Medicare Blog

why cna't i just sign up for medicare plan aa and b without a middle man

by Ashlynn Schaden Published 2 years ago Updated 1 year ago

Is it wise to sign for Medicare Part A alone?

Medicare Part A is hospital insurance. For most applicants, it does not require a premium payment. Many people sign for Medicare A alone, it is permissible to do so. One common question: is it wise only to take part A? There are four parts to Medicare offering the three basic services listed below.

What happens if I don’t sign up for Medicare Part B?

Those who do not sign up for Medicare Part B when they’re first eligible and don’t qualify for a Special Enrollment Period may be subject to a late enrollment penalty. This could mean paying a 10% higher monthly premium for every 12-month period that you were eligible for Part B but didn’t enroll.

Does Medicare Part a mean I Can’t get Medicare Advantage?

Without Medicare Part B, having Part A by itself means no access to Medicare Advantage or Medigap health plans. When starting Medicare health insurance for the first time, many first-time enrollees have questions as they make sense of Medicare.

Should I enroll in Medicare Part B now or wait?

For example, you may wait to enroll in Medicare Part B if you have group coverage through your employer or you’re an active-duty service member with TRICARE coverage. Ultimately, the choice to enroll in or delay Part B will depend on your specific situation, including your health needs, costs, and other coverage you may have.

Check when to sign up

Answer a few questions to find out when you can sign up for Part A and Part B based on your situation.

When coverage starts

The date your Part A and Part B coverage will start depends on when you sign up.

What happens if you sign up for Part A and not Part B?

The Part B late penalty adds ten percent to the premium. Then, it multiplies by the number of full years you went without Part B while you were eligible.

When is the best time to get Medicare Part A?

The best time to get Medicare Part A is when first becoming eligible, during the initial enrollment period. Without Medicare Part B, having Part A by itself means no access to Medicare Advantage or Medigap health plans.

What is the best time to apply for Medicare?

Initial Enrollment Period. The initial enrollment period for Medicare is an important time. In fact, your initial enrollment period (IEP) is the best time to apply for Medicare Part A.

How long does the late penalty for Medicare last?

The Part A late penalty lasts for twice the number of full years a person was eligible, but didn’t enroll in Part A. Payment of the penalty starts at the time a late enrollee signs up, and begins Medicare Part A.

What is Medicare Part A?

Medicare Part A Only. Medicare Part A provides hospital insurance, meaning it covers related services, supplies, and the room itself for a hospital stay. With that said, Medicare Part A alone leaves a glaring gap in health coverage: medical services for situations outside of a hospital stay remain entirely uncovered.

Is Medicare Part A premium free?

For most people, Part A is premium-free. Although permissible to sign up for Medicare Part A only, this only comes recommended when group insurance provides medical coverage equal to Part B, or better. Some retirees continue under insurance from an employer or union when first becoming eligible for Medicare. Without any late enrollment penalty, ...

Does Medicare Part A have a stop loss?

In order to protect yourself, know that Medicare Part A sets no annual stop-loss amount. In other words, there is no built-in safety net to protect against excessive financial loss due to hospital expenses. Beyond that, Medicare Part A and Part B do not have a prescription drug insurance benefit.

What happens if you don't have Medicare Part B?

Going without Medicare Part B and not having other coverage might leave you paying high out-of-pocket costs for doctors’ visits, preventive care, and medical services. Health care needs tend to increase as people get older, and any potential savings from delaying enrollment in Part B could be offset if you get sick and don’t have medical coverage. If you wait to enroll and then contract an illness, you may not be able to sign up for Medicare Part B until the next General Enrollment Period. In the meantime, you may have to pay for all medical costs out-of-pocket.

What are the pros and cons of delaying Medicare Part B enrollment?

If you already have other coverage, the biggest advantage of delaying Part B enrollment is not paying an additional premium for benefits you may not need or use.

What type of coverage does not count as creditable?

The following types of coverage do not count as creditable coverage based on current employment and would not exempt you from paying the Part B penalty if you delay enrollment: COBRA. Retiree benefits. TRICARE (unless you, your spouse, or dependent child are an active-duty member)*. Veterans’ benefits.

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

Many individuals qualify for premium-free Medicare Part A (hospital insurance), provided that they have worked at least 10 years (or 40 quarters) and paid Medicare taxes during those time periods. For these individuals, it typically makes sense to keep Part A, since the coverage comes at no added cost. However, because Part B comes ...

Is it better to enroll in Part B or Part B?

For those who only spend part of the year living overseas, or those who foresee eventually moving back to the U.S., it may be safer to enroll in Part B when first eligible to avoid paying a large penalty later.

Do you have to pay for medical expenses out of pocket?

In the meantime, you may have to pay for all medical costs out-of-pocket. Those who do not sign up for Medicare Part B when they’re first eligible and don’t qualify for a Special Enrollment Period may be subject to a late enrollment penalty.

What happens if you don't enroll in Medicare Part B?

People who fail to enroll in Medicare Part B when they first should will face lifetime penalties, a coverage gap and disruptions in care. The penalty is hefty: an extra 10 percent for each full year you could have had Part B but didn’t apply and were not covered beyond 65 by health insurance from a current employer.

Does Medicare cover everything?

Medicare doesn’t cover everything. Decide whether traditional (also called original) Medicare and a supplement Medigap plan or a Medicare Advantage plan, which combines Medigap and prescription coverage, is best for you. Learn more about Medicare Advantage plans and search for a Medigap plan here.

Who missed the deadline to sign up for Medicare Part B?

George Zeppenfeldt-Cestero of Manhattan missed the deadline to sign up for Medicare Part B. He calls the effort to rectify the situation “my nightmare.”. Credit... Twenty years ago, George Zeppenfeldt-Cestero left his job as a hospital administrator in New York to open a one-person health care consulting firm.

When do you have to enroll in Medicare Part A?

Enrollment in Medicare Part A, which covers hospitalization and requires no premiums for most beneficiaries, occurs automatically at age 65 if you’re drawing Social Security retirement benefits. You have to take steps to enroll if you delay taking Social Security past age 65. If you’re not yet receiving Social Security benefits, ...

How long do you have to apply for Part B?

You have seven months — the month in which you turn 65 and the three months both before and after it — to apply for Part B without penalty. You can apply online at https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b or at a Social Security office. If you’re still employed and working at a company or organization with 20 ...

How many Medicare beneficiaries were paying Part B penalties?

Such Part B mistakes appear to happen with some frequency. Last year, nearly 700,000 Medicare beneficiaries were paying Part B penalties, according to the Centers for Medicare and Medicaid Services.

What happens if you miss the enrollment window?

If you miss that window, you have to wait for the general enrollment period, which runs from January 1 through March 31 each year. That creates two problems. First, Medicare will add a permanent 10 percent penalty to your premiums for each year you delayed. Mr.

When does Medicare open enrollment start?

The general enrollment period (not to be confused with the Open Enrollment Period currently underway when those already receiving Medicare can change plans) runs from January through March, remember. But coverage doesn’t begin until the following July 1. If you didn’t sign up for Part B and recognize your error in March, you can be insured in July.

Is Medicare a full retirement age?

Both threshold ages used to be 65 but now, the full Social Security retirement age has passed 66 and will gradually rise to 67.

What happens if you don't get Part B?

NOTE: If you don’t get Part B when you are first eligible, you may have to pay a lifetime late enrollment penalty. However, you may not pay a penalty if you delay Part B because you have coverage based on your (or your spouse’s) current employment.

When do you get Part A and Part B?

You will automatically get Part A and Part B starting the first day of the month you turn 65. (If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.)

What is the individual health insurance marketplace?

NOTE: The Individual Health Insurance Marketplace is a place where people can go to compare and enroll in health insurance. In some states the Marketplace is run by the state and in other states it is run by the federal government. The Health Insurance Marketplace was set up through the Affordable Care Act, also known as Obamacare.

Do you have to pay a penalty if you don't get Part A?

NOTE: If you don’t get Part A and Part B when you are first eligible, you may have to pay a lifetime late enrollment penalty. However, you may not pay a penalty if you delay Part A and Part B because you have coverage based on your (or your spouse’s) current employment.

When do you have to be on Medicare before you can get Medicare?

Individuals already receiving Social Security or RRB benefits at least 4 months before being eligible for Medicare and residing in the United States (except residents of Puerto Rico) are automatically enrolled in both premium-free Part A and Part B.

How long does it take to get Medicare if you are 65?

For someone under age 65 who becomes entitled to Medicare based on disability, entitlement begins with the 25 th month of disability benefit entitlement.

How long do you have to be on Medicare if you are disabled?

Disabled individuals are automatically enrolled in Medicare Part A and Part B after they have received disability benefits from Social Security for 24 months. NOTE: In most cases, if someone does not enroll in Part B or premium Part A when first eligible, they will have to pay a late enrollment penalty.

What is the income related monthly adjustment amount for Medicare?

Individuals with income greater than $85,000 and married couples with income greater than $170,000 must pay a higher premium for Part B and an extra amount for Part D coverage in addition to their Part D plan premium. This additional amount is called income-related monthly adjustment amount. Less than 5 percent of people with Medicare are affected, so most people will not pay a higher premium.

What happens if you don't enroll in Part A?

If an individual did not enroll in premium Part A when first eligible, they may have to pay a higher monthly premium if they decide to enroll later. The monthly premium for Part A may increase up to 10%. The individual will have to pay the higher premium for twice the number of years the individual could have had Part A, but did not sign up.

How long does Medicare take to pay for disability?

A person who is entitled to monthly Social Security or Railroad Retirement Board (RRB) benefits on the basis of disability is automatically entitled to Part A after receiving disability benefits for 24 months.

What is MEC in Medicare?

Medicare and Minimum Essential Coverage (MEC) Medicare Part A counts as minimum essential coverage and satisfies the law that requires people to have health coverage. For additional information about minimum essential coverage (MEC) for people with Medicare, go to our Medicare & Marketplace page.

When is open enrollment for Medicare 2021?

The next open enrollment will be from Oct. 15 to Dec. 7 , 2021, and any changes you make will take effect in January 2022. Editor’s note: This article has been updated with new information for 2021.

What is Medicare Advantage?

Medicare Advantage is the private health insurance alternative to the federally run original Medicare. Think of Advantage as a kind of one-stop shopping choice that combines various parts of Medicare into one plan.

How much is Medicare deductible for 2021?

Medicare charges a hefty deductible each time you are admitted to the hospital. It changes every year, but for 2021 the deductible is $1,484. You can buy a supplemental or Medigap policy to cover that deductible and some out-of-pocket costs for the other parts of Medicare.

How much is Part B insurance for 2021?

The federal government sets the Part B monthly premium, which is $148.50 for 2021. It may be higher if your income is more than $88,000. You’ll also be subject to an annual deductible, set at $203 for 2021. And you’ll have to pay 20 percent of the bills for doctor visits and other outpatient services.

Does Medicare Advantage cover prescription drugs?

Most Medicare Advantage plans also fold in prescription drug coverage. Not all of these plans cover the same extra benefits, so make sure to read the plan descriptions carefully. Medicare Advantage plans generally are either health maintenance organizations (HMOs) or preferred provider organizations (PPOs).

Does Medicare cover wheelchair ramps?

In addition, in recent years the Centers for Medicare and Medicaid Services, which sets the rules for Medicare, has allowed Medicare Advantage plans to cover such extras as wheelchair ramps and shower grips for your home, meal delivery and transportation to and from doctors’ offices.

Does Medicare cover telehealth?

In response to the coronavirus outbreak, Medicare has temporarily expanded coverage of telehealth services . Beneficiaries can use a variety of devices — from phones to tablets to computers — to communicate with their providers.

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