By Maura O’Toole
BALDWINSVILLE – When it comes to applying for Medicare, what you have to do will depend on your individual situation. Suppose you already receive Social Security or Railroad Retirement benefits (or will get them at least 4 months before you turn 65). In that case, you will automatically be enrolled in Medicare Part A and Part B when you become eligible. Your Medicare coverage will be effective the first of the month in which you turn 65, or if your birthday is on the first day of the month, your Medicare coverage will be effective the first day of the prior month. Suppose you retire at 65 and are not already receiving Social Security or Railroad Retirement benefits. In that case, you will have to sign up for Parts A and B during your 7-month Initial Enrollment Period. How do you signup for Medicare if you need to enroll yourself?
- Contact Social Security three months before turning 65 to enroll
- You can also apply online at socialsecurity.gov/retirement
- Individuals not enrolling during this time may have to pay a late enrollment penalty
Once you have enrolled in Original Medicare Part A and Part B, you have some additional decisions you will need to make regarding your Medicare coverage. This includes deciding whether or not you want to enroll in a Part D Prescription Drug Plan, a Medicare Supplement (Medigap) Plan, or a Medicare Advantage plan.
Part D Prescription Drug Plans
It is essential to understand that Original Medicare Part A and Part do not cover prescription drugs. So, if you want coverage for drugs, you will have to enroll in a Part D plan (stand-alone or included with a Medicare Advantage Plan). Additionally, if you choose not to enroll in a Part D plan if you enroll, later on, you may be hit with a late enrollment penalty that can be costly, and once you are penalized, you will have to pay that penalty forever. For this reason, it is strongly suggested that everyone who becomes eligible for Medicare enrolls in a Part D Plan. There are very low or no-cost options available for those who do not take many or any drugs. Your initial enrollment period for Part D is a seven-month window that starts three months before you become eligible, includes the month you become eligible, and ends three months after becoming eligible.
Medicare Supplement Plans (also known as Medigap Plans)
Medicare Supplement Plans work in conjunction with Original Medicare and fill in the gaps or supplement those benefits. These plans are standardized and have been given letter names (Plan G, for example). Medicare Supplement plans help pay for the out-of-pocket costs like deductibles, copays, and coinsurance not covered by Original Medicare. The six-month initial enrollment period for Medicare Supplements is six months and starts the month you become eligible for Medicare and runs for the next five additional months. During this time, you have Guarantee Issue rights, which means the insurance company cannot deny you or increase your rates for any pre-existing health conditions.
Medicare Advantage
Medicare Advantage Plans completely replace Original Medicare and often include additional benefits like dental, vision, hearing, OTC benefits, transportation, meals after inpatient admissions, fitness memberships, and more. Most Medicare Advantage plans also include Part D prescription drug benefits. There are many low and no-cost plans available. Your initial enrollment period for Part D is a seven-month window that starts three months before you become eligible, includes the month you become eligible, and ends three months after becoming eligible.
If you live in Central New York, Medicare Advisor Maura O’Toole from the Huntington Agency can help with any questions you may have; just give her a call at 315-312-0803.
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Maura O’Toole is with the Huntington Agency, 6 Southgate Road, Baldwinsville, NY 13027
(315) 312-0803
