There is a misconception among Americans that you can wait until your 65th birthday to figure out your medicare insurance plans richmond va. Waiting until you turn 65 to educate yourself on the nuances of Medicare is a dangerous mistake. Generally, by the time you turn 65, you should already be enrolled in Part A and Part B, and know which type of additional coverage you may want to buy.
Here are the steps to planning for Medicare at age 65.
Figure out whether you are retiring or not
Working past 65 carries a whole different set of decisions about your health care than if you retired, so you should make your retirement plans before your 65th birthday. If you plan to retire at 65, you will make the transition from employer coverage to Medicare by following the steps below. However, if you plan to work past 65, you may not even need to enroll in Medicare right away.
Having insurance through a large employer is considered creditable coverage for Medicare. Therefore, if you work past 65 for an employer who employees 20 or more people and you have insurance through them, you can delay all parts of Medicare without incurring a late penalty. Although you can delay Medicare if you have creditable coverage, you might as well enroll in premium-free Part A, unless you contribute to a health savings account. Once you enroll in any part of Medicare, you can no longer make contributions to an HSA.
Learn your specific enrollment periods
Medicare has certain enrollment periods that are identical for all beneficiaries, but it also has ones that are unique to the individual. The first enrollment period you should remember before turning 65 is your Initial Enrollment Period (IEP). Your IEP starts three months before your 65th birthday month. For example, if you turn 65 in August 2020, then your IEP starts on May 1, 2020.
Although your IEP ends three months after your 65th birthday month, you should enroll in Part A and Part B within the first three months of your IEP. If you apply within the first three months, then your Part A and Part B will start on the 1st of your birthday month. If you apply during your birthday month or anytime after that, you will have a delayed start date. Missing this period could result in late penalties.
Another enrollment period you should learn is your Medigap Open Enrollment Period (OE). This period starts the day you are both age 65 or over and you are enrolled in Part B and continues for six months. During this time, you have the chance to enroll in any Medigap plan in your area without having to answer any health questions. This allows you to avoid being turned down for pre-existing conditions. After this period has passed, it’s unlikely you’ll be able to skip answering health questions for a Medigap plan. If you have any serious or chronic conditions in your health history, you may be turned down for coverage.
Research the available Medicare plans
There are two main types of Medicare plans you should consider: Medigap plans and Medicare Advantage plans. Medicare Advantage replaces Original Medicare (Part A and Part B), and generally includes Part D coverage for prescription drugs. These plans are very similar to your employer’s group health plan. You may have to use network providers to access your benefits.
Medigap plans, on the other hand, supplement Part A and Part B. When you buy a Medigap plan, it picks up some or all of your out-of-pocket expenses with Original Medicare, except for the Part B deductible. Medigap also can’t be used to cover any Part D prescription drug costs. However, there are no provider restrictions with Original Medicare and Medigap; you can see any doctor who accepts Medicare.
Medigap plans have higher premiums, but you pay less out of pocket when you get care. Medicare Advantage plans usually have lower premiums, but you generally have a plan deductible and copayments.
The best path for you depends on your budget, your health status, and the type of access to doctors you want. Once you’ve figured out the type of coverage you want and when to enroll in it, you will have a smooth transition into Medicare.
