different Medigap policy after this open enrollment period, you may be subject to medical underwriting.

Medicare Advantage

Alternatively, you can choose to purchase Part A and B coverage through a private Medicare Advantage (MA) plan. It’s still Medicare, but the plan is administered through a private insurer and may have a limited network of providers. If you plan to spend part of the year out of state, you’ll want to check out the MA plan’s out-of-network coverage.3

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This content is provided for informational purposes only. It is provided by third parties and has been obtained from sources believed to be reliable, but accuracy and completeness cannot be guaranteed. The information is not intended to be used as the sole basis for financial decisions, nor should it be construed as advice designed to meet the particular needs of an individual’s situation.We are not affiliated with any government agency including the Social Security Administration.

1 Josh Weller. Journal-Advocate. March 11, 2018. “Facts you should know about enrolling in Medicare parts A & B.” http://www.journal-advocate.com/sterling-community/ci_31727651/facts-you-should-know-about-enrolling-medicare-parts. Accessed March 11, 2018.

2 Sarah O’Brien. CNBC. Feb. 21, 2018. “Don’t ignore this gap when signing up for Medicare.” https://www.cnbc.com/2018/02/21/dont-ignore-this-gap-when-signing-up-for-medicare.html. Accessed March 11, 2018.

3 Amy Rubino. Capital Gazette. Feb. 25, 2018. “Covering the Bases: Check nationwide coverage of your Medicare Part D drug plan.” http://www.capitalgazette.com/lifestyle/health/ac-cm-covering-20180225-story.html. Accessed March 11, 2018.