How to Apply for Medicare

Individuals may sign up for Medicare during their open enrollment unless they qualify for automatic enrollment in the plan. During Medicare enrollment, applicants must decide the plans in which they wish to enroll.

They may elect Part A insurance only, which covers inpatient hospital stays. Or, they may purchase both Part A and Part B which gives them coverage for medical services in addition to hospital coverage. During Medicare enrollment, they must also decide if they wish to enroll in original Medicare or a Medicare Advantage plan.

It is important to for individuals to apply for Medicare during their enrollment period. If they do not enroll during this time, they may have to wait until the next enrollment period to sign up. Or, they may face a late enrollment penalty if they do not elect Part B insurance when they qualify for it. Look below for important information on how to apply for Medicare and why it is important to know the appropriate enrollment period.

When is the Medicare enrollment period?

To sign up for Medicare, individuals must first determine their enrollment period. Some individuals are automatically enrolled, while others must apply for Medicare to receive coverage. To determine when to enroll, applicants may use the following guidelines:

Automatic Enrollment

In certain instances, individuals are automatically enrolled in Medicare. If an applicant begins receiving Social Security or Railroad Retirement Board benefits at least four months prior to age 65, they are automatically enrolled in Medicare Part A and Medicare Part B.

Apply for Medicare During Eligibility

The initial enrollment period begins three months prior the beneficiary turning 65 years of age. It includes the month the individual turns 65 years of age and ends the three months after the month they turn 65 years of age. Individuals who do not enroll during their initial enrollment period may have to pay a late enrollment penalty. The penalty lasts for as long as the beneficiary receives Part B coverage. Additionally, the applicant’s Part B penalty may increase up to 10 percent for each month they chose not to purchase coverage.

Related Article: Eligibility Requirements for Medicare

Beneficiaries who miss their initial Medicare enrollment period may also have to wait until the next general enrollment to apply. The general enrollment period is from January 1st through March 31st.

Renewing Medicare

In most cases, beneficiaries do not need to sign up for Medicare every year. Once enrolled, their coverage continues. However, there may be instances in which a beneficiary must renew their coverage. Individuals enrolled in a Medicare Advantage Plan or a prescription drug coverage plan may need to elect new coverage or choose a new plan in certain circumstances. This typically happens then the plan no longer offers coverage in the beneficiary’s area.

What options are available during Medicare enrollment?

When an individual becomes eligible to sign up for Medicare, they have a variety of options for their coverage. During Medicare enrollment, the coverage a person chooses depends on their existing health coverage and their employment status. Applicants have the following options during the Medicare enrollment period:

Part A

The Medicare Part A coverage is the hospital insurance portion of Medicare. It covers inpatient hospital stays, skilled nursing facilities and hospice. If an applicant worked and paid Medicare taxes, in most cases their Part A premium is free. As such, an individual should enroll in Part A during their initial enrollment period. If a person has not worked enough hours to earn free Part A, they will be required to pay a monthly premium for the coverage during the Medicare enrollment period.

Part A and Part B

Individuals may opt to enroll in both Medicare Part A and Part B. The Medicare Part B plan is the medical insurance portion of the healthcare coverage. Beneficiaries must pay a premium for their Part B coverage. In some instances, a person may choose to delay purchasing Part B along with Part A. An applicant may delay enrolling in Part B without penalty if their current employer has more than 20 employees.

Part D

Medicare Part D covers prescription drugs. The plan is optional, and individuals may choose to not sign up for one during Medicare enrollment. If an applicant does signup for Medicare Part D coverage, they must pay a premium for the plan.

How to Sign Up for Original Medicare

During the Medicare enrollment period, applicants may select original Medicare for their coverage. Those who wish to also apply for Medicaid may do so during this time as there is no Medicaid open enrollment period and individuals may enroll at any time.

To apply for original Medicare seniors must visit the Social Security Administration website and sign up for Medicare online. They must either login or create an account to apply. Once logged in, the applicant must provide the following information:

  • Full name
  • Social Security Number
  • Date of birth
  • Employment information
  • Health insurance information

After entering all required information, individuals must electronically sign the application. Individuals will receive confirmation at the end of the application. Applicants who are not able to complete the Medicaid application at once may save the application and return to it later.

How to Sign Up for a Medicare Advantage Plans

During Medicare enrollment, applicants may choose to apply for a Medicare Advantage plan. Applying for a Medicare Advantage plan during enrollment allows individuals to get their Part A and Part B coverage in a consolidated plan. These specialized plans are offered by third-party insurance companies contracted with Medicare to provide coverage.

Applicants may locate a suitable plan by using the plan locator tool located on the Medicare website. The site allows applicants to search for a plan based on their area. The applicant must then contact the insurance company to apply for coverage. Applicants must adhere to Medicare enrollment period guidelines when applying for a Medicare Advantage plan.

Submitting a Medicare Application for Medigap Insurance

When an individual is ready to apply for Medicare, they may want to consider a Medigap policy. Signing up for Medigap during Medicare enrollment gives applicants extra coverage to pay for costs that Medicare does not cover. Applicants must have both Part A and Part B to qualify for Medigap insurance.

To locate a plan, applicants must visit the Medicare website to access the Medigap plan locator. The site collects basic information such as ZIP code, health status and information about existing health insurance plans. Once an individual locates a plan, he or she must contact the insurance company directly to sign up for Medicare coverage.

Submitting a Medicare Application for Prescription Drug Coverage

During the Medicare open enrollment period, applicants may elect to purchase a prescription drug plan. Applicants have two options for prescription drug coverage when submitting a Medicare application. Applicants covered under Medicare Advantage automatically get prescription drug coverage with their plan. Others must purchase the coverage through a third-party insurance company.

To purchase Medicare Part D coverage, applicants must contact the insurance company directly. They may also contact Medicare by phone at 1-800-MEDICARE (1-800-633-4227). Applicants will need to provide their Medicare number and the date on which their Part A and Part B benefits began.

How to Enroll in Medicare During the Special Enrollment Period

Beneficiaries must select a Medicare plan during Medicare open enrollment or they may be required to wait until the next enrollment period. They may also face late enrollment fines if they do not submit a Medicare application for Plan B coverage during their initial enrollment period. However, beneficiaries may enroll or change their under certain circumstances. The following conditions qualify an individual for enrolling outside the enrollment period or changing coverage outside the enrollment period.

  • Moving to an area not serviced by their current plan
  • Dropped coverage from an employer health plan
  • Meeting both the Medicaid and Medicare eligibility requirements

Beneficiaries must contact Medicare before dropping any existing health coverage to determine if they qualify for special enrollment. If an individual drops coverage before verifying this information, they may not be able to apply for a Medicare policy right away and may need to wait until open enrollment.

Related Article: Program of All Inclusive Care for the Elderly (PACE)

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