12 Must Know FAQs to Get Ready For Medicare

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Navigating the transition from private health insurance to Medicare can feel daunting. Although Medicare is a complicated enough system, getting ready for enrollment is straightforward. You just need to ensure you’re read up on the subject.

Remember, Medicare is offered individually to each person who enrolls. You cannot cover a spouse under your Medicare coverage. Conversely, they cannot cover you under theirs. You will each have to enroll separately when eligible.

Read the below to ensure you’re confident for the transition:

   1. I can claim social security at age 62, will Medicare begin at the same time?

No, it will not. The earliest age at which Medicare will begin is 65. The only exceptions are for those who have certain disabilities, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS). Medicare may begin sooner for that group.

   2. Will Medicare contact me to enroll when I’m eligible?

Medicare will mail you an enrollment kit a few months before you turn 65 if you are already receiving social security retirement or railroad retirement benefits. Otherwise, its up to you to be proactive and apply.

You can apply to enroll in Medicare up to three months before you turn age 65. Enrollment can be done online or in person at your local social security office.

   3. Are there deadlines to sign up?

Yes, and they are incredibly important! You will be automatically enrolled in Medicare Parts A and B if you are already receiving social security retirement benefits. Coverage generally begins the month in which you turn 65.

You have a seven-month enrollment period in which to sign up for Medicare Parts A & B if you are not already receiving social security retirement benefits. The enrollment period begins three months before you turn age 65. You can always enroll between Jan 1 to March 31 of any given year if you miss your initial enrollment period, but late enrollment carries steep penalties. Your monthly Part B premium will increase by 10% for every twelve-month period you delay signing up. The penalty lasts for your entire life.

Regardless of how you enroll in Part A and B, you will have to sign up for Part D prescription drug coverage or a Medicare Advantage Plan. (Medicare Advantage Plans replace Parts A, B, and D). Medicare Part D and Medicare Advantage Plans have the same initial enrollment periods as Medicare Parts A and B.

   4. What are the different types of Medicare?

  • Medicare Part A is hospital insurance. It offers coverage for inpatient stays, lab tests, surgeries, as well as home health care and skilled nursing facilities.
  • Medicare Part B is physician services. This covers your doctor visits and necessary preventative services.
  • Medicare Part C is better known as Medicare Advantage. This is private insurance that replaces Parts A, B, and D. These plans may offer services original Medicare doesn’t cover, such as dental and vision services. However, you will typically have to use physicians within network.
  • Medicare Part D is prescription drug services. This will pay for brand-name and generic drugs.

   5. I have an HSA. Will that impact my Medicare?

Your Health Savings Account (HSA) won’t impact Medicare, but Medicare may impact your HSA. You and your employer should stop contributing to your HSA at least six months before you apply for Medicare Part A to avoid penalties. You can still continue to withdraw from your HSA throughout your retirement to help pay for your share of medical expenses.

   6. How much does it cost?

Costs vary. Part A has no premium. Part B is means tested and could vary year to year based on your income. Part D is also means tested while Medicare Advantage Plans are private policies with varying costs due to age and location. Beyond this you will also have copays, coinsurance, and deductibles. Remember that the premium you pay is just one portion of your total cost of care. Medicare.gov put out a nice at-a-glance piece on yearly costs.

   7. What about dental and vision coverage?

Original Medicare does not provide coverage for dental or vision. However, some Medicare Advantage plans do. It is worthwhile to review your coverage on a yearly basis to ensure you have a policy that fits your full needs. Private dental and vision insurance is also available for purchase in addition to Medicare.

   8. What’s the difference between Medicare Advantage and Original Medicare?

Original Medicare is government funded health insurance broken down between Parts A, B, and D. Medicare Advantage plans are private policies issued by insurance companies that replace Medicare Parts A, B, and D. You cannot have both Medicare Advantage and Original Medicare – it is one or the other. The Medicare Rights Center created a good side-by-side snapshot of the two programs.

   9. What are the key features of a Medigap plan?

Medigap plans (also called supplemental insurance) help pay for some of the things that original Medicare doesn’t. These include things like coinsurance, copayments, and deductibles. Some policies may also include coverage when travelling outside the US.

  • No networks. You can go anywhere that takes Medicare.
  • No vision or dental coverage, though some may offer coverage for some preventative procedures.
  • No prescription drug coverage
  • Policy is non-cancellable so long as you pay the premium
  • Medical underwriting is usually required for these plans

  10. What if I’m still working and covered under another plan at age 65?

If you retire after age 65 and have employer health coverage, then you will get a special eight month Medicare enrollment period beginning when you retire or when your group health insurance plan ends, whichever is sooner. You do not generally pay a late enrollment penalty if you sign up during the special enrollment period.

   11. How often can I make changes?

You can make changes on a yearly basis. Medicare open enrollment runs from October 15th to December 7th every year. (Note, open enrollment is different from the Jan 1 to March 31 late enrollment period mentioned earlier). You can change your coverage and switch plans during the open enrollment period.

   12. Will Medicare still cover me if I retire abroad?

No. The US government generally precludes Medicare from paying for services for retirees outside the country and its territories. You may be able to tap into affordable healthcare systems abroad, but insurance companies may limit your participation or acceptance based on age.

Conclusions and Parting Thoughts

Medicare is an old program and one that has seen many revisions over time. Those revisions add complexity but getting started tends to be straightforward despite that. If you’re confused about which policy is best for you or what you should consider when selecting a plan, contact a qualified professional to help you weigh your options.

The information contained herein is intended to be used for educational purposes only and is not exhaustive. Diversification and/or any strategy that may be discussed does not guarantee against investment losses but is intended to help manage risks and return. If applicable, historical discussions and/or opinions are not predictive of future events. The content is presented in good faith and has been drawn from sources believed to be reliable. The content is not intended to be legal, tax, or financial advice. Please consult a legal, tax, or financial professional for information specific to your individual situation.

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