Confusion about when to enroll in Medicare for people turning 65 can have costly consequences. Depending on your situation, if you sign up for Medicare, you could be paying for insurance you don't need. Or, if you're not careful, you could be
.
If you don't sign up for Medicare when you need to, you could end up without any health care coverage for many months. Your coverage won't start until after the
. And, when you do enroll, you could get hit with a
that drives up your health care costs significantly for the rest of your life.
So, if you or someone you love is turning 65, make sure you understand what to do. Whether to enroll in Medicare at 65 turns pretty much entirely on whether you or your spouse is still working and getting insurance through that job.
If you and your spouse are both retired
, even if you are getting retiree coverage or COBRA from a former job,
. If you do not, you are likely to have a gap in health care coverage. Technically, your retiree coverage or COBRA will stop covering your care as soon as you are eligible for Medicare. However, if you enroll in Medicare, your other coverage might pick up costs that Medicare does not cover, such as your Medicare coinsurance and copays. Speak to your employer's insurance company to find out. To enroll in Medicare, call Social Security at
800-772-1213
or visit
or at
If either you or your spouse is actively working and getting health insurance through that job or on your own:
- If there are fewer than 20 people employed at the job or you have insurance on your own, you should enroll in Medicare in the three months before you turn 65. If you do not, you are likely to have a gap in coverage. Your job coverage generally will not continue paying your bills once you are eligible for Medicare, except possibly to fill any coverage gaps after Medicare pays.
- So long as there are 20 or more people employed at the job providing your coverage, your job coverage should continue covering your care, and you do not need to enroll in Medicare. That said, Medicare might offer you better coverage than your job, so you might want to enroll in Medicare and drop your employer coverage. Traditional Medicare covers care from most doctors and hospitals anywhere in America.
How do you enroll in Medicare?
You will be automatically enrolled in Medicare Part A (hospital and other inpatient coverage) and Part B (doctor, medical and other outpatient coverage)
. You will not need to pay a Medicare Part A premium if you or your spouse has worked and paid into Medicare for at least 10 years. You will need to pay a Part B premium unless you are eligible for
. Otherwise, what you pay for
And, this
.
Be aware that some commercial insurers, such as Aetna, Humana and UnitedHealthcare, in some areas are
. And, these Medicare Advantage plans generally have very different provider networks, benefits and out-of-pocket costs from what you get through your employer health plans. You should understand the
and call Medicare at 800-633-4227 to make sure Medicare knows which plan you are choosing.
If you'd like prescription drug coverage, you can
. There are many to choose from. And, if your income is low, you may be
.
Keep in mind that you will have
. Medicare does not cover dental or vision care, nor does it cover hearing aids. It also does not cover custodial nursing home care or other
.
has deductibles and coinsurance that you can budget for if you buy
,
which fills all these gaps.
, health plans offered by commercial insurers that offer Medicare benefits, also have copays and deductibles and generally limit coverage to a network of doctors and hospitals. Your out-of-pocket costs for in-network care is capped at $6,700, but your costs are unlimited if you go out of network.
Earlier on Huff/Post50:
