Getting Started with Medicare

June 2, 2020

When getting ready to enroll in Medicare there are many questions people will have. Luckily, there are advisors and resources available to help with the answers. When looking at enrollment, there are a few issues to think about:

  • When do I become eligible to enroll in Medicare?
  • What if I am still working and on my employer’s plan or a COBRA plan?
  • Where and how do I enroll?
  • Who can I speak with about Medicare Enrollment?older couple golfing thinking about medicare

Medicare rules, regulations, and requirements can be complicated and misunderstood, creating misconceptions. It has become increasingly important to take the right action during the right enrollment period, using the right enrollment platform for your “Original Medicare” Part A and Part B to become effective at the right time.

When to enroll has everything to do with your personal, work situation, availability of employer health coverage, and points in time. For some, enrolling in “Original Medicare” Part A and Part B at age 65 is the right thing to do. For others who are working beyond age 65, it may be later.

When do I become eligible to enroll in Medicare?

Medicare eligibility for many people begins at age 65 triggering the IEP or Initial Enrollment Period.

The IEP is a seven-month period that begins 3 months prior to the month of the 65th birthday and includes the month of the 65th birthday and the following 3 months.  At what point enrollment takes place during the IEP will determine the Medicare Effective Date.

Those collecting Social Security will receive a packet from the Social Security Administration within three to six months of their 65th birthday containing information regarding automatic enrollment in Medicare Part A and Part B.

Learn More About Timing for Enrollment

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What if I am Still on an Employer’s Plan or a COBRA Plan?

For some, enrolling during the IEP is not required. Maintaining employment and employer coverage beyond age 65 through a company with more than 20 employees allows for a delay in Medicare enrollment until under SEP (Special Enrollment Period) guidelines.

Today, more people are choosing to work beyond age 65, maintaining health insurance through their employer or spouse’s employer. As employee monthly payroll contribution costs, deductibles and out of pocket costs continue to increase, a growing number are looking for options.

Exercising the right to enroll in Medicare during the SEP can provide attractive health insurance options to employer coverage that can include greater levels of coverage, expanded network access, lower out of pocket expenses, and more favorable monthly premium cost.

Retirement or loss of employer coverage that triggers a COBRA event also allows for delayed Medicare enrollment under SEP guidelines. However, it is important to remember that COBRA does not count as active employer group coverage. If you are over the age of 65 and lose employer coverage or turn 65 while covered under COBRA, you should enroll in Medicare immediately to avoid late enrollment restrictions and penalties.

Working Past 65

If you continue to work past age 65, you should enroll in Medicare Part A and Part B within 8 months of once you stop working or your employer coverage ends, whichever happens first. Apply for Medicare two or three months in advance of when your employer coverage ends.

Remember, there is family or husband and wife Medicare coverage…each person is required to enroll on their own when they turn 65 or are no longer covered by the employer plan.

General Enrollment Period

Enrollment during the GEP (General Enrollment Period) because of not enrolling during the IEP or SEP comes with consequences and penalties. The GEP takes place January through March to receive a July 1st Medicare effective date. In addition, a late enrollment penalty will be assessed, resulting in a higher monthly premium for Part B and Part D coverage.

Where and how do I enroll?

Where to go and how to enroll in Medicare is a function of when you look to enroll. During the IEP because of turning 65 or the SEP due to employer-based coverage ending. Depending on the situation, there are different ways to enroll:

  • Social Security Office – during IEP or SEP
  • Mail – during IEP or SEP
  • Online – during IEP

Who Can I Speak with about Medicare Enrollment?

Understanding Medicare, the many requirements, and enrolling at the right time is each person’s responsibility. To avoid missing enrollment deadlines and late enrollment penalties, take the time to talk with the Medicare Specialists at InsureOne Benefits.

You must stop contributing to the HSA Health Savings Account upon enrolling in Medicare to begin the month you turn 65. If enrollment in Medicare takes place beyond age 65, HAS contributions should end 6 months prior to the Medicare effective date. Once you enroll in Original Medicare, HSA funds can be used to pay:

  • Part B Premiums
  • Part D Premiums and copays
  • Medicare Advantage Plan Premiums

Medicare Supplements and Advantage Plans

Medicare health insurance plans can lower or for some, eliminate hospital or medical out of pocket costs and provide greater access to doctors and hospitals on a local, statewide or national basis and can offer greater levels of coverage and services to better meet personal healthcare needs.

Because Medicare does not pay for everything, enrollment in a Medicare Supplemental or Advantage Plan is recommended. Some plans are designed or “scripted” by CMS the Center for Medicare Services and all plans are subject to CMS rules, regulations, guidelines, and CMS approval.

It has been said that “no one size fits all”. That can be said about Medicare Supplemental or Medicare Advantage Plans.  Both offer excellent coverage but, take different approaches to meet coverage needs.

Contact InsureOne Benefits for a complimentary consultation to discuss your specific needs and how these plans can help you.

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