As you near the age of 65, there is plenty to think about. One big issue is whether you actually have to sign up for Medicare once your turn 65 or not.
It isn’t actually as simple as a yes or no answer, unfortunately. It all depends on a few circumstances for you as an individual. The biggest factor in knowing whether or not you have to sign up for Medicare when you turn 65 is if you’re still working. And even then, the answer will differ based on a few specifics about your employer.
Before digging into all of that, here’s a look at some information about Medicare.
Basics of Medicare
Medicare is America’s health insurance program for people 65 years old and above. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure. The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
There are six basic types of Medicare Advantage Plans, although some of that will be based on where you live:
- Health Maintenance Organizations (HMO)
- Preferred Provider Organizations (PPO)
- Private Fee-for-Service Plans (PFFS)
- Point of Service Plan (POS)
- Special Needs Plans (SNP)
- Medicare Savings Accounts (MSA)
Social Security enrolls you in Original Medicare (Part A and Part B). Part A deals with hospital insurance and helps pay for inpatient care at a hospital or a limited time in a skilled nursing facility. This can also pay for some home health care and hospice care. Part B helps pay for services from doctors and other healthcare providers, outpatient care, home health care, durable medical equipment, and some preventative services.
Part C are those Medicare Advantage Plans, and Medicare Part D is your prescription drug coverage. If you’re not sure which parts you qualify for or you should sign up for, there is no one better than the health insurance agents at Your Insurance Gal Agency to help walk you through all those complicated options.
Signing up for Medicare
The initial seven-month sign-up period for Medicare starts three months before you turn 65 and runs through three months after you turn 65. If you don’t sign up in that period, you could have to pay penalties whenever you do sign up. So it’s clearly a big deal to know when exactly to sign up for Medicare.
If you’re already receiving Social Security benefits, for example, then you are automatically enrolled in parts A and B of Medicare and your card will arrive in the mail three months prior to your 65th birthday. If you are a retiree who has a retiree health plan provided by a former employer, then you need to sign up for Medicare Parts A and B. Medicare is usually mandatory in this circumstance because it is primary to retiree health plans.
Medicare while working
Now that you have that brief background on Medicare, back to the original point: do you have to sign up for Medicare when you turn 65?
If you are still working at 65, there are a few different ways to go. First off, what is the size of the company you work for? If you work for a company with less than 20 employees, you have to sign up for Medicare as soon as you’re eligible. If you fail to do so, you will incur late enrollment penalties.
If you have insurance through an employer, or spouse’s employer, at 65, you can delay enrolling in Medicare until the employment ends or the coverage stops, whichever happens first. When the employer-tier coverage ends, you will begin a special enrollment period of up to eight months where you can sign up for Medicare without incurring late penalties.
Even if you or your spouse are still working when you’re 65, you should still take the time to do your research on what your Medicare options are. Just because you have employee healthcare, it’s quite possible that you’ll be able to get more coverage through your Medicare options. You can also sign up for different parts of Medicare instead of combining parts for an entire plan.
As you can see, the answer to signing up for Medicare when you turn 65 is entirely depending on your specific situation. However, you’ll want to be prepared to make that decision with as much knowledge as possible. You don’t want to wait until you turn 65 to try and cram to make the decision.
Take time to really dig into the specifics of your employer plan, if you’re still working, and figure out which will get you the most protection. And once your eyes start getting tired from reading through all that information about health plans, reach out to some experts, like the agents at Your Insurance Gal Agency, who know the ins and outs of Medicare and keep up with all the changes in the system so they give you the best advice possible.