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What is Medicare, When can I apply, How do I apply, How does it work, What is a Medi-Sup Plan...

Do you find yourself asking these Questions? Do you wish there was a quick page on Medicare basics? There are many great resources, but where to start?

Turning 65...what is Medicare: Medicare is for those turning 65 whom need medical insurance coverage. If you take your social security payouts at age 65, or Railroad Board Benefits, Part A & B is automatic and you will receive your Red, White & Blue card in the mail. If you don't, you can apply at the Social Security site for Part A & B. You may have to pay for part A and/or part B. Read more on starting Medicare on pages 15-19.

Once you receive your Medicare card it will have your effective dates on it. At age 65, when you first apply for Medicare, the effective date is the first day of the month of your birth date. That means if you apply in time you can receive a first of your birthday month effective date. *

You can apply for Medicare 3 months before your birthday month, during your birthday month, and up to 3 months after your birthday month. Example: Your birthday is July 5th. You can apply during April - June, July (your birthday month), and Aug - Oct. Your effective date will depend on when you apply...view effective dates on Page 12.

With Medicare you have a few options. 1) Traditional Medicare Parts A & B (can be combined with a Part D drug plan and/or a Medicare Supplement plan - also known as Medi-gap plans). 2) Part C Medicare Advantage plan (includes Part A & B, and can include Part D plus other benefits such as Vision & Hearing). Part C Medicare Advantage plans must be equal to Part A & B plans, and can include added benefits which Part A & B do not offer.

Good to know item: Parts A&B are run by the government and Part C, Part D & Medicare Supplement plans are run by Private insurance company's. Part D is a drug coverage option and a Medicare Supplement plan is to help pay some of what Part A & Part B do not cover in full.

Medicare Supplement plans can be added when a person has chosen to have Part A & B Medicare, but can NOT be added if someone has chosen to purchase a Part C Medicare Advantage plan instead of Part A & B (some of the Medicare Advantage plans already include drug coverage and they do not want double coverage happening).

Penalties: Please keep in mind that there are penalties related to choosing to not purchase Part A (if you have to pay for it...most people get it free if they've worked 10 continuous years), or choosing not to purchase Part B, when it is first available; when turning age 65. There are also penalties for not choosing to purchase a drug plan when you first can, with Part A & B, or choosing a Medicare Advantage plan that does not include drug coverage

Have Drug coverage that will stay in effect when you turn 65? If you have prescription coverage through your employer, union, or government agency (such as the VA), you may choose to stay with your existing plan, if the drug benefits are creditable... which means "as good as", "or better" than Medicare’s standard Part D benefit. Ask your Human Resource person if your drug plan is an allowable plan in Medicare's eyes. If it is, then you will probably not face a penalty when applying for Drug coverage after your current drug coverage ends. This is very important to find out before your Initial Enrollment Period (IEP) is over (see above 7 month period which is your IEP).

What if you have a Group Insurance plan active when turning age 65 that is considered credible coverage? Should you sign up for Medicare during your IEP when turning 65, or if you should you delay Medicare? And what if you choose to keep your employer coverage and take Part A & B, then which pays first...employer or Medicare? It all depends on a few being the size of your company. For more information on whom pays first with active employee coverage read page 20.

Do you have Retiree Insurance in place when turning age 65? Something else to consider... retiree coverage might not pay your medical costs during any period in which you were eligible for Medicare but did not sign up for it. When you become eligible for Medicare, you may need to enroll in both Medicare Part A and Part B to get full benefits from your retiree coverage read page 18. (Retiree coverage differs from group active employee coverage).

Wondering if you can keep your Marketplace plan with that great discounted premium when you turn 65...usually not, however, there are a few circumstances that would allow you to keep it in place. You can find more information on that by clicking here.

Picture of Kyla

Two great resources I've found that will answer many questions you have on Medicare are:

Medicare & You article & the SHIBA guidebook.

I hope the above has given you some comfort and answered a few of your questions, on the start to your Medicare journey...Kyla

* Please keep in mind there are options for Medicare, beginning before age 65, due to being disabled and qualifying after a period of being disabled (usually 24 mo).


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