Frequently Asked Questions
At age 65, you are finally eligible to enroll in Medicare and reap the benefits from a program you’ve contributed to all these years. Yet getting the most out of Medicare can be daunting. According to the National Council on Aging, almost a third of baby boomers age 60 and older find the program and its alphabet soup of Parts A, B, C and D confusing.
Missing your enrollment date may mean penalties or even higher premiums for the rest of your life. At the same time, you don’t want to pay for additional coverage you don’t need, especially if you’re still working.
Here are a few frequently asked questions we routinely cover in detail at our breakfast seminars:
How do I sign up?
If you are already receiving Social Security, you are automatically enrolled in Medicare Parts A and B (known as Original Medicare) at 65. You’ll receive a Medicare card two or three months before your birthday, and coverage starts on the first day of your birthday month.
Part A covers hospitalization and usually comes with no premiums, assuming you or your spouse paid into Medicare while working. Part B, which covers medical services, does require premiums. We can help you determine exactly what amount you will be required to pay.
If you aren’t yet receiving Social Security, you will need to apply for Medicare during one of the designated annual enrollment periods. Your initial enrollment period lasts for seven months, beginning three months before the month in which you turn 65. To help avoid a potential gap in coverage, consider enrolling during the three months prior to your 65th birthday. We can help.
Should I enroll at 65 if I'm still working and covered?
Consider enrolling in Part A anyway, as it is generally premium-free and may cover some expenses not included in your employer’s health plan. If your company has fewer than 20 employees, consider enrolling in Part B because Medicare is considered your primary insurance. You can enroll without penalty at any time during the eight months after you stop working or your employee health coverage ends. However, if you miss that window, you may be subject to penalties that, in the case of Part B, could last as long as you remain covered. However, enrolling in Medicare A & B when first eligible, may be prudent. We can help you analyze your
personal situation, and make the best decision for you, your family and retirement.
Where do Parts C and D come in?
Part C, known as Medicare Advantage, a replacement for traditional Medicare, includes plans administered by private companies such as health maintenance organizations and preferred provider organizations. They offer the benefits of Parts A and B, and often include such additional benefits as vision, hearing and dental coverage. Costs for Part C plans vary according to the insurer. Some plans require referrals or restrict you to doctors in a network, and you must already have Parts A and B in order to enroll. Another consideration: Some plans may limit their coverage to a certain geographic area, so if you anticipate traveling a great deal or relocating, Medicare Advantage might not be for you.
Part D offers prescription drug coverage for both brand-name and generic prescription drugs. You must be enrolled in Medicare to enroll in a Part D plan, which you purchase from a private insurer. Premiums, deductibles and co-payments vary by plan The process can be daunting, however we can help you through all of it.
Which services aren't covered by Medicare?
Original Medicare (Parts A and B) won’t cover co-payments, co-insurance or deductibles, nor will it cover medical care when you travel outside the U.S. Some services, such as long-term care, acupuncture and cosmetic surgery, also aren’t covered. Long-term care, is not covered, and represents the greatest financial threat to Baby Boomer retirement.
The vast majority of Americans supplement Original Medicare with Medicare Supplement Insurance, also known as Medigap. Plans providing such coverage follow federal and state standards, and costs vary a little by policy and insurer. To buy a Medigap policy, you must be enrolled in both Parts A and B. To guarantee availability, you must sign up within six months of enrolling in Part B. We cover all of this during the seminar, up to and including enrollment.
Where can I learn more?
The official Medicare site, medicare.gov, offers detailed information on signing up; the specifics of Parts A, B, C and D; costs associated with Medicare; penalties for missing enrollment; and other important issues. Or, simply attend an Unscrambling Medicare seminar.
We can help you gain a deeper understanding of how health care costs could affect your need for income in retirement. Together we will discuss ways to incorporate future health care costs into your planning.
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