If you’re turning 65, you’ve probably given some thought to Medicare and wondered if you need to enroll. Here are a few things to know that will help you figure out if you need to enroll.
Eligibility for Medicare starts at 65, although enrollment will begin three months prior to your 65th birthday and continue for a total of seven months.
Here we come to our first possible answer: if you are already collecting Social Security benefits, you will be automatically enrolled in Medicare Part A, which covers hospital stays, and Medicare Part B, which covers physicians’ fees.
On the other hand, what if you are still working and have health insurance through your employer or union?
In that case, you will want to know whether your plan is the primary insurer, or if Medicare is. Generally speaking, if your employer has fewer than 20 employees, Medicare is the primary insurer and you will need to enroll.
When Medicare is the primary insurer, it pays for costs first, leaving your employer’s plan to pick up additional costs not covered by Medicare. Your employer will be able to confirm what their arrangement is and whether or not you will need to do anything to be covered.
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One thing you should know is that if you do not sign up for Medicare Part B, you will face penalties for late enrollment unless you are subject to a Special Enrollment Period. If you sign up after the allotted time, you may face delays in coverage and higher monthly premiums, which may increase 10 percent for every 12 months in which you were eligible but did not sign up.
Clearly, then, it is important to sign up for Medicare when you are eligible, around the time you turn 65. This is known as the Initial Enrollment Period (IEP), and it includes the three months before the month of your birth, your birth month, and the three months after.
Another thing to know is that when you enroll for Medicare is the date that will determine when your benefits start. If you sign up at any point in those first three months prior to your birth month, your Medicare benefits will begin on the 1st day of your birth month.
On the other hand, if you sign up during your birthday month, coverage will begin the 1st day of the month after your birth month.
Signing up the month after your birth month will mean coverage starts later, 3 months after your birth month. If you enroll during the second month after your birth month, you’ll have to wait 5 months, and if you wait until the very last month, you’ll get coverage 6 months after your birth month.
In addition to the allotted time around your birthday, consider signing up during the general enrollment period, which is typically from January 1 to March 31.
So, to summarize: if you are receiving Social Security benefits, you will not have to sign up for Medicare. If you are not receiving Social Security benefits, you will need to enroll in Medicare unless your employer can confirm that you do not.