When you turn 65:
- Are you currently on an individual/family health plan prior to turning 65? If so, your initial decision should be easy. You will need to sign up for both Medicare Parts A and B when you first become eligible. Please note…..If you have a Marketplace ACA plan and receive a reduced premium then any subsidy you are getting must be cancelled once you are eligible for Medicare because at that point you no longer qualify for that tax credit subsidy.
- Are you currently actively working and on a group health plan through your employer? If so and you plan to remain on your group health plan there are several things to consider:
- You might want to delay signing up for Medicare Parts A and B IF you are still working and your work insurance is considered the Primary Payor to Medicare. For a group plan to be creditable coverage for Medicare, meaning they are considered the Primary payor to Medicare, your employer must have at least 20 full time employees.
- If your employer has under 20 full time employees, in most cases they would be considered the Secondary Payor to Medicare meaning you MUST sign up for Medicare Parts A and B as soon as eligible.
- If you have a Health Savings Account (HSA) you may want to ask your personnel office or insurance company how signing up for Medicare will affect you. If you contribute to an HSA once Medicare Part A or B starts you will face penalties. ***Check with your group HR Admin at work or your current insurance company to make sure how your plan works with Medicare before you sign up for Medicare.
- COBRA is NOT creditable coverage for Medicare and therefore if you are offered COBRA you must sign up for Medicare or face penalties and possible gaps in your coverage!
- Review this Medicare Publication: Medicare and other Medicare Publications.
- You can start this process 3 months prior to your birthday month. If you do not sign up for Medicare when you first become eligible then you might be subject to a penalty once you do finally sign up.
- You will need to contact Social Security and request the coverage. You can find more information and apply for Medicare online at SSA.gov by clicking Here.
- If you are already receiving Social Security benefits, you will automatically be signed up for Parts A and B effective the first day of the month you turn 65.
When you Retire past your 65th birthday:
- Update due to Covid 19…..if you signed up for Medicare Part A when you turn 65 you can now complete your Medicare Part B enrollment online for the first time ever! This applies to qualified Medicare beneficiaries who are over age 65 and have been on a qualified group health plan, or recently left your group health plan within the last 8 months. As long as the group health plan you were on was considered qualified (usually meaning there were more than 20 full-time employees at the company) you have a Special Enrollment Period (SEP) to sign up for Medicare Part B. You can now complete your Medicare Part B enrollment online for the first time ever. You can access the Medicare Part B online application, including directions, through the following online Medicare Part B SEP enrollment link https://secure.ssa.gov/mpboa/medicare-part-b-online-application/
- COBRA is NOT creditable coverage for Medicare and therefore if you are offered COBRA you should sign up for Medicare or face penalties and possible gaps in your coverage!
- If you have a month or less time before you need your Part B or Part A and B to go into effect, you will need to complete the above-mentioned forms and then walk them into your local Social Security office and ask for assistance so that you will not miss your needed effective date.
- Part A: premium is free if you or your spouse paid Medicare taxes while working for 10 years (40 quarters) or more. If you do not qualify then you may purchase Part A, the cost is now close to $500.
- Part B: premium for 2020 is $144.60. However, if your income is high (as defined by Medicare as earning over $87,000 for an individual or $174,000 for a married couple) you could pay more due to the income-related monthly adjustment amounts (IRMAA) See Chart. However, if you are low income you might get help paying for some of the cost for Medicare. Programs That Can Help Save You Money.
- Part C: depends on the plan you purchase.
- Part D: depends on the plan you purchase. (Low income individuals may qualify for Extra Help with Prescription drugs).
- Medigap plan: depends on the plan you purchase and the carrier you purchase your plan from.