Applying for Medicare can be confusing. What is it that you need to know when you apply for Medicare? We’re going to cover what you should do when applying for Medicare in 2022 in this article.
As Benjamin Franklin once said, “By failing to prepare, you are preparing to fail.” Let’s discuss what you should know to prepare to be successful when applying for Medicare.
People are Medicare eligible for different reasons
Did you know people are Medicare eligible for different reasons? Some people are eligible when they turn 65, and some are eligible before they turn 65.
If you’re under 65, you’re eligible for Medicare if you have received Social Security Disability Insurance (SSDI) for at least 24 months. In addition, if you have ALS or End-Stage Renal Disease, you may also qualify for Medicare.
It’s essential to know the different ways you could qualify for Medicare. This will make it easier for you to make decisions when it comes time to enroll.
Do you get Part A & B automatically?
Suppose you live in the U.S. and collect Social Security. Assume you receive SSDI, Survivor Benefits, or regular Social Security benefits; you’re automatically enrolled into Part A and B.
However, you must be receiving Survivor Benefits or Social Security benefits for at least four months before your 65th birthday month to be automatically enrolled in Medicare.
You can choose to decline or keep Part B but cannot decline Part A unless you get rid of Social Security. If you’re not collecting Social Security, then you will not be automatically enrolled into Medicare. You need to sign up by getting in contact with Social Security.
There are enrollment periods for Medicare
The Medicare enrollment process differs based on when you apply for Medicare and what your situation is.
There are three main enrollment periods for Medicare. The Initial Enrollment Period (IEP), the General Enrollment Period (GEP), and the Special Enrollment Period (SEP).
- Initial Enrollment Period:
The Initial Enrollment Period is your 7-month period when you become eligible for Medicare. The timeframe for this period is 3 months before your 65th birthday and ends 3 months after your 65th birthday. Coverage rates can vary depending on the month the person enrolls into Medicare.
- General Enrollment Period
The General Enrollment Period is held from January 1st – to March 31st annually. Coverage begins July 1st. This is for beneficiaries who missed their IEP and do not qualify for a SEP.
- Special Enrollment Period
The Special Enrollment Period is an opportunity to enroll in Medicare besides the Initial Enrollment Period or the General Enrollment Period. It is for people who have creditable coverage from an employer with 20+ employees.
This means you or your spouse must be actively working for the employer that is providing coverage. You have an 8-month window from the day you lose coverage or employment (whichever happens first), to apply for Medicare.
Qualification for a Special Enrollment Period
Many people struggle with the decision if they should get enrolled in Medicare. Generally, if you’re still working and have large employer coverage, you could delay Part B and enroll later during a Special Enrollment Period with no penalty.
However, COBRA coverage and retiree coverage don’t count toward being eligible for the Special Enrollment Period to enroll in Medicare later. Therefore, if you have this kind of coverage before you turn 65, you must enroll in Medicare during your IEP.
Different rules will also apply if qualify for Medicare before 65 due to disability and have employer coverage.
Who Pays First?
If you have Medicare and another health insurance plan, coordination of benefits will determine how your Medicare works with other health coverage. If you’re thinking of enrolling in Medicare while you have employer coverage, it’s essential to know:
- If you have large employer insurance, then Medicare will be secondary.
- If you have small employer insurance, then Medicare will be primary. Therefore, you must enroll in Part A and Part B when you have small employer insurance.
It’s also important to know that most retirees require you to be enrolled in Part A and B.
Conclusion
You will never regret preparing for Medicare. Knowing some basics about Medicare before you apply will help you so much. There is a lot to know about Medicare before you enroll, so it is best to get ahead and prepare early so you don’t make a mistake.
Knowing the points listed will make you more knowledgeable & confident when applying for Medicare when it comes your time.