When to start the Medicare journey is a topic we’re frequently asked about. Unfortunately the answer depends on your situation! In this post, we’ll talk a bit about common situations we see and our usual approaches to those situations when it comes to enrolling in Medicare. Remember, though, this may not cover all situations, and it certainly may not cover your situation! This will be a helpful guide, but we always encourage people to sit down with a licensed Medicare agent or to contact Medicare to make sure the process is smooth sailing! With that, let’s get right to it!
When should I start thinking about Medicare?
It’s not a bad idea to start pondering Medicare 5-6 months before your 65th birthday–yes, even if you’re still working. Five to six months will allow you to get a good grasp of what the process looks like, what your process looks like, and what all of the different terms and acronyms mean. All of this without the pressing stress of a deadline.
In that 5-6 months, you should familiarize yourself with Original Medicare, Medicare Advantage, and Medicare Part D plans at the very least. You’ll have time to ponder the pros and cons of each, and to figure out how Medicare may replace or work with your current insurance depending on whether you’ll continue working or not (more on that later!).
Okay, I’ve started thinking about it–now what?
Great! You’ve started looking into the terms and different types of plans. At this stage, you may have seen the different terms, but you don’t have to be an expert (not now or really ever–that’s what we’re here for!).
Three months before your 65th birthday, you can start the process of enrolling in Medicare Parts A and B. If you know at this point Medicare coverage is the path you’re taking, we recommend getting started a few months before your 65th birthday with the online paperwork on SSA.gov or by scheduling an appointment with your Social Security office (whether you’ll be taking social security at this time or not). You have up to 3 months after your birthday to sign up for Medicare Parts A and B, so there’s not a huge rush! But, if you want your coverage to begin on the month of your 65th birthday, getting a head start is always a good idea!
Why Wouldn’t I Sign Up for Medicare?
You’re 65, right? Why not sign up for Medicare right when you turn 65? In this day and age, many people are continuing to work past the age of 65. In many cases, people will continue to have good health insurance provided to them by their employer or a spouse’s employer. If this is the case, you can hold off on signing up for Medicare until that coverage is lost.
It’s important to note, however, that the employer coverage must meet certain federal guidelines to avoid the Part B penalty for not signing up when you’re initially eligible to do so. For this reason, we still recommend people talk to a Licensed Agent or get in touch with Social Security to make a good plan and ensure their coverage fits the box!
Can I get Medicare even if I have employer coverage?
Yes! At 65, you may sign up for Parts A and B even if you do have coverage through an employer. In this situation, you may choose to discontinue the employer plan in favor of Medicare, or you may decide to have coverage both through your employer plan and through Medicare.
I’m over 65, and I am going to retire. What does that look like?
If you’re over 65, and you’ve had qualified health coverage through your employer, you have 8 months once your coverage ends (COBRA doesn’t count!) to enroll in Medicare. This is called a Special Enrollment Period and gives you ample time to do all of the paperwork. However, we recommend, if possible, to start thinking about the paperwork a few months in advance so there’s no lapse in coverage. Understandably, this isn’t always possible, but if you’re planning your retirement, it’s a good idea to start the Medicare planning a good few months in advance! Don’t make Medicare stress ruin the excitement of your newfound free time!!
If you miss this 8 month period, you’re not out of luck. You have time to enroll every year from January 1 – March 31 in what’s called the General Enrollment Period (GEP). If you have to wait, though, you may be subject to the Part B penalty for not enrolling during your 8 month window of enrollment–best to avoid that!
After all of that, you see, the process may look different for everyone! To wrap it all up: get started early when at all possible. Of course, unexpected situations may arise in which pre-planning wasn’t part of the game. We get it! Get started enrolling in Medicare as early as you can in these situations.
So, get started early and be sure to discuss your situation with a professional. We know your neighbor may have done it a certain way, but your neighbor isn’t you! It doesn’t cost a thing to talk to licensed agents or Medicare or Social Security. Go over your game plan with someone who speaks to many different people and knows the ins and outs of the system–it will save you a lot of stress!
As always, this is meant to be a good reference guide, but we are not providing answers to all of the questions out there in this post. Please contact us or Medicare to get insight on your situation!