Getting Started
Where do I start?
Getting started with Medicare enrollment can seem like a monumental task that can cause decision paralysis. Many newly aging-in prospects express confusion and anxiety with the process of enrolling in the right plan for their needs, and who can blame them? There are hundreds of different carriers out there vying for your business, thousands of different plans available, sometimes only in certain service zip codes, and a jumble of industry words and abbreviations that can make your head spin.
We’re here to help with the process. After working with the Medicare population, we have catalogued a lot of the questions we often hear into a helpful FAQ.
First, let’s talk about the steps to take as you age into Medicare.
What are my next steps?
The first steps to take in your Medicare journey are to enroll into Medicare Parts A and B. In order to enroll in Medicare supplements, Medicare Advantage, or Prescription Drug Plans you will need to be issued your Medicare number as well as Parts A and B issue dates.
If you are a turning 65 and are already receiving social security, you will automatically be enrolled in Part A and Part B starting for the first of the month you turn 65. If you are not taking social security at the time you age in and would like to begin receiving Original Medicare or other options, you will need to contact Social Security to have them issue you a Medicare number and enroll in Part A and Part B. Note: If you are continuing to work past 65 and want to continue using your employee coverage you do not have to sign up for Part B. Always check with an employer to make sure they have a system set in place for Medicare eligible employees.
Once you have a Medicare number and Parts A and B issued your next step it to choose whether to stick with Original Medicare, buy a Medicare supplement, move to a Medicare Advantage Plan, and/or purchase a stand alone Prescription Drug Plan.
See the checklist below to follow the steps to apply for Medicare.
Checklist When Applying For Medicare
Step 1: Determine Your Medicare Eligibility
Medicare is health insurance for people 65 or older. You’re first eligible to sign up for Medicare three months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS.
Go to Medicare.gov or call your local agent to find out if you qualify.
Step 2: Enroll in Original Medicare (Part A & Part B)
- Apply online via www.ssa.gov
- Call the SSA at
1-800-772-1213
TTY 1-800-325-0778 - Apply in person at your local Social Security office
Step 3: Create Your MyMedicare.gov Account
After completing your initial Medicare enrollment, you must create a MyMedicare.gov account to manage your coverage online. The account registration process is quick and easy.
Step 4: Consider Medicare Advantage
Once you are enrolled in Medicare Part A and Part B, you have the option to switch to a Medicare Part C plan — also known as Medicare Advantage — to replace your Original Medicare coverage.
Step 5: Consider for Medicare Part D (Optional)
Medicare Part D is the optional prescription drug coverage available to anyone with Medicare Part A and Part B. There are a variety of Part D plans to compare and choose from.
Step 6: Consider Medigap (Optional)
Optional supplemental insurance policies known as Medigap help cover deductible costs, out-of-pocket copays and coinsurance expenses that Medicare does not cover. To be eligible for enrolling in Medigap, you must first be enrolled in Medicare Part A and Part B.
F.A.Q.
Our most common questions asked by newly applicable Medicare members.
If you are getting Social Security when you turn 65, you’ll automatically be enrolled.
If you’re not getting Social Security when you turn 65, you’ll need to sign up for Parts A and B. Contact Social Security three months before you turn 65. If you worked for a railroad, contact the Railroad Retirement Board.
Note: People on Social Security disability will automatically be enrolled in their 25th month of disability.
You can enroll during a seven-month window. The window includes the three months before the month you turn 65, your birthday month and the three months after the month you turn 65.
You may have to pay a penalty in the form of a higher premium.
It’s the same seven-month window as Part B.
It includes the three months before the month you turn 65, your birthday and the three months after the month you turn 65.
From October 15th to December 7th, all people with Medicare can change their health care plans.
You can switch to Medicare Advantage or Original Medicare during this Annual Enrollment Period, join a Medicare Prescription Drug Plan or change plans.
Open Enrollment Period (OEP) January 1st to March 31st. During this time, you can make a one time change from a Medicare Advantage plan to another like Medicare Advantage plan or disenroll back to Original Medicare.
Yes! You’re given a 12-month trial period with a Medicare Advantage Plan if you are coming from a Medicare Supplement plan.
If you would like to switch back to a Medicare Supplement using this trial right, you must return to the exact plan you were in when you made the switch.
You can also enroll in Parts C and D during a Special Enrollment Period for special circumstances such as:
- Losing your employer coverage
- Moving to a new service area
- If you have Extra Help
- You may face a late enrollment penalty.
- The penalty increases based on each month that you delay. (1%/per month)
- This can get costly.
Medigap has a six-month Open Enrollment Period. It automatically starts the month you’re 65 or older and enrolled in a Medicare Part B.
For example: If you turn 65 on April 3 but don’t join a Medicare Part B until May 25, your Medigap Open Enrollment Period will start on June 1. This is the first day of the month in which you are both 65 and enrolled in Part B.
During your six-month Open Enrollment Period, you can buy any Medigap policy sold in your state.
During your six-month Open Enrollment Period, you can purchase a Medigap policy even if you have pre-existing health conditions.
Even if you have a disability or have health problems, an insurance company cannot do any of the following:
- Refuse to sell you any Medigap policy it offers
- Charge you higher premium than they charge others who are 65 or older
- Delay the start of your coverage
You can apply for a Medigap policy after your Open Enrollment Period ends. However, there’s no guarantee your application will be accepted if you don’t meet medical underwriting requirements, except in certain limited situations.
If you’re able to buy a Medigap policy, there may be an additional cost in the form of a penalty. You incur this penalty from Medicare.
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