Janell Sluga Medicare & Individual Health Insurance Account Executive View Bio

Lawley Medicare Solutions Learning Center:

Ask Janell!

QUESTION: I am turning 65 later in the year and wondering how I join Medicare. Does it happen automatically?

ANSWER: Medicare coverage eligibility begins at age 65. Individuals with disabilities may get Medicare coverage earlier. Historically, at age 65, individuals were eligible for Full Social Security Benefits, but now Full Retirement age is based on your year of birth, and probably starts after age 66. You can receive early retirement benefits from Social Security at age 62. These eligibility rules for Social Security benefits has changed the Medicare enrollment procedures. If you are collecting Social Security in some form (widow’s benefits, early retirement benefits, or disability) then Medicare will start automatically at age 65. Medicare will send you a packet of information with your Medicare ID Card three months before your 65th birthday month. If you accept the benefits, you do nothing. You simply tear off the card, and put it in your wallet. Your coverage will begin automatically the first of your birthday month.

When you receive this Medicare packet and you do NOT want to enroll in Medicare Part B (which costs $174.70 monthly for most Americans) then you send back the card and have JUST Medicare Part A. To return the card, you must sign the refusal statement on the back and mail it back to Social Security Administration using the yellow envelope enclosed in that packet. In order to refuse Medicare Part B, you must have insurance coverage from a current employer plan from either yourself or your spouse.

If you are NOT collecting Social Security benefits, you MUST contact the Social Security Administration (SSA) to begin receiving Medicare benefits at age 65. If you do NOT enroll when originally eligible, you will have some restrictions as to when you can enroll and incur premium penalties when you enroll later.

In thinking about when to contact SSA, remember that there have been some difficulty in getting through to the staff there. You can go to the local SSA office or call 1-800-772-1213, or use the SSA.gov website. If you go in person or call the office, they will schedule an appointment in approximately six weeks to sign up for the benefits, so you want to go earlier rather than close to your birth month. Ideally three months before your birthday month. Your login at SSA.gov provides a way to sign up directly, which may be quicker for you.

When you contact Social Security, they will review your situation and help you determine whether or not you need Medicare Parts A & B. You may choose to enroll in Part A and NOT Part B. They also will explain the billing procedure for paying for Medicare Part B premium (since you are NOT collecting Social Security, you can’t have it deducted from that check). You will receive an invoice every three months ($174.70 X 3 = $524.10) to pay the Part B premium amount directly.

If you have insurance from another source you may NOT NEED to enroll in Medicare at age 65. The other source must be an employer plan of either yourself or your spouse’s full-time active employment. Most retiree plans require you to join Medicare at age 65 if you want to continue to receive coverage from their plans.

I cannot stress enough how important this decision is with regard to refusing Medicare or not signing at the correct time. If you have any doubts or are not sure what to do, contact the Social Security Administration three months prior to your 65th birthday and find out what you should do. If you receive the packet automatically, you will probably receive it three months prior to your 65th birthday month. If you have questions or think you may have lost or destroyed your packet, go to your local Social Security Administration office, or call 800-772-1213, to clarify your particular situation.

In some situations, if you wait until after your 65th birthday to contact Social Security and you don’t start Medicare at the appropriate time, you may have time without coverage, or penalties to pay.

It is YOUR 65th birthday! Let’s celebrate it early by visiting Social Security and getting your Medicare situation straightened out ahead of time.

Read all Inside Medicare articles HERE.

 

LAWLEY HAS A TEAM DEDICATED TO MEDICARE INSURANCE!

Our licensed Medicare & Individual Health Insurance team can help clients understand the details of Medicare insurance plans, assist with choosing the right benefits and coverage, and provide guidance when life events that affect health coverage occur.

For questions, concerns, or to reach Lawley Medicare Solutions, fill out the contact form below or call 716.849.1540.