Medicare is a federal health insurance program that covers certain medical services and supplies in hospitals and doctors’ offices. The insurance is provided to U.S. citizens and permanent residents who meet one or more of the following criteria:
Medicare covers three categories of health care expenses:
For most Medicare Advantage plans, you must use network doctors, hospitals, and other providers. Monthly premiums and out-of-pocket costs vary. You can switch between Medicare Advantage and Original Medicare, or to a different Medicare Advantage plan, but only during either the fall open enrollment period that begins October 15 and ends December 7 each year or the Medicare Advantage open enrollment period that begins January 1 and ends March 31 each year.
Keep in mind that some items and services are not covered by Original Medicare:
Some Medicare Advantage providers, however, may cover certain dental and vision care services.
Automatic enrollment. The following individuals are automatically enrolled in Medicare Part A and Part B:
If you are automatically enrolled, a Medicare card will be mailed to you three months before your 65th birthday or three months before your 25th month of disability benefits. You can decline Part B coverage before the date it takes effect. If you do not want to pay Part B premiums, follow the instructions that come with the card and return it. If you need help paying Medicare premiums, contact the Social Security Administration.
Active enrollment. You must take action to enroll in Medicare if:
Enrollment period. The time frame for enrolling in Medicare covers the three months before your 65th birthday, the month you turn age 65, and the three months following your 65th birthday. If you don’t enroll during this initial period, you may do so during the general enrollment period that occurs every year between January 1 and March 31. If you sign up late, you run the risk of having to pay a higher premium because of a late-enrollment penalty.
Special enrollment period. If you lost your employer-provided coverage because of the Covid-19 pandemic, you have an eight-month special enrollment period in which to choose your Medicare coverage. You can enroll in Medicare at www.ssa.gov/benefits/medicare. Usually, a former employer will complete Form L564 to confirm that you had employer-provided coverage. If this is not possible because of the pandemic, confirm with social security that you can complete Form L564 and ask what additional information it will require as verification.
If you or your spouse are still working and are covered by employer-provided health insurance, you can keep your current plan and sign up for Medicare without penalty at a later date. Talk to your employer about how your current health plan coordinates with Medicare.
Completing your enrollment application. You can complete your Medicare application in one of three ways:
If you were automatically or actively enrolled in Medicare, you may choose to join the Medicare Advantage plan after you receive your Medicare number and after the date, your Part A and/or Part B coverage starts. You can do this by completing an application or visiting www.medicare.gov.
Additional information on Medicare can be found in the Medicare & You handbook at www.medicare.gov/Pubs/pdf/10050-medicare-and-you.pdf.
This material has been provided for general informational purposes only and does not constitute either tax or legal advice. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a tax preparer, professional tax advisor, or lawyer.
Kristen Smith is a guest blogger, representing Axial Financial Group in Burlington, MA. She offers securities as a Registered Representative of Commonwealth Financial Network, Member FINRA/SIPC. CRR, LLP (also represented as CRR, CRR CPA), Axial Financial Group, and Commonwealth Financial Network are separate and unrelated entities. Kristen can be reached at 781-273-1400 or ksmith@axialfg.com. This material has been provided for general informational purposes only and does not constitute either tax or legal advice. Although we go to great lengths to make sure our information is accurate and useful, we recommend that you consult a tax preparer, professional tax advisor, or lawyer.