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5 Things to Know About Medicare Before You Turn 65

1. Understand the ABCD’s of Medicare

There are several types of Medicare coverage. Original Medicare, Medicare Parts A & B, is health insurance managed by the federal government for Americans 65 and older, those younger than 65 with certain disabilities, and people of any age with End Stage Renal Disease (ESRD). You can supplement Medicare with a “Medigap” policy that fills in the some or all of the copays and deductibles in Original Medicare. Or you can choose a Medicare Advantage Plan (Medicare Part C) which may resemble a managed care plan you had as an employee) or a Prescription Drug Plan (Part D).

2. Time your enrollment carefully

There are different time periods during which you can enroll in Medicare. For most people, the Initial Enrollment Period – a seven-month period around your 65th birthday – is the appropriate time. There are also Special Enrollment Periods for people who are retiring and losing employer health coverage, or whose spouse who carried coverage is retiring.

It is important to learn about these different times you can enroll, and which apply to your situation. Why? If you don’t enroll on time, you could be without coverage for up to four months and you may have to pay a penalty—and this penalty lasts as long as you have Medicare.

Timing is also important if you decide to purchase supplemental insurance. You should sign up for supplemental insurance within six months of when you sign up for Part B. If you wait too long, the insurance company can deny you coverage, charge you higher premiums for pre-existing conditions, and impose a waiting period before your coverage starts.

3. Understand how your current insurance works with Medicare

Many people continue to work past age 65, and have health coverage through their employers. Others may be retired, and have insurance through the military (VA or TRICARE benefits) or employee unions.  There are different rules depending on whether you are “actively employed” or retired.

Depending on your circumstances, it may make sense for you to delay getting parts of Medicare when you turn 65. Explore some of these special situations.

Be sure to contact the benefits administrator of your current plan to ask about how it works with Medicare, and when (and whether) you need to sign up for Medicare.  You may also want to call the Social Security Administration to make sure that your employer’s advice is consistent with SSA policies.

4. Find out if you qualify for extra assistance

After you retire, and even if you are working part-time, your new financial situation may allow you to be eligible for additional benefits to pay for health care costs.  Don’t assume that programs “aren’t for people like me.” Take the BenefitsCheckUp to learn whether you are likely to be eligible for programs that could help you with your out-of-pocket expenses from Medicare. You will get a report created just for you that includes a list of the programs you may be eligible for, along with application forms and links to online applications.

5. Get help from a trusted, reliable source

It’s OK to ask for help!  In fact, it’s recommended no matter what enrollment period you are in. Be smart about where you seek advice and think about how you learn best. Do you want to speak with someone who has been trained in Medicare or do you prefer to do your own research first?  Either way, MyMedicareMatters.org can help you. Continue to browse this website or go straight to the Medicare QuickCheck™ to evaluate your options and locate trained advisors who can assist with enrollment if you are ready.  

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