Recently I sat down with a client who will celebrate her 65th birthday next month. She wanted help sorting out her Medicare enrollment options. Letters, brochures, and other Medicare-related items covered her dining room table. Even if your friends won’t all remember your birthday, every company with a Medicare product does!
Your work history and available options will likely differ from hers. Regardless, every woman nearing her 65th birthday should pay attention to Medicare enrollment. If you don’t, you could pay financial penalties for the rest of your life.
When Should You Get Started?
Begin to get organized and educated 3-4 months prior to your 65th birthday. There is a lot to know and several things to decide on!
Medicare calls the first time you can sign up the Initial Enrollment Period (IEP). It includes the 3 months before your birth month, your birth month, and the three months after you turn 65 (for a total of 7 months).
For example, if you were born in June, your IEP would include March, April, and May of the year you turn 65. It would also include July, August, and September. Your IEP would be March 1 – September 30th around your 65th birthday.
First, determine if you are eligible for Medicare. Most people qualify for Medicare by earning “work credits”. But you may also qualify because of a spouse or former spouse:
- If your spouse is age 65 and eligible, you are Medicare-eligible;
- Divorced (and not remarried) women who stayed married for 10+ years to an eligible person are Medicare-eligible; and
- Widows who were married at least 1 year to an eligible person before they passed away are Medicare-eligible!
There are a few other exceptions, but you should know IF you need to sign up before worrying about anything else.
Get Educated
When you think of the people who designed Medicare, think “actuary”, not “marketer”. The number of Medicare parts, the terminology, and the various deadlines can make almost anyone’s head spin! (I would love to know what the designers of Medicare thought when they had to enroll themselves).
So it’s up to you to become educated, and I recommend getting qualified help to guide you through your options.
- What’s the difference between Part A and Part B?
- Should you get a Medicare Advantage plan or a Medicare Supplement Plan?
- What is a formulary and an in-network provider?
Getting the right answers for your unique situation can mean the difference of thousands of dollars.
You can expect a lot of mail as well. Medicare Advantage and Medicare Supplement insurance companies will send offers for their plans. Official documents come from the Department of Health and Human Services and/or Centers for Medicare & Medicaid Services. If your employer offers Medicare coverage, you may get mail from them as well. That’s why my client had a table full of materials, and you can expect the same.
The Costs of Inaction
Ignoring the Medicare deadlines could prove costly. Medicare imposes several penalties for missed deadlines.
Both Part A and Part B of Medicare have a late enrollment penalty. Late Part A enrollment creates a higher premium for twice the number of years that you were eligible but didn’t sign up. Two year late means 4 years of increased premiums. For Part B, you might pay a higher premium for as long as you’re in Medicare!
Prescription coverage through Part D also has a late enrollment penalty.
You may not have to pay these penalties if you still have employer coverage or other special situations. But I would make sure you know the correct deadlines for each Medicare Part.
Medicare Supplements can decline you unless you enroll during your Initial Enrollment Period. They often use medical underwriting and disqualify certain medical conditions. By missing this crucial deadline you could miss out on the benefits of a Supplement plan for the rest of your life.
Lessons Learned
My client and I successfully cleaned off her dining room table. I left her with some clear, manageable steps to finish her Medicare enrollment so she could breathe a sigh of relief. I encourage you to use the resources below, get help, and get the benefits you deserve!
Resources
- Getting Started with Medicare (Medicare.gov)
- State Health Insurance Assistance Programs (SHIP)
- “Medicare and You” handbook (Medicare.gov)
