A big part of healthy aging is having the right health coverage in place. If you’re age 65 or older, your best path to peace of mind begins with Medicare. Medicare can help you maintain your wellness, manage your expenses, and access the care you need if you do become ill.
First Things First: What is Medicare?
Medicare is a federal health insurance program for adults age 65 and older. Younger people diagnosed with certain health conditions are also eligible for Medicare.
The federal Medicare program is made up of two parts:
- Part A (Hospital Insurance Benefits)
- Part B (Medical Insurance Benefits)
Medicare Part A usually does not require a monthly premium if you have paid Medicare taxes during your working life. Medicare Part B does require a monthly premium, but in many cases, it can come right out of your Social Security check.
Together, Medicare Care Parts A and B are often called “Original Medicare.”
Learn more: Medicare Basics: What Is Medicare?
Should I enroll in Medicare as soon as I turn 65?
The best time for you to enroll in Medicare may not be the same for everyone. Different factors may affect when to enroll in Medicare such as whether you are still receiving health insurance through an employer-sponsored plan and the size of your employer group or if you are carrying your own insurance.
In general, you should enroll in Medicare at age 65 if you do not have any other health insurance, or if you are:
- retired/not employed,
- self-employed, or
- receiving health coverage from a company with fewer than 20 employees.
Your Initial Enrollment Period is a 7-month window that begins 3 months before the month you turn 65 and ends 3 months afterwards. For example, if you turn 65 in February 2021, your Initial Enrollment Period runs from November 1, 2020 through May 31, 2021.
If you will still be receiving health insurance through an employer with at least 20 or more employees when you turn 65, you can wait until that coverage ends to enroll in Medicare. When your eligible employer coverage ends, you will have a limited time—called a Special Enrollment Period—to enroll in Medicare without penalty. This 8-month period begins the month after your employer coverage ends, and you will not pay a late enrollment penalty for signing up during this time.
If you fail to enroll in Medicare during your Initial or Special Enrollment periods, you can still enroll during the General Enrollment Period (January 1 through March 31 annually); however, enrolling at this time will result in a lifelong cost penalty and your coverage won’t start until July of that year.
Finally, there's also an Annual Open Enrollment Period. It runs from October 15 through December 7 each year and provides an opportunity for you to join, switch or drop plans as long as you make your request to do so by December 7.
Tip: The longer you wait to enroll in Medicare, the more costly your premiums will become.
What if I want more coverage than Original Medicare provides?
You’ve got options! Once you’ve enrolled in Original Medicare, you can purchase additional coverage to help lower your remaining out-of-pocket costs and increase your peace of mind.
One way to help reduce your out-of-pocket medical costs is to purchase a Medicare Supplemental Plan (sometimes called Medigap plans). All Medicare Supplemental Plans are standardized by the federal government. This means that every company that sells Medicare Supplemental Plan A, for example, must offer the exact same set of benefits for that plan.
In addition to Medigap plans, many people also choose to purchase Medicare Part D prescription drug plan. Medicare Part D helps you pay for your medications at the pharmacy and by mail. Every company that offers a Medicare Part D prescription drug plan must meet a minimum standard level of coverage.
In recent years, a type of all-in-one plan called Medicare Advantage (MA) has gained popularity. MA plans bundle Original Medicare and Part D coverage together in one monthly premium.
While deciding which type of Medicare coverage is best for you, it’s important to think beyond the monthly cost of your premiums and the coverage you need right now. Be sure to consider your overall out-of-pocket costs and the coverage you may need in the future, too.
Before you enroll in any Medicare plan, it is a good idea to speak with a someone who can help you understand the best options for your personal situation.
Ready to get started?
We’re here to help! Call (800) 255-4550 or email firstname.lastname@example.org. Our licensed consultants are available Monday through Friday from 8am to 4:30pm.
The Vermont Area Agency on Aging’s State Health Insurance Program Coordinator: (800-642-5119)
The U.S. Centers for Medicare & Medicaid Services: www.medicare.gov, or call 1-800-MEDICARE.