How do I enroll in Medicare?
- Generally, the age for entering Medicare is 65. Your initial enrollment period (IEP) is a 7-month window that begins 3 months before your 65th birthday, includes the month of your birthday and continues for 3 months after your birthday month.
- However, certain conditions, for example, ALS or ESRD allow for early enrollment in the program. Additionally, Disabled people who are approved for Social Security disability insurance (SSDI) benefits will receive Medicare. However, SSDI recipients aren’t eligible to receive Medicare benefits until two years after their date of entitlement.
What is the Annual Enrollment Period (AEP)?
- The Annual Enrollment Period (AEP)—also referred to as The Medicare Advantage and Prescription Drug Plan Annual Enrollment Period or the Medicare Fall Open Enrollment—allows you to make changes to your Medicare Advantage coverage and runs October 15-December 7 each year.
What is the Medicare Advantage Open Enrollment Period (OEP)?
The Medicare Advantage Open Enrollment Period is when Medicare Advantage policyholders are eligible to make a one-time plan change. OEP runs from January 1-March 31 each year. During OEP, Medicare Advantage members are eligible to:
- Switch to a different Medicare Advantage plan
- Drop their Medicare Advantage plan
- Return to Original Medicare
- Sign up for a stand-alone Medicare Prescription Drug plan if returning to Original Medicare
What is the General Enrollment Period?
- The General Enrollment Period runs from January 1-March 31 and is an opportunity for individuals who missed their IEP and are not eligible for a Special Enrollment Period (SEP), to enroll in Original Medicare. Your coverage starts July 1. You might pay a monthly late enrollment penalty.
What are Late Enrollment penalties?
Those who do not enroll in Medicare Part B and/or Part D during your Initial Enrollment Period (IEP), and subsequently enroll, may be subject to delays and late enrollment penalties.
Part B Penalty: If you didn’t get Part B when you’re first eligible, your monthly premium may go up 10% for each 12-month period you should have had Part B but didn’t sign up. In most cases, you’ll have to pay this penalty each time you pay your premiums, for as long as you have Part B.
Usually, you don’t pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a Special Enrollment Period.
Part D Penalty: The late enrollment penalty is an amount that’s permanently added to your Medicare drug coverage (Part D) premium. You may owe a late enrollment penalty if, at any time after your Initial Enrollment Period is over, there’s a period of 63 or more days in a row when you don’t have Medicare drug coverage or other creditable prescription drug coverage. Generally, you’ll generally have to pay the penalty for as long as you have Medicare drug coverage.
The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage.
Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($33.06 in 2021) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.
The national base beneficiary premium may change each year, so your penalty amount may also change each year.
What are Medicare Part A and Part B?
Medicare Part A helps cover most medically necessary hospital care, skilled nursing facility care, nursing home care, hospice, and home health services. There is a monthly premium for Part A, but many people qualify for premium-free Part A*.
Medicare Part B helps cover most medically necessary services, preventive care, lab tests, x-rays and some health and ambulance services. You pay a monthly premium for Part B.
*If you have worked and paid Social Security taxes for at least 40 calendar quarters (10 years)
How do I know if I have Medicare Part A and B?
It will be clearly stated on the front of your red, white, and blue Medicare card under the heading “is entitled to.”
How do I use my Medicare Card?
If you are in Original Medicare, in combination with a Medicare Supplement, you should present both cards when seeking medical services. Additionally, there will be a separate prescription drug card, which should be used when filling prescriptions at your pharmacy. If you are in a Medicare Advantage plan with prescription drug coverage (MAPD), you will have a card from the plan that you will use for all services and you should safely store your Medicare card as your plan is the provider of services, not Medicare.
How/When do I switch Medicare plans?
Each year, you have a chance to make changes to your Medicare Advantage or Medicare Prescription Drug Coverage for the following year during the Medicare Advantage and Prescription Drug Plan Annual Enrollment Period (AEP) from October 15th – December 7th. Additionally, those in Medicare Advantage plans have the right during the Open Enrollment Period (OEP) January 1 – March 31st, to make 1 plan change.
You can also make changes to your Medicare Advantage and Medicare Prescription Drug Coverage during certain Special Enrollment Periods (SEP), which applies in instances such as moving or losing other insurance coverage. There are certain rules about when you can make changes and the type of changes you can make are different for each SEP. Click here for specifics.
Does Medicare cover dental?
Medicare doesn’t cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices.
However, Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you’re in a hospital. Part A can pay for inpatient hospital care if you need to have an emergency or complicated dental procedures, even though it doesn’t cover dental care.
Am I covered for emergencies when I travel?
Within the United States, or while transiting through Canada from/to Alaska, you are covered for emergencies and should go to the nearest emergency room to seek necessary treatment regardless of your plan. This coverage does not necessarily extend to any follow-up treatment while outside of your Service Area.
International travel, however, depends on the plan you’ve purchased (if any). Original Medicare does not provide international coverage. Certain Medigap plans do provide for foreign travel emergency care while some plans do not. The same is true with Advantage Plans. If you often travel outside the United States, that will be important to keep in mind while enrolling, to ensure you’re getting a plan with the type of coverage you need. Additionally, it may be worthwhile to consider additional travel or repatriation insurance. Click here for additional information.
What is the Medicare Supplement “Guaranteed Issue” Period?
You are guaranteed that you can purchase a Medicare Supplement or “Medigap” Plan, regardless of health, for 6 months beginning the month that you are enrolled in Medicare Part B. Additionally, some states have more liberal “Guaranteed Issue” rules. Please consult your state insurance department or your MediSmart Advisor for the specifics of your locality.