Were you Born in 1952? A Complete Guide to Enrolling in Medicare

January 8, 2017

by: Margie Johnson Ware, Aging and Health Specialist

You know you’re getting old when your so-called “baby brother” is suddenly eligible for Medicare. And in the mold of big sisters everywhere, I decided to write up a checklist of all the things he needs to keep in mind as he considers his options and enrolls. Are you also turning 65 this year? Read on for my comprehensive guide.

1. When and how should I apply to Medicare?

  • First, it’s important to know when to sign up. You sign up for Medicare for the first time during your Initial Enrollment Period. The Initial Enrollment Period is the seven months surrounding your birth month (the three months before your birth month, your birth month, and the three months after your birth month). For example, if you were born in February 1952, you are eligible to enroll starting November 2016 (because November is three months before February) and can still enroll through the end of May 2017 (the three months after February).
  • If you are already receiving Social Security benefits at age 65, you will be automatically enrolled in Medicare and should be receiving a Medicare card in the mail approximately three months before you turn 65. If the card has not arrived 30 days prior to your birth month, call the Social Security Administration. If you are not already receiving Social Security benefits, you will need to sign up yourself.
  • To sign up, you can go to www.medicare.gov  and apply online. If the information that you give matches the records that Medicare has, there is no reason to have to produce a birth certificate or other forms of documentation. If you were born outside the US or there are discrepancies in the records, you may have to apply over the phone or in person and provide said documentation.

2. Which parts of Medicare should I sign up for?

  • If you are still working at age 65 (or your spouse is still working), you may want to delay enrolling in some of the parts of Medicare until you retire. This is because Medicare is not free, and you might save some money by using just your employer insurance for the time being. Then when you retire, you can use your Special Enrollment Period to sign up for Medicare. However, you should consult your HR department or a Medicare expert before you decide to delay enrollment. You can learn more about this by reading “65 and Still Working? A Guide to Medicare.” You can also take the Medicare Questionnaire for access to free, expert Medicare advice from a licensed professional.
  • If you are not working and/or do not have any form of health insurance at age 65, you should definitely enroll in Medicare. You have two main options to choose from: Original Medicare (with Part D and Medigap potentially added on) and Medicare Advantage.
  • Option one is Original Medicare (i.e. Medicare Part A plus Medicare Part B). Original Medicare covers basics like hospital services (Part A) and doctor’s visits (Part B). It is called Original Medicare because it was the first type of Medicare program created by the federal government in 1965. You can add an optional Part D plan to your Original Medicare to get your prescription drugs covered, and you can also add a Medigap plan (aka supplemental coverage) to cover the cost gaps in Original Medicare. If you choose Original Medicare, it is strongly recommended that you add both Part D (to get prescription drug coverage) and Medigap (to help pay the costs of Original Medicare). Without these two additions, it can be very difficult to afford prescriptions and other medical expenses.
  • Option two is the Medicare Advantage (MA) plan. MA is a privately managed alternative to Original Medicare (which is run by the federal government). An MA plan covers all of the services of Original Medicare, and usually includes Part D (drug coverage) as well. An MA plan may even offer additional services that Original Medicare does not cover–such as dental, hearing or vision coverage.

3. Where can I find trustworthy, expert advice?

  • It’s important to look before you leap when choosing your Medicare plan. Take time to read and discuss these options with a licensed Medicare benefits adviser. You can access their help for free by taking the Medicare Questionnaire or call your local State Health Insurance Assistance Program (SHIP) for federally-funded Medicare counseling.
  • Once you’ve picked your plan and successfully enrolled, it’s time to celebrate! Plan a big party for yourself and anyone else you know who is new to the world of Medicare beneficiaries. You’ve earned it (literally)!