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When To Apply For Medicare

when to apply for medicare

When it comes to subjects like Medicare, keeping up with important dates and deadlines can be difficult if you already have a lot on your plate. Each portion of Medicare has its own enrollment deadlines that largely depend on your situation and eligibility, and it’s important to keep up with the deadlines because you may be charged late fees if you don’t enroll on time. Don’t get caught in the rush during enrollment season, get all of the facts now of when exactly you should apply for medicare .

When to Sign Up For Medicare

How can you make sure that you’re adhering to the deadlines? Rest assured that we’re here to help you sort through the important dates so that you never fall behind. If you’re approaching your 65th birthday, then read on to discover more about the dates and deadlines to keep in mind when it comes to Medicare enrollment.

Medicare Part A Enrollment Deadlines

Some people get enrolled in Medicare Part A automatically. If you meet one of the following conditions, then you may be enrolled in Medicare Part A three months prior to your 65th birthday or during the 25th month of your disability depending on circumstance: You currently receive benefits from the Railroad Retirement Board or Social Security, are younger than 65 and have a disability, have been diagnosed with Lou Gehrig’s disease or live in Puerto Rico and draw benefits from the Railroad Board or Social Security. Those who meet the above qualifications won’t need to worry about enrollment deadlines.

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Unless you get enrolled into Medicare Part A automatically due to health conditions or retirement status, your ability to enroll in Medicare begins three months prior to your 65th birthday and ends three months after the month you turn 65. Essentially, you have a total of seven months to enroll in Medicare when you first become eligible. If you don’t enroll during your initial enrollment period, then you may be charged a penalty fee if you enroll later. Penalty fees are assessed for as many months as you lacked Medicare coverage, and this sum can add up over time. Numbers and dates tend to run together for some people, so let’s take a look at an example to give you an idea of the reality of Medicare Part A deadlines.

  • Meet Janice Dowry. Janice’s 65th birthday is on June 30th. Her initial enrollment period will begin March 1st of the year she turns 65 and continue through September 30th of the same year.
  • In other words, Janice has a total of seven complete months to sign up for Medicare: the three months leading up to her 65th birthday, the month containing her 65th birthday and the three months that follow the month of her 65th birthday.
  • Janice decides to enroll as soon as she can to avoid any late fees. She enrolls in Medicare in March when she’s first eligible. Because she enrolled within the initial three-month period before her birthday, Janice’s Medicare Part A coverage will begin on the first of the month that contains her birthday. In this case, her coverage will start on June 1st.

What if Janice had waited to enroll until after her 65th birthday? You have a full seven months to enroll initially in Medicare, and you can take as much time as you need during this initial enrollment phase to make a well-informed decision about your coverage. However, your coverage will be later the longer you wait to enroll.

  • Janice hasn’t quite made up her mind about the portions of Medicare in which she wants to enroll. By her 65th birthday, Janice is still uncertain.
  • Finally, Janice decides to enroll in Medicare a few weeks after her birthday in July. She enrolls in Medicare Part A on July 23rd.
  • Because she waited, Janice now has to wait for her coverage to begin a full two months after signing up. This means that her coverage will start toward the end of September.

If Janice had waited until the very end of her seven-month enrollment period, then her coverage would have begun three months after the date she finally signed up. However, the three-month gap is still much shorter than the gap that might have happened if Janice had chosen to forgo enrollment entirely. In that case, Janice would have had to wait until the beginning of the general enrollment period on January 1st of the following year, and her coverage wouldn’t begin until July of the next year. Of course, there are always exceptions to the rule. Medicare enrollment deadlines generally apply to all eligible beneficiaries. However, you may qualify for a special enrollment period provided that you meet certain qualifications. Let’s go back to Janice to see if she might qualify for a special enrollment period.

  • Janice is still working when she turns 65, and she has a group health plan through her current employer that covers her and her spouse. She decides to forgo Medicare Part A because she doesn’t need the coverage right now.
  • Six months later, Janice decides to retire and needs Medicare Part A coverage since her group health plan no longer provides the insurance she needs.
  • Fortunately, people who have group health plans when they first become eligible for Medicare have a special enrollment period that allows them to enroll in Medicare within eight months of losing their work-based coverage. Think of this eight-month period as a floating enrollment extension.
  • Janice enrolls in Medicare Part A one month after losing her group health insurance. She won’t be charged a late enrollment penalty because she acted within her allotted time frame.

If Janice had COBRA coverage, retiree coverage or End-Stage Renal Disease, then she may not have been able to enroll during the special enrollment period because these conditions do not qualify individuals to delay Medicare Part A enrollment. However, you may also get a special enrollment period if you’re volunteering out of the country when you first become eligible. For additional special conditions, you can check with your local Social Security office or visit the Medicare website. Suffice it to say that earlier is usually better when it comes to Medicare enrollment.

Medicare Part B Enrollment Deadlines

Medicare Part B enrollment deadlines mimic those of Part A enrollment deadlines. Initial enrollment into Part B is automatic for the same people listed above in Part A, and you have seven months to enroll in Part B if you don’t qualify for automatic enrollment. However, there are a few differences when it comes to Medicare Part B. First, Part B requires a premium whereas most people don’t have to pay a premium for Medicare Part A. Because of this, you may be tempted to forgo Part B coverage. You should note that if you cancel Part B coverage or decide against enrolling in it then you may not be able to enroll in Part B until the general enrollment period that lasts from January 1st through March 31st each year. Medicare Part B penalties are also different from Part A penalties. In essence, you get charged a 10 percent penalty fee for each full year that you lacked Medicare Part B coverage when you could have enrolled. For the following example, we’ll return to Janice to see how much her premium would be if she failed to enroll in Medicare Part B on time.

  • When Janice enrolled in Medicare Part A, she declined Part B coverage because she had insurance through a private source and didn’t want to bother with the monthly Medicare premium. She should have enrolled in Medicare Part B during her initial enrollment period of March 1st through September

    30th because her 65th birthday was on June 30th.

  • More than two years later, Janice realizes that Part B premiums might be cheaper than her current private insurance so she decides to enroll in Medicare Part B during open enrollment, which lasts from January 1st through March 31st every year.
  • Janice enrolls in Medicare Part B coverage about 18 months after her initial enrollment period. Medicare charges a 10 percent fee for every full 12-month period that you lack coverage. In Janice’s case, she’ll be charged 10 percent above the cost of the usual premium or $115.40 instead of the $104.90 that most people pay.

Unfortunately, Janice will have to pay this late penalty fee indefinitely. Unlike the penalty fee for missing the Medicare Part A enrollment deadline, the penalty for missing the Part B deadline lasts for as long as you have Medicare Part B. As long as Janice keeps Medicare Part B, she’ll have to pay the higher premium. However, there may be hope yet. Janice may qualify for a special enrollment period that helps her avoid the late penalty fee. Medicare Part B shares the same guidelines for special enrollment with Medicare Part A. For example, Janice might have been working at the time she qualified for Part B coverage. In this case, she could delay her enrollment until she retires or loses the work-based coverage.

Medicare Part C Enrollment Deadlines

Medicare Part C is usually referred to as a Medicare Advantage Plan. In these plans, you get the benefits of Medicare Parts A, B and D at once. Many people choose Medicare Advantage because there are more flexible options in terms of benefits and premium costs, but some simply like the convenience of having a private insurer administer their health insurance. Typically, Medicare Advantage Plans have their own set of enrollment and modification guidelines because they’re administered by private insurers. However, if you decide to enroll in a Medicare Advantage Plan then there are some dates you should keep in mind.

  • You can enroll in a Medicare Advantage Plan during your initial enrollment period when you become eligible for Medicare. In other words, you have seven months surrounding your 65th birthday to enroll in an Advantage plan rather than in original Medicare.
  • From April 1st through June 30th, you can enroll in a Medicare Advantage Plan if you have Medicare Part A and enrolled in Part B during the general enrollment period.
  • From October 15th through December 7th, you can switch from original Medicare to Medicare Advantage or make other modifications to your Part C coverage.
  • From January 1st through February 14th, you can dis-enroll from Medicare Advantage and enroll in an original Medicare plan.

Let’s say that your birthday is October 5th. You have an initial enrollment period that lasts from July 1st through January 31st to enroll in a Medicare Advantage Plan. After that, you’re stuck with your current plan until the next available enrollment period. If you dislike your coverage options, then you’ll have to wait until the following October to modify your plan. If you want to enroll in original Medicare instead, then you’ll need to dis-enroll from your Advantage plan and enroll in an original plan beginning in January of the following year.

Medicare Part D Enrollment Deadlines

For people who need a lot of prescriptions or those with costly prescriptions, a Medicare Part D drug plan may help offset the cost of monthly prescriptions. The enrollment guidelines for Medicare Part D are similar to those for Medicare Part C or Advantage Plans. You have the seven-month period surrounding your 65th birthday to enroll in Part D coverage, but you can also add this coverage later under certain conditions. Let’s return to Janice Dowry to see how she might enroll in a Medicare Part D drug plan.

  • Janice enrolled in Medicare Part A when she was eligible but waited until her special enrollment period to enroll in Medicare Part B. She declined additional drug coverage at the time because she was in relatively good health.
  • Since enrolling in Parts A and B, Janice has developed a chronic condition that requires costly prescriptions. She decides to enroll in a Part D plan to offset the cost of her medical care.
  • Janice can enroll in Medicare Part D from April 1st through June 30th and make changes to her plan from October 15th through December 7th.

You should also keep in mind that the Medicare Advantage dis-enrollment period is reserved specifically for dis-enrolling from Medicare Advantage and cannot be used to modify or cancel a Medicare Part D plan. You can only switch Part D plans during the allotted period.

Medigap Enrollment Deadlines

If you’re looking for ways to supplement your coverage through Medicare, then you may want to consider buying a Medigap policy. Medigap insurance helps pay for medical care and services that Medicare Parts A and B don’t cover. It’s a supplemental form of insurance that you can buy only if you already have Parts A and B, and Medigap is sold through private insurance companies that must adhere to federal standards. As with other portions of Medicare, you can only enroll in Medigap policies at certain times throughout the year. However, Medigap works a little differently from other plans in the following ways:

  • You have a six-month initial enrollment period to apply for Medigap coverage. The six-month initial enrollment period begins the month you turn 65 and enroll in Medicare Part B. Let’s say that your birthday is November 14th. In this case, you have from November 1st through April 30th to enroll in a Medigap policy.
  • After this initial enrollment period, you may not be able to get a Medigap policy at all. Some insurers allow limited enrollment based on certain underwriting guidelines, but these plans are restrictive.
  • If you’re working when you turn 65, then you may not need Medicare Part B. Likewise, you probably don’t need a Medigap policy. If you decide to enroll in Part B and a Medigap policy once you lose your work coverage, then you may qualify for a special enrollment period without incurring a late enrollment fee.

There are special considerations you should note for enrolling in a Medigap policy. For example, you need to enroll in Medigap during your initial enrollment period if you have a pre-existing condition or frequent health problems. If you enroll during your six-month initial enrollment period, then you can choose any plan that an insurer offers without getting denied coverage for medical conditions or other issues. Otherwise, an insurer can deny you coverage for these conditions depending on their underwriting requirements. If you need coverage for medical treatments that original Medicare doesn’t cover, then enroll when you’re first eligible to ensure that you get the plan you need.

The Importance of Enrollment Deadlines

Why do these deadlines matter? As mentioned above, you could be charged late enrollment penalties for enrolling after your initial enrollment period. But more important, recent changes to the healthcare law in America have made it even more crucial to enroll in Medicare on time. The Affordable Care Act imposes a “shared responsibility fee” on taxpayers each year who don’t comply with the requirement to obtain health insurance. Medicare beneficiaries are covered as long as they adhere to the enrollment deadlines contained within the Medicare system. In other words, enrolling in Medicare on time ensures that you avoid paying the late enrollment fees as well as the shared responsibility fee for non-compliance. You can find detailed information on enrollment guidelines, eligibility requirements and other facts related to Medicare by browsing through our site or visiting the Medicare website.

© 2015 Health Network Group, LLC

Category: Insurance

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