Most people get Medicare just before they turn 65 (though people with disabilities get Medicare after they receive SSDI for 24 months and people with ALS get Medicare the first month they receive SSDI). As a general rule, you are way better off with Medicare than with commercial insurance. But, figuring out what to do can be daunting. I’m going to try to make it easy for you with this Medicare checklist.
- If you don’t have coverage from a current job—yours or your spouse’s—you likely want to sign up for Medicare in the three months before your 65th birthday month, so that your Medicare coverage begins on the first day of your birthday month. (Your current health insurance in most cases will no longer be your primary coverage after your birthday month.) If you have not already signed up for Social Security, you can sign up for Medicare online through the Social Security Administration. Click here for what to do about enrolling in Medicare if you have coverage from a current job.
- If you’ve already signed up for Social Security, you will get Medicare automatically. You should receive a notice in the mail about your automatic enrollment in Medicare Part A (hospital insurance) and Part B (medical insurance), both of which you need whether you enroll in traditional Medicare or a commercial Medicare Advantage plan. The Medicare Part A premium is fully paid for if you or your spouse worked for at least 40 quarters and paid taxes; if not, there’s an additional premium. The Medicare Part B premium, which you must pay whether you take traditional Medicare or opt for a commercial Medicare Advantage plan, will be deducted from your Social Security check automatically.
- You will be automatically enrolled in traditional Medicare.
- You can choose to join a Medicare Advantage plan (Part C), instead of traditional Medicare, simply by signing up with a Medicare Advantage plan; you will be automatically switched out of traditional Medicare. Here’s what to think about before signing up for a Medicare Advantage plan.
- If you stick with traditional Medicare, as 70 percent of people do, you will need supplemental insurance to fill gaps in traditional Medicare and prescription drug coverage.
- Supplemental insurance: If your income is low, you may qualify for Medicaid, which fills the gaps in traditional Medicare. (However, in some states, if you sign up for Medicaid, you do not have the option of traditional Medicare; you must join a Medicare Advantage plan. Call your state Medicaid program to learn more.) If you are not eligible for Medicaid, you can sign up for a Medicare supplemental insurance (Medigap) plan, if you do not get supplemental coverage from your job. Each different type of Medigap coverage is standardized and labeled with a letter of the alphabet; all plans with the same letter cover the same benefits. Do not confuse these Medigap plans that fill gaps in traditional Medicare, with Medicare Parts A, B, C and D. Call your local Area Agency on Aging or State Health Insurance Assistance Program to learn more. For contact information, go to Just Care’s Get Help page.
- Prescription drug coverage: Here are three things to think about when choosing a Medicare Part D drug plan. You can find a list of drug plans to choose from on Medicare.gov. And, here are six tips for keeping your drug costs down if you have Medicare.
- Each fall, during the Medicare open enrollment season, you will be able to switch Medicare plans, and you will likely be better off if you do some homework. Here are two questions you should answer during the Open Enrollment period.
- If you’re in traditional Medicare, you can assume your coverage will remain the same in terms of access to doctors and hospitals. So, no homework there. But, you will need to check into your Medicare Part D drug plan options, which can change dramatically from one year to the next.
- If you’re in a Medicare Advantage plan, you cannot assume your coverage will remain the same. The network doctors and hospitals can change at any time, and the premiums, copays and deductibles can change each year. You will need to do some research around costs and to ensure you are in a plan that allows you to see the doctors and hospitals you want to use. You can switch to traditional Medicare, but if you do not have Medicaid or retiree coverage to fill gaps, you will need a Medigap policy.
For up-to-date and key trusted advice on how to keep your costs down and be safe and healthy, subscribe to Just Care’s short informative free weekly newsfeed by clicking the orange button below. For more about Medicare benefits, Medicaid, Social Security and long-term services and supports, click here. For detailed information about Medicare eligibility and enrollment as well as the full array of Medicare benefits, visit Medicare Rights Center’s Medicare Interactive.
To understand when Medicare is the primary payer and when it is secondary, click here.
If you have Veterans’ or other military benefits, learn how they work with Medicare.