In this article, we suggest some questions you need to ask yourself about how to sign up for Medicare at age 65 and where to go for advice.
Signing up for Medicare for the first time? You need to be sure of what you are signing up for.
Medicare is the health insurance underwritten by the Federal government for: Senior citizens 65 or older and for younger people already receiving certain Disability Benefits or already enrolled.
As we shall see, Medicare plans provide Hospital Insurance (Medicare PART A), which is normally free and Medical Insurance (Medicare PART B) paid for by premiums offset by tax relief and state subsidies.
The program is designed to be flexible enough to allow individuals to tailor plans to meet their specific individual and family needs.
Medicare – First Time SignUp?
Medicare (Part C) plans allow users to design a custom plan that can be more closely aligned with their medical needs.
These plans combine parts A&B, and supplements can be added e.g. dental and vision to tailor plans to meet individual and family needs. These plans, ADVANTAGE PLANS, are run in cooperation with private insurance companies to provide some of the coverage. Advantage Plans may include prescription drugs coverage or you may choose Medicare Part D. WARNING: you cannot have prescription drugs coverage from more than one plan.
This is a broad description of the way that Medicare works with private insurers to deliver quality assured health insurance coverage.
NEXT, ask yourself what has changed since your last (ACA) enrollment. Perhaps you were covered by your employer’s insurance. Would it now be your personal plan of choice?
Check your recent history of medical service usage e.g. doctor visits, prescription drugs. Reflect this in your Medicare planning.
Do you anticipate hospital visits (planned surgery), dental or hearing treatment?
When do you sign up for Medicare for the first time?
Generally, in the period three months before the month of your 65th birthday and the three months following. It may be expensive to miss this first opportunity.
Talk to your employer first if you are leaving a group plan
Check with your local Social Security office to make sure of your position and consider the alternatives. Original Medicare (A and B) are mandatory but you can choose the plan type that suits your needs. You can add the Medicare advantage plan (C) and if you anticipate the regular use of prescription drugs you should consider plan D.
If you or your spouse have been paying for your Social Security benefits for ten years (or 40 quarters), you will be automatically enrolled in Medicare Part A when you turn 65.
When you are nearing your 65th birthday make sure you check on this at your local Social Security office and also learn about additional coverage.
How much does it cost?
Part ‘A’ of Medicare is funded by the Federal Government from taxes. Part ‘B’ covers specified treatments and services. You would be liable for any costs outside these limits. The average premium (Part B) costs about $110 pm.
The Affordable Care Act (ACA) defines eleven (11) supplementary plans (MEDIGAP) which offer the opportunity to insure against potentially life-affecting outcomes. The exact amount will depend on the plan you choose and the benefits it offers. Make sure you go through the Summary of Benefits and understand the fine print.
Medicare Advantage plans may cost no more than Original Medicare but may offer additional and more flexible coverage.
Once you have been accepted on a Medicare plan you cannot be refused continued coverage regardless of your circumstances.
How do I judge the Quality of the plans on offer?
All plans offered through an exchange (Federal, State or Private) must display a STAR rating (1 – 5).
The star ratings (5 is best) give a clear guide to the quality of the plan; the premium and the coverage will give you a guide to value.
Where should I go for advice?
It may seem complicated but the most important facts are your birthdate and your previous health insurance status.
The exchanges exist to give you free, unbiased access to Medicare insurance plans which match your needs.
TrueCoverage offers free online tools to compare the widest choice of various Medicare plans and give you quotes and advice on premium tax relief and the benefits available in your state.
You can enroll online yourself and at any time request help from one of our trained advisors.
We hope this article has helped you understand how to sign up for Medicare at age 65.