Medicare provides health care coverage to people age 65 and older, regardless of their income or medical history. Younger adults with permanent disabilities may also qualify for Medicare.
How will I be affected by the changes in Medicare to 2021?
Under current law, there are no changes to Medicare benefits. The program will continue as planned until 2021, at which point all beneficiaries will start paying a higher premium for outpatient services and prescription drugs unless Congress acts.
What should I do if I currently rely on Medicare?
If you’re already receiving benefits and plan to enroll when eligible: don’t delay signing up if you want to avoid annual late enrollment penalties and lifetime additional late enrollment penalties (AEPs). Suppose your income is below the yearly limit for Modified Adjusted Gross Income (MAGI). In that case, you may be able to reduce your monthly premiums by signing up during a special enrollment period (SEP). If your income is above the yearly limit for MAGI, you’ll need to wait until open enrollment and sign up then.
What should I do if I’m currently ineligible for Medicare?
If you’re not yet 65: You can start preparing now and use this time to learn about eligibility requirements and estimate what your costs will be in terms of premium and deductible amounts. This way, when you become eligible at age 65, you’ll be prepared. If you enroll within six months after becoming eligible, you still have plenty of time before general enrollment begins on October 15th. If you are unsure if you are eligible for Medicare, you can talk to Medicare expert from www.clearmatchmedicare.com
If I’m 65 or older, what do I need to know?
At age 65, you’ll be automatically enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance), which covers outpatient services. You can choose to accept your automatic enrollment into Medicare Part B only. Still, it’s best to decline if you don’t want it because an interruption in medical coverage could have serious consequences for anyone with health issues. You must also enroll in a prescription drug plan within the six months that begins three months before the month you turn 65 and ends three months after the month you turn 65. If you miss this window of opportunity, you’ll be able to sign up during general enrollment from January 1st through March 31st of the year you turn 65. If you wait too long, you could face a late-enrollment penalty
When can I sign up for Medicare?
You can enroll at any time during a seven-month window that begins three months before the month you turn 65 and ends three months after your birth month. Generally, if you miss this enrollment window, you’ll need to wait until the next general enrollment period (January 1st through March 31st) or pay higher premiums for life. You can also apply for Social Security benefits before turning 65, and Medicare will automatically be included in your application. Not everyone is automatically enrolled when they’re eligible at age 65. People who are still working past age 65 may not receive notification about automatic Medicare enrollment and should contact their health plan or visit the website to sign up for benefits before age 65. Some people who are not eligible at age 65 can enroll any time during the year if they meet certain requirements, such as having a disability or being entitled to Social Security or Railroad Retirement Board benefits. Certain disabled children younger than 22 may also get Medicare, regardless of other eligibility criteria.
What do I need to know about Part D?
Suppose you’re getting prescription drug coverage through an employer’s HR benefit plan. In that case, you’re considered covered under a “creditable prescription drug plan,” which requires no additional action when you turn 65 and become eligible for Medicare. You’ll automatically continue the same coverage you have through your employer when you apply for Medicare, and in most cases, your premiums will remain the same. Suppose this is not the case with your employer-based plan. In that case, you’ll be able to switch to a Part D plan that most closely matches what’s offered by your former employer or choose another option that provides at least two prescription drug coverage choices and meets all federal requirements.
If I decide to enroll in Part A and Part B when I turn 65, what happens if my spouse is still working?
Suppose one spouse is already receiving Social Security benefits when the other spouse turns 65 or becomes eligible for Medicare due to a disability. In that case, they can choose either program but not both. If you continue to work past age 65, your spouse can choose to enroll in Part A without affecting your ability also to enroll. They may not want the same coverage you have, though; it’s important to talk with your HR representative about these options before you decide.
What happens if I do nothing?
If you don’t sign up for Medicare when you’re first eligible (at age 65) or later during any open enrollment period, you could pay higher premiums for life. This is because the government has determined that people who delay signing up for Medicare are healthier on average than those who join initially. Insurance companies use this information when they set their rates. Since there’s no for them to distinguish between late enrollees and those who sign up initially, the late enrollees often pay a higher premium. To avoid paying more or because you might not afford premiums later in life, it’s important to enroll as soon as you’re first eligible.
What do I need to know about Medicare Advantage?
Medicare Advantage is an alternative way of receiving your Part A and B benefits. You’ll receive the same benefits under the same rules that apply to original fee-for-service Medicare, but you may have different out-of-pocket costs. Some plans charge monthly premiums, and some don’t, so check your plan before signing up. Generally, these health care plans work best for people who want more than one healthcare provider or hospital to choose from or who don’t want to deal with the paperwork and hassle of submitting their claims.
What do I need to know about Medicare supplement insurance?
Medicare Supplement Insurance (Medigap) plans are designed to help cover your out-of-pocket costs under Parts A & B. They can be an excellent way for people to protect against high medical bills that aren’t covered by Parts A & B but are also not automatically included in your plan. Medigap plans must meet federal requirements, so they have standardized benefits before you sign up. You can find more information on these plans available through the official website.
What do I need to know about my late enrollment penalty?
If you’re not eligible for Medicare Part A (Hospital Insurance) when you turn 65 but sign up later, you’ll pay a permanent monthly surcharge for as long as you have Medicare. You can avoid this extra charge by signing up for Part A during your initial enrollment period. Your initial enrollment period begins the month you turn 65 and ends three months later. If you don’t sign up during this time, your penalty kicks in on the first day of the third month after the end of your initial enrollment window. There are exceptions or exemptions for people who delayed signing up because they continued working or had employer coverage based on current employment. You can find more information on how late penalties are applied by reading Chapter 7 in your Medicare & You handbook.
What do I need to know about the Gap?
The “donut hole” refers to a gap in Medicare Part D prescription drug coverage that you reach once you spend a certain amount of money, $3,750 in 2019. This means you’ll have to pay for all of your prescriptions until the total cost reaches what the federal government calls the out-of-pocket threshold, which is $5,500 this year. Your plan will start covering 95% of your medication costs again at this point – but only after paying 100% yourself first! Use our handy dandy donut whole calculator to figure out when you’ll reach your donut hole this year.
What do I need to know about Medicaid?
Medicaid eligibility begins three months before you turn 65, which is why it’s essential to sign up for Medicare during the period outlined above. If you’re not signed up by then , your state can still help you pay for health care under its program. You may have to spend down some of your savings or assets before becoming eligible – so check with your state’s department of insurance if you think this might be a concern.
What do I need to know about drug coverage?
Your Medicare Part D prescription drug plan is designed to help cover the costs of medications you take every day. Still, like everything else, it isn’t automatically included in your plan. If you choose not to sign up for Part D at first, that’s okay – there are other ways to cover these costs. If you decide that enrolling in a Part D plan is right for you, check out our strategy guide below for some helpful tips!
Medicare Part D Strategy Guide: How to make the most of your coverage
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Once you sign up, what else do I need to know?
Even after signing up for Medicare, there are a few more things you’ll need to keep track of. One of the most important is making sure that both Parts A and B are paid up. You can’t get any services covered under Part A if it isn’t, and the chances are that won’t be cheap! Make sure your doctor submits all of your medical costs to Medicare as bills come in, even if it’s been months since treatment happened. Also, remember that some providers may not accept assignments, which means they only accept the amount they feel like reimbursing. It’s always a good idea to know what you’re in for before any treatment, so check your plan information or talk to your doctor ahead of time.
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What do I need to know about tax implications?
There are a few different ways that your benefits could be taxed: one is if you decide not to sign up and pay the penalty instead, and another is when you invest in a Medicare Advantage managed care plan. There’s also an income-related phase-out affecting anyone who earns more than $160,000 per year. However, there are certain exemptions for people who make within this threshold but live in an area with high medical costs (like Alaska and Hawaii). These complicated rules can all be found on the official website under Chapter 14 of the 2019 Medicare & You handbook.
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What do I need to know about paying for care?
There are a few ways you can pay for your medical costs without signing up for Medicare if you don’t have coverage through your job. You could choose to become eligible by spending down some of your savings or assets, using Medicaid instead, or buying into the program through a Medicare Advantage managed care plan. If none of these options work, you’ll need to wait until January 1st of the year you turn 65 before signing up for Part A.
