Enrolling in Medicare

For many, their Medicare eligibility begins when they turn 65. However, to be completely ready for your Medicare enrollment, there’s a lot you need to do and prepare for, but MedSup for Seniors can help every step of the way.

Eligibility—How to Know When to Sign Up for Medicare

The first thing you need to know is when to expect the Medicare enrollment process. Your eligibility is based on age and/or work status.

If you are in or approaching your mid-60s, there is no better time to begin preparing for sign-up. At age 65, you officially become eligible, and can start enrolling in any plan of your choice.

This age-based eligibility is called the Initial Enrollment Period (IEP), and includes the 7 months surrounding your 65th birthday. However, if you’re not yet retired, you may not want Medicare yet if you’re covered by an employer or group health plan. You may still want to enroll during the IEP regardless, but, if you choose not to, you will not be penalized for it.

You may also sign up for Medicare after age 65 if you have good reasoning for delaying your enrollment, such as already having proper coverage. You will be allowed a Special Enrollment Period (SEP) that lasts between 30 and 60 days to enroll in whatever coverage you are eligible for.

Automatic Enrollment

While some may have to enroll manually through the Initial Enrollment Period, others are enrolled automatically. So, the first thing you need to check is whether or not you will be automatically enrolled in Original Medicare (Parts A and B).

If you receive Social Security benefits roughly 4 months prior to your 65th birthday, you will simply receive a card in the mail informing you of your enrollment, and you will officially be signed up for Medicare.

This card will also explain how to disenroll if you choose, which may be useful if you are not yet retired and want to wait on Medicare until you do. If you are not automatically enrolled, you may contact Social Security in-person, over the phone, or online to sign up.

Other Medicare Plans and How to Enroll

Original Medicare, however, is not your only option. Other options for Medicare coverage include:

  • Medicare Advantage (Part C)
  • Part D (Prescription Drug Coverage)
  • Medicare Supplements (Medigap)

To sign up for these plans, let us do the shopping for you to find the best option for your situation. We only use top-rated companies that offer the lowest rates for your area. For Part C (Medicare Advantage Plans – MA, or MAPD) and/or Part D (Prescription Drug Plans), there are four main times you can either start or switch your coverages (IEP, AEP, SEP, OEP).

When you first become eligible for Medicare A/B you can sign up for a Medicare Supplement plan and a Prescription Drug Plan, or you can opt to not have a supplement/separate drug plan and go the MAPD route.

*MA – Medicare Advantage Plan (with no drug coverage). This is for those who have credible prescription drug coverage from another source, such as for those veterans who can get their prescription drugs filled through the VA.

*MAPD – Medicare Advantage Prescription Drugs. This is a combination of Medicare A/B with additional benefits, such as dental, vision, and hearing, and it includes prescription drug coverage. This is a stand-alone plan provided by an insurance company working independently (if you will) of original Medicare.

The Initial Enrollment Period (IEP) is explained by the following chart. To summarize, you can sign up for the parts of Medicare (A/B, A/B/D, or A/B/C) during a 7-month window – without proof of insurability! In other words, you can be on your deathbed (but we hope not!) and no health questions can be asked when you sign up for a Medicare Supplement during the IEP. The 7-month window covers three months before your birthday, the month of your birthday, and three months after your birthday.

There are other situations where you can enroll in a Medicare Supplement up to 6 months before your birthday. Coverage for all parts of Medicare, except for in certain situations, will begin the 1st of the month (and the same month) that you turn 65. If you are opting to go the Medicare Advantage Plan (MA or MAPD) route you have to wait until you are within 3 months of your birthday to start the enrollment process (in most cases). The Annual Enrollment Period (AEP) takes place every year between October 15th and December 7th. This is when you are seeing all those advertisements on TV, and it can become confusing very quickly.

You can switch back and forth a thousand times during the AEP, but whichever plan you have in place at midnight on December 7th is the one you will be committed to. The option chosen during AEP begins on January 1st of the following year and will be in effect for the entire calendar year. Please note: The AEP does not affect your Medicare Supplement! In other words, if you have a Medicare Supplement policy, you can ignore all those commercials as they do not affect your coverage choices, except for in one area – Part D Prescription Drug plans. This is one of the most confusing parts of Medicare.If you are covered by a Medicare Supplement you will need to choose a new Part D Prescription Drug plan, or choose to keep the one you have, during EACH AEP, and we can help you with that.Just have a list of your prescription drugs handy and give us a call. We will get them plugged into our computer system that will then provide a list of all the drug plan options available in your area. We will advise you which one(s) will be the cheapest and get you signed up for the coming year.It’s that simple!In addition to the Initial Enrollment Period (IEP) and the Annual Enrollment Period (AEP), there are other scenarios when you may be eligible to sign up (or change) your existing coverage. These are called Special Enrollment Periods (SEP). The list of situations is long and can be confusing, so just leave the details up to us.

We will help you determine if there is a special situation that applies where you are eligible to make any changes outside of the other enrollment periods. There is also what is called a separate Open Enrollment Period (OEP) for those who have just signed up for a Medicare Advantage Plan (MA/MAPD). During the period of January 1st to March 31st you are eligible to either change back to a Medicare Supplement (if you dropped one to go the MAPD route) or to change from one MAPD plan to another (i.e. to a different insurance company). You can make one change during the OEP, but at least it provides you a safety net if you change your mind from your decision during AEP. Please know that there are penalties involved with not enrolling in Medicare when eligible unless you can prove you have credible coverage (such as employer group health insurance, COBRA, TRICARE, ChampVA, VA, to name a few). We will look at your situation and advise you as to the best route to go.We are here to serve you!”

Your Guide For Medicare Enrollment—Call MedSup for Seniors