Are you considering enrolling for Medicare? Here’s what you need to keep in mind.
Medicare Eligibility Is Not Standard.
Some people are eligible when they turn 65 and some under 65 are eligible if they have received Social Security Disability Insurance (SSDI) or certain Railroad Retirement Board (RRB) benefits for at least 2 years. Some individuals with End-Stage Renal Disease may be eligible for Medicare.
Some people get Medicare Part A and Part B automatically and some need to sign up for them.
Those living in the United States and U.S. Territories who are already collecting Social Security are automatically enrolled in Part A and Part B when first eligible. Others, however, need to sign up for Medicare.
Enrolling in Medicare Can only Happen at Certain Points in Time.
Someone eligible for free Part A due to age can enroll in Part A any time after they’re first eligible during the Initial Enrollment Period. The law, however, only allows enrollment in Medicare Part B and premium-Part A during:
- Initial Enrollment Period (IEP) – the 7-month period when someone is first eligible. For those eligible due to age, IEP begins 3 months before they turn 65 and ends 3 months after they turn 65.
- General Enrollment Period (GEP) – January 1 through March 31 of each year with coverage starting July 1.
- Special Enrollment Period – Individuals can enroll in Medicare outside the IEP or GEP if they didn’t enroll in Medicare when first eligible. Coverage usually starts the month after the person enrolls, but can also be delayed 3 months in limited circumstances.
Determining whether a person qualifies for SEP is important to consider when making a decision.
It is critical that employees and dependents consider if Part B is right for them when they’re first eligible for Medicare. Decisions depend on whether a person has insurance based on their current employment.
Knowing Who Pays First
When Medicare and other health insurance plans are responsible for paying the same medical claim, coordination of benefits determines how Medicare will work with other plans. When delaying or declining Part B, it’s important to know:
- If their employer-sponsored Group Health Plan coverage pays primary or secondary
- If paying secondary to Medicare, whether it will pay if one doesn’t enroll in Part A or Part B.