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When should I apply for Medicare?

Medicare is a national health insurance program for people age 65 or older, and people younger than age 65 who have certain disabilities or permanent kidney failure. The program is designed to help with the cost of health care. However, it does not cover all medical expenses or the cost of most long-term care.

There are four parts to Medicare:

  • Part A – Hospital insurance helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care;
  • Part B – Medical insurance helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services;
  • Part C – Medicare Advantage plans are available in many areas; and
  • Part D – Prescription drug coverage helps pay for the cost of prescription drugs.

As with most federal benefit programs there often seems to be much confusion about Medicare. One source of confusion is when and how to apply.

MedicareIf you are already getting Social Security retirement or disability benefits or railroad retirement checks, you will be contacted a few months before you become eligible for Medicare and given the information you need to apply. If you are already receiving Social Security retirement and the other benefits mentioned above, you will be automatically enrolled in Medicare Parts A and B, but have the option of turning it down.

If you are not already receiving retirement or disability benefits, you should contact Medicare about three months before your 65th birthday to sign up for Medicare. You can sign up for Medicare even if you do not plan to retire at age 65.

When you first become eligible for Part A, you have a seven-month period (your initial enrollment period) in which to sign up for Part B. A delay will cause a delay in coverage and result in higher premiums. If you are eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65 and ends three months after that birthday. If you are eligible for Medicare based on disability or permanent kidney failure, your initial enrollment period depends on the date your disability or treatment began.

If you do not enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a “general enrollment period” from January 1 through March 31. Your coverage begins on July 1 of the year you enroll. However, your monthly premium increases 10 percent for each 12-month period you were eligible for, but did not enroll in, Medicare Part B.

Although there are special circumstances that will allow you to enroll outside of your initial enrollment period and the general enrollment period, you must meet specific criteria in order to qualify.

The morale of the Medicare enrollment story is to make sure you are enrolled in Medicare as soon as you are eligible, otherwise you may be locked out or receive higher premiums.

By Eric J. Einhart-Guest Blogger

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