Copyright 2016 DeeAnn F. Dickson All Rights Reserved
April 2016
Except as provided by the Copyright Act, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior written permission of the publisher.
LIMIT OF LIABILITY/DISCLAIMER OF WARRANTY: Although the author has made every effort to ensure that the information in this book was correct at distribution time, the author does not assume and hereby disclaim any liability to any party for any loss, damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or any other cause.
ISBN: 978-1-4835667-1-9
How to Use this Guide
This guide book is for everyone first enrolling in Medicare Health Insurance. If you are already receiving Social Security retirement benefits, you will be automatically enrolled in Medicare Part A and Part B when you turn 65. Even if the government automatically enrolls you in Medicare, you will still need to choose a Medicare Part D Prescription Drug plan and a Medicare Supplement plan.
If you are not receiving Social Security retirement benefits, you will have to enroll in Medicare. Even if you are postponing filing for Social Security until you reach your full retirement age or later, you will have to sign up for Medicare when you turn age 65 or after losing your current employment health insurance.
If you miss the seven-month initial enrollment period or employment health insurance eight-month special enrollment period, there may be late enrollment penalties and gaps in your health insurance coverage.
This is an interactive guide so feel free to Ctrl key + click on the See to go to another section or click on <Medicare publications> for easy access to many Medicare government issued publications.
I would really appreciate any feedback on sections that you found confusing or that need more clarification. Let me know if there are questions about Medicare that need to be covered.
Welcome to Medicare!
Contents
Website: www.medicareplanshop.com
THE FOUR PARTS OF MEDICARE HEALTH INSURANCE
Medicare is a government-sponsored and financially-supported Hospital Insurance (Part A), Medical Insurance (Part B), Medicare Advantage (Part C), and Medicare Prescription Drug (Part D) for United States citizens or legal residents who have lived in the U.S. for at least five consecutive years and are:
Age 65 or older or
Under age 65 with certain disabilities or
Have End-Stage Renal Disease (ESRD)
The A, B, C, and D of Medicare
Medicare Part A (Hospital Insurance) helps cover:
Inpatient care in hospitals
Skilled nursing facility care
Hospice care
Home health care
Medicare Part B (Medical Insurance) helps cover:
Services from doctors and other health care providers
Outpatient care
Home health care
Durable medical equipment
Some preventative services
Medicare Part C (Medicare Advantage):
Administered by Medicare-approved private insurance companies
Must include all benefits and services covered under Original Medicare Part A and Part B
Usually includes Medicare prescription drug coverage (Part D) as part of the plan
May include extra benefits and services at no charge or for an extra cost
Medicare Part D (Medicare prescription drug coverage):
Administered by Medicare-approved private insurance companies
Helps cover the cost of a drug if the drug is included in the plans drug formulary (list)
Section 2
WHEN AND HOW TO ENROLL IN MEDICARE PART A AND/OR PART B
There are three types of enrollment periods:
Initial
Special
General
Find your situation below to find out when and how you can enroll.
IF YOU ARE TURNING AGE 65 AND YOU ARE ALREADY GETTING BENEFITS FROM SOCIAL SECURITY OR THE RAILROAD RETIREMENT BOARD (RRB)
That means you are already in the retirement system. You will receive your Medicare red, white, and blue card in the mail three months before you turn 65. (If your birthday is on the first day of the month, your Medicare Part A and Part B will start the first day of the prior month).
If you are covered under a current employment group health plan:
If you dont want to keep Part B, you must follow the directions enclosed with your Medicare card to inform Medicare you dont want to start paying for Part B at this time. If you dont notify Medicare, your Part B premium will be automatically deducted from your Social Security check.
< Enrolling in Medicare Part A & Part B>
IF YOU ARE TURNING AGE 65 AND YOU ARE NOT RECEIVING SOCIAL SECURITY OR RAILROAD REIREMENT BOARD BENEFITS:
Since you are not in the retirement system, you will have to personally enroll in Medicare.
ALERT: Enrollment is not automatic and you can face late enrollment penalties and coverage delays if you dont enroll on time.
If you are covered under a current employment group health plan:
If you dont want to enroll in Part B at this time, you can delay paying the Medicare Part B premium and avoid late enrollment penalties if you are covered under a current employment group health plan.
< Enrolling in Medicare Part A & Part B>
Initial Enrollment Period
Your Initial Enrollment Period (seven months) begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.
For example, if you are turning 65 on July 15, you can enroll in Medicare beginning in April for a July 1 effective date. If you enroll in July through October, the effective date will be delayed up to three months.
ALERT: If your 65th birthday falls on the first of the month, then your Part B effective date is the first of the prior month.
ALERT: If you dont sign up during your Initial Enrollment Period, you may have to pay a late enrollment penalty and will not be able to enroll until the next General Enrollment Period which is January 1 through March 31 of each year and coverage does not begin until July 1.
How to Enroll in Medicare Part A and/or Part B
To enroll in Medicare Part A and/or Part B, you have to contact Social Security. It is very important that you keep proof of when you tried to enroll in Medicare. Always write down the name of the person who helped you and ask for a written confirmation.
You have three ways to enroll:
Call 1-800-772-1213, Monday through Friday, from 7AM to 7PM (TIP: Avoid calling Social Security on Monday. Try around 6PM if you are having trouble getting through).
Go online Print out and save your confirmation page.
Go to your local Social Security Office or make an appointment by calling 1-800-772-1213.
If you worked for a railroad, contact the RRB at 1-877-772-5772.
IF YOU ARE OVER AGE 65:
Special Enrollment Period
If you did not enroll for Medicare Part A and/or Part B when you turned 65 because you were covered by a current employment group plan, then you may have the chance to sign up for Medicare during a Special Enrollment Period (eight months after the end of your group coverage).
