Are you turning 65 this year? It’s important to start thinking about Medicare enrollment before your birthday! Your actual Initial Enrollment Period to sign up for Medicare begins three months before you turn 65 and ends three months after you turn 65. You do have seven months to enroll, but if you miss your Initial Enrollment Period you might have to pay a lifelong penalty!
We covered the most important parts of Medicare in our previous blog, the Three Most Important Things to Know About Medicare. If you are turning 65 soon, this article will give you all the information you need to start the process of enrolling in Medicare.
Enrolling in Medicare & Working Past Age 65
Great, so you turn 65 and you understand when your Initial enrollment Period is. But what about special circumstances? What if you’re still working when you turn 65? We’re so glad you asked!
So many Americans these days are working past age 65. If you are still getting health insurance benefits from your job, then should you enroll in Medicare? You CAN delay signing up for Medicare IF you are actively employed for a firm that has 21+ employees. If you work at a company with 20 or fewer employees, you will need to sign up for Medicare.
Just because you can delay enrolling in Medicare, should you? It can be difficult to decide which health insurance route is right for your situation. If you are still working and your family is covered on your employer’s plan, you’ll probably want to stick with it as Medicare coverage is for individuals only. However if you are employed and have a high deductible health plan, you may want to transition to Medicare Part A.
There are so many factors that can be a part of this decision, from your income level (and whether or not you might be subject to IRMAA for Part B and Part D premium) to your individual health needs, it can be best to walk through all of your options with a trusted Medicare advisor.
Exceptions, Exceptions, Exceptions for Medicare!
If your spouse is still working and you are insured under your spouse’s health plan, you may be able to wait to enroll without incurring a penalty. You will want to make sure the employer coverage is considered Creditable Coverage, meaning the plan provides prescription drug coverage and coverage for the essential health benefits.
The same rule applies for the size of the Company the Spouse works for. If the company has 20 or fewer full time employees then you will want to sign up for Medicare.
If you don’t want to experience any gaps in health insurance coverage, it’s critical to understand the timeline of Medicare in a transition. Once your employer coverage is gone, you must enroll during a Special Election Period (SEP). This is an 8-month period that begins when your employer coverage ends or when you stop working, whichever comes first.
Keep in mind that if you sign up for Medicare before you turn 65, then your coverage will start the month you turn 65.
If you sign up the month you turn 65 or during the three months after, the coverage would start on the first of the next month.
Medicare Advantage vs. Traditional Medicare
How do you decide what is right for you? Here is a quick checklist to consider:
Choose Original Medicare if:
- You want provider flexibility
- If you’re a frequent healthcare user
- Can afford a Medicare Supplement Insurance plan
- Plan to spend your retirement traveling
- Like to minimize risk
If you have significant health conditions such as cancer, end-stage renal disease, or diabetes complications, Original Medicare and a Medicare Supplement plan will provide you with more protection and less overall costs. Medigap policies will help cover the out-of-pocket costs left over by Original Medicare.
Depending on the Medicare Supplement health plan you enroll with, you could have little or even no cost-sharing related to your medical care.
Choose Medicare Advantage if you:
- Live in an area with a broad network
- Can’t afford a Medicare Supplement Insurance plan
- Don’t mind getting referrals
- Do not plan to travel outside of your service area
Partner with Advanced Benefit Solutions for Medicare
Turning 65 is an exciting milestone that comes with an important decision to make regarding your Healthcare Coverage. This can be a confusing and daunting decision to make, however Advanced Benefit Solutions commitment is to assist you in making this educated decision as painless as possible.
Our goal is to assist you in selecting the correct Medicare plan the first time so you can have the peace of mind and freedom to enjoy your retirement years while knowing that you have the best health plan for your needs.
We will be happy to assist you in making this decision as well as answer any questions you may have.
Reach out to Patty Riland, our specialist in enrolling in Medicare, by emailing patty@abenefitsolutions.com or by telephone at 512.254.2835 today to get started.
