Medicare Blog

pro and con of enrolling in medicare when turning 65

by Ceasar Cummerata Published 2 years ago Updated 1 year ago

You're allowed to enroll in Medicare starting three months before the month of your 65th birthday. And it pays to sign up on time, because if you don't, you could face costly surcharges on your Part B premiums -- whether you pay them directly or have them deducted from your Social Security benefits.

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How to enroll in Medicare if you are turning 65?

How to enroll in Medicare if you are turning 65. 1 Visiting your local Social Security office. 2 Calling Social Security at 800-772-1213. 3 Mailing a signed and dated letter to Social Security that includes your name, Social Security number, and the date you would like to be enrolled in ... 4 Or, by applying online at www.ssa.gov.

What does Medicare Part C mean when you turn 65?

For most people, turning 65 means you’re eligible for Original Medicare, Part A and Part B. This federal program provides hospital insurance and some medical insurance to older Americans and those under 65 with certain disabilities. At this time, you may also choose to enroll in Medicare Part C, also called Medicare Advantage.

What happens if you don't enroll in Medicare on time?

The penalties that come with not enrolling in Medicare on time only apply if you don't have access to an eligible group health plan. It may be the case that you're retired and don't have employer benefits at all.

Is there an ideal age to sign up for Medicare?

Though Medicare eligibility begins at 65, that's not necessarily the ideal age to sign up. For many people, turning 65 is a big milestone, and understandably so. In fact, age 65 is when you're first allowed to get coverage under Medicare. You're allowed to enroll in Medicare starting three months before the month of your 65th birthday.

What is the downside of Medicare?

There are some disadvantages as well, including provider limitations, additional costs, and lack of coverage while traveling. Whether you choose original Medicare or Medicare Advantage, it's important to review healthcare needs and Medicare options before choosing your coverage.

What are two major problems with respect to the future of Medicare?

Financing care for future generations is perhaps the greatest challenge facing Medicare, due to sustained increases in health care costs, the aging of the U.S. population, and the declining ratio of workers to beneficiaries.

What is the biggest disadvantage of Medicare Advantage?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

What are the consequences of not signing up for Medicare at age 65?

You waited to sign up for Part B until March 2019 during the General Enrollment Period. Your coverage starts July 1, 2019. Your Part B premium penalty is 20% of the standard premium, and you'll have to pay this penalty for as long as you have Part B.

Why do doctors not like Medicare Advantage plans?

If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.

What will happen if Medicare runs out of money?

It will have money to pay for health care. Instead, it is projected to become insolvent. Insolvency means that Medicare may not have the funds to pay 100% of its expenses. Insolvency can sometimes lead to bankruptcy, but in the case of Medicare, Congress is likely to intervene and acquire the necessary funding.

Is it necessary to have supplemental insurance with Medicare?

For many low-income Medicare beneficiaries, there's no need for private supplemental coverage. Only 19% of Original Medicare beneficiaries have no supplemental coverage. Supplemental coverage can help prevent major expenses.

What are the top 3 Medicare Advantage plans?

Best Medicare Advantage Providers RatingsProviderForbes Health RatingsCMS ratingHumana5.03.6Blue Cross Blue Shield5.03.8Cigna4.53.8United Healthcare4.03.81 more row•Feb 25, 2022

What is the difference between Medicare Parts ABC and D?

Part A provides inpatient/hospital coverage. Part B provides outpatient/medical coverage. Part C offers an alternate way to receive your Medicare benefits (see below for more information). Part D provides prescription drug coverage.

Do I need Medicare Part D if I don't take any drugs?

No. Medicare Part D Drug Plans are not required coverage. Whether you take drugs or not, you do not need Medicare Part D.

Do you automatically get a Medicare card when you turn 65?

You should receive your Medicare card in the mail three months before your 65th birthday. If you are NOT receiving benefits from Social Security or the RRB at least four months before you turn 65, you will need to sign up with Social Security to get Parts A and B.

Is Medicare Part A free at age 65?

You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if: You are receiving retirement benefits from Social Security or the Railroad Retirement Board.

How many employees do you have to have to have Medicare Part B?

If the employer has fewer than 20 employees: If your or your spouse's employer has fewer than 20 employees and the health coverage is not part of a multiemployer group plan, at age 65 you must enroll in Medicare Part B, which will be your primary insurance. If you have an HSA and want to keep contributing: If you have an HSA ...

What is Medicare Part A?

If the employer has fewer than 20 employees: If your or your spouse's employer has fewer than 20 employees and the health coverage is not part of a multiemployer group plan, at age 65 you must enroll in Medicare Part A, which will be your primary insurance. “Primary” means that Medicare pays first, and then the employer insurance kicks in ...

What happens if you overlook Medicare enrollment rules?

Medicare processes and rules are complex and rife with exceptions; if you overlook something in the enrollment rules, you may pay a high price in terms of both penalties and gaps in coverage. So you should consult with Medicare and with the benefits administrator for your employer coverage — before you enroll or decide to delay enrollment.

How long do you have to keep HSA contributions?

Stop making contributions to your HSA at least six months before you sign up for Part B. And you’ll want to sign up for Medicare at least a month before you stop work ...

How long do you have to work to get Medicare Part A?

If by the time you reach 65 you’ve worked a total of approximately 10 years over your career, you’re entitled to premium-free Medicare Part A, which pays for in-patient hospital charges and more.

What percentage of Americans will be working in 2026?

Millions find themselves in this situation. The proportion of Americans ages 65 to 74 who are working is projected to reach 30.2% in 2026, according to the Bureau of Labor Statistics. But Medicare is complicated, and there are a lot of caveats and some surprise expenses to be avoided.

Is Medicare cheaper than group health insurance?

If your employer (or your spouse’s employer) requires you to pay a large portion of the premium on your group health insurance, you may find Medicare cheaper and the coverage adequate. So compare your current coverage and out-of-pocket expenses — including premiums, deductibles, copays and coinsurance — with your costs and benefits under Medicare, which may also pay some expenses not covered by your group plan.

What is a stand alone Medicare plan?

Stand-alone Medicare prescription drug plan (Medicare Part D) – you might want this type of plan if you need prescription drug coverage. You need Part A or Part B to qualify. If you don’t enroll during your Medicare Initial Enrollment Period (IEP), you might have to wait to sign up.

What is Medicare Advantage?

Medicare Advantage (Medicare Part C) – this program gives you an alternative way to get your Medicare Part A and Part B benefits (many plans also include prescription drug benefits too). You need Part A and Part B to qualify, and then the plan (instead of the government) manages those benefits for you.

When is the best time to enroll in Medicare Supplement?

Medicare Supplement insurance – this coverage may help pay your Medicare Part A and Part B costs, like copayments, coinsurance, and deductibles. You need Part A and Part B to qualify. Usually the best time to enroll is during your Medicare Supplement Open Enrollment Period. That 6-month period starts the month you’re both 65 or older, and enrolled in Part B.

What if you are still working at 65?

What if you’re still working when you hit 65? If you qualify for Medicare, but you’re not getting Social Security benefits yet, you usually don’t get enrolled automatically in Medicare.

When does IEP start?

So if your 65th birthday is in November, your IEP runs from August through February. Your IEP is different if you’re not yet 65, but you qualify for Medicare by disability.

Is Medicare Part A or B?

You might be automatically enrolled in Medicare Part A and Part B (Original Medicare). But if you want to sign up for other Medicare coverage, right about when you’re first eligible for Medicare might be a good time to enroll. If you’re not already getting Social Security retirement benefits when you turn 65, you generally won’t be automatically ...

Do you have to take action if you are automatically enrolled in Medicare?

But even if you’re automatically enrolled in traditional Medicare, you do have to take action if you want other Medicare coverage.

1. You're still working and have access to a group health plan

Just because you're turning 65 doesn't mean you're on the cusp on retirement. You may still have plans to work another few years -- or longer.

2. You're retired but are still covered under your spouse's group health plan

The penalties that come with not enrolling in Medicare on time only apply if you don't have access to an eligible group health plan. It may be the case that you're retired and don't have employer benefits at all.

What happens if you don't sign up for Part A and Part B?

If you don’t sign up for Part A and Part B, your job-based insurance might not cover the costs for services you get.

What is a Medicare leave period?

A period of time when you can join or leave a Medicare-approved plan.

When do you need to sign up for Medicare?

If the employer has less than 20 employees: You might need to sign up for Medicare when you turn 65 so you don’t have gaps in your job-based health insurance. Check with the employer.

Do you have to tell Medicare if you have non-Medicare coverage?

Each year, your plan must tell you if your non-Medicare drug coverage is creditable coverage. Keep this information — you may need it when you’re ready to join a Medicare drug plan.

Does Medicare work if you are still working?

If you (or your spouse) are still working, Medicare works a little differently. Here are some things to know if you’re still working when you turn 65.

Does private insurance pay for services?

Some private insurance has rules that lower what they pay (or don’t pay at all) for services you get if you’re eligible for other coverage, like Medicare.

How to enroll in Medicare if you are a railroad retiree?

If you are eligible for Railroad Retirement benefits, enroll in Medicare by calling the Railroad Retirement Board (RRB) or contacting your local RRB field office. Keep proof of when you tried to enroll in Medicare, to protect yourself from incurring a Part B premium penalty if your application is lost.

When do you have to be 65 to get Medicare?

Most people become eligible for Medicare when they turn 65. Your Medicare enrollment steps will differ depending on whether or not you are collecting retirement benefits when you enter your Initial Enrollment Period (IEP).

Where does Social Security retirement come from?

If you get Social Security retirement benefits, your package and card will come from the Social Security Administration (SSA). If you get Railroad Retirement benefits, your package and card will come from the Railroad Retirement Board .

Do you have to be enrolled in Medicare if you are on Social Security?

If you are receiving Social Security retirement benefits or Railroad Retirement benefits, you should be automatically enrolled in both Medicare Part A and Part B.

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