Founders Life and Health Blog
Deciding when to enroll in Medicare
Are you almost 65?
If you are getting ready to turn 65 this year, you are not only probably getting bombarded with mail and calls about getting enrolled in Medicare, but you may be wondering, when am I supposed to enroll in Medicare? That is exactly what we're going to be talking about today
Hi, there. My name is Jo Hutchison and I am an independent health and Medicare advisor with Founders Life & Health here in beautiful St. Louis. And today, we are going to be talking about when exactly you can enroll in Medicare.
Are you going to continue to work?
When we're trying to decide when to enroll in Medicare, the decision is largely based on whether or not you are going to continue to work after you turn 65. And honestly, it's kind of like a Choose Your Own Adventure book, if that's still a thing. I don't even know if the kids still read those. But when I was a kid, you had to choose your own adventure book. And it was great because you got to figure out, do I go on this path or this path and the end to the story was always different. The difference here is that the ending is going to be the same, it's just the route on how we're going to get there is going to be a little bit different.
Initial Enrollment Period
Our first path or option on enrolling in Medicare is going to be during your initial enrollment period when you turn 65. The initial enrollment period is going to be seven months long. It's going to be the three months before your birth month, the month of your birth, and then the three months after your birth month. You have all seven of those months to enroll in Medicare and decide if you want to take a Medicare Supplement or a Medicare Advantage, or neither. This is pretty straightforward for people that are not coming off of group coverage. Maybe you're an independent contractor and you've been paying for your own health insurance. Maybe you have marketplace coverage. Either way, when you turn 65, you will be able to use that initial enrollment period to enroll in Medicare.
Just a little tidbit on when coverage starts for that initial enrollment period. Coverage will always start on the first day of the month of your birthday. For example, my birthday is October 11th. That means my coverage will start on October 1st. If you are one of the lucky people that has a birthday on the first of the month, then your coverage will actually start on the first of the month prior to that.
Okay, so that's for all of my people that do not have group coverage. If you currently have group coverage and you are going to continue to work, then we have a couple of options. This is more options on the choose your own adventure path. Best place to start here is to just sit down and look at costs. So what does it cost you on your group plan every month? What is taken out of your paycheck? And then sit down and look at what would your Medicare costs be every month if you decided to go with Medicare. And it could be a big difference, it could be not a big difference, but that is at least enough data to start with to figure out which path you kind of want to look at.
After you've looked at the costs side by side on your group coverage versus going with Medicare and say, maybe you've decided that you want to go with Medicare. That's great. You're still in your initial enrollment period. Just use those seven months to go ahead and get yourself enrolled.
If you've decided that you want to stay with your group coverage, that is also fine, but it's going to open up another avenue down the road for when you're going to actually enroll in Medicare. I want to add here, there's two really important things to pay attention to if you are deciding to stay with your group coverage.
The reason I bring those two things up is because if you don't have creditable coverage, and if you are not working with somebody that has at least 20 employees, then when you do enroll in Medicare down the road, during your special election period, then you are going to get hit with a penalty for your Part D penalty, which is 1% for every month that you delayed taking Part D. And you don't want to be hit with that penalty. So make sure upfront that your coverage that you're deciding to stay with is creditable and we won't have that issue down the road.
Special Enrollment Period
Here's the next time period when you can enroll in Medicare. Say that you decided to stay with your group coverage. It was creditable coverage, and you are now 67, and you've decided to go ahead and retire and come off of that group coverage. That's going to kick off a special enrollment period. Your special enrollment period is going to last for eight months from after the event that basically kicks off the special enrollment period. So if you retire in May, then you've got eight months to enroll in Parts A and B.
Here's a really important part though, if you want to enroll in Part C, which is also called Medicare Advantage (click here to learn more about Medicare Advantage) or obviously you want to enroll in Part D because you're going to need your prescription drug coverage. You're going to have to do that in the first two months of your special enrollment period. Some people get confused because they tell you it's an eight-month special enrollment period from after you retire in this circumstance. But if you want to enroll in Parts C and D, you're going to have to do it in the first two months.
There are going to be a couple other things that could kick off a special enrollment period. For example, if you move in or out of a particular county and into a different county, that's going to kick off a special enrollment period. Also, if you're moving into or out of an institutional facility, like a nursing home, that could kick off a special enrollment period. There's a bunch of different things that can happen that would kick that off.
Annual Enrollment Period
Last but not least is what's called a AEP, which is the annual enrollment period. The annual enrollment period runs from October 15th to December 7th every year. Usually around the beginning of October is when we all get flooded with the Medicare commercials, football players telling us about Medicare benefits, and all of that type like stuff. During that time period is when people can move from one Medicare Advantage plan to another Medicare Advantage plan. That's also when you can change your Part D coverage. If you need to change your prescription drug coverage for one reason or another, that's when you can do that.
One thing I really want to stress here with all of these enrollment periods is the reason why they're so important is because you don't want to be caught paying a penalty down the road, especially for your Part D. You can also be charged a penalty if you delay Part B and you don't enroll in the right time for Part B.
Pay attention to all those timeframes, because nobody likes to pay extra penalties.
When it's time to enroll in Medicare, the best thing to do really is to reach out to a Medicare advisor. Talk to somebody that knows the ins and outs of the business, that knows the timeframes so that you don't get stuck with one of those penalties, and also can help get you into the right plan. Our services are completely free of charge to you. Click here to contact us anytime!
Now that we have talked about WHEN to enroll in Medicare, let's talk about HOW to enroll in Medicare. Click to this next blog post for pointers on the right way to enroll.
About the Author
Hello! I’m Jo Hutchison and I’m the owner of Founders Life & Health. I’m a proud baseball mom, lover of live music and all things potato.. My husband and I have two great boys and two lazy hound dogs. My boys play a LOT of baseball so when I’m not helping my clients we can almost always be found on a baseball field somewhere in the Midwest.