MEDICARE 101

What is Medicare?

This video explains what Medicare is in an easy and concise way.

 
 

What's Your Situation?

Every client has a unique situation, that's why we work one-on-one with you, to determine the best option. Listing all the rules and deadlines would be too overwhelming, instead, we've listed just a few of the major things to be aware of. Call us to discuss your current requirements.

Important Medicare Deadlines

When you work with us, you won't need to worry about any of these, as we'll track and ensure compliance with any situation you may have. We have listed several situations in which you may be eligible for Medicare insurance.

Turning 65

Important Dates / Deadlines:

  • You only have a 7 month window in which to sign up for Part B. This is called your "Initial Enrollment Period" (IEP). You can sign up 3 months prior to, and up to 3 months after your 65th birth month. Don't delay, if you sign up after you turn 65, your effective date is penalized by 1 month. Example: If you turn 65 in January, and you wait until February to sign up for Part B, you're Part B effective date will be April 1st. You will not have Part B coverage until April 1st. Find your local Social Security Administration Office to sign up (you must go in person). Find your local SSA office here 
  • If you miss signing up for Medicare Part B during your 7 month window, you will be penalized 10% for every 12-month period that you don't have Part B. Once you get Part B, you will pay 10% of the current Part B premium. If the part B premium is $100/mo, you will pay $110/mo. You will pay this penalty for the rest of your life.
  • If you miss signing up for Medicare Part B, you will only be able to sign up for it during the Part B enrollment period, which is January 1st to March 31st of each year. If you sign up for Part B during this time, your effective date will be July 1st. This means you will not have any Part B coverage until July 1st.
  • You won't start paying for Part B until your Part B effective month.
  • The earliest month this can go effective is your 65th birth month, unless you're birthday falls on the 1st of the month, in which case, your effective date will be the 1st day of the month prior to your birth month.
  • You have up to 3 months after your Part B effective date to sign up for a Medicare Advantage Plan or Medicare Prescription Drug Plan.
  • You have up to 6 months after your Part B effective date to sign up for a Medicare Supplement Plan as a "Guaranteed Issue". Outside of this window, you are allowed to apply, but your application would go through medical underwriting and there is a chance you can be denied coverage.

Retiring and/or Losing Existing Coverage

Important Dates / Deadlines:

  • You only have 63 days after you lose credible coverage in which to sign up for Part B. If you miss this window, the above penalties & deadlines apply.
  • COBRA is not considered credible coverage.
  • If your company is giving you insurance coverage for a set period of time (let's say 1 year of severance), you are not required to sign up for Medicare Part B because you have credible coverage, BUT, you must sign up for Part B no later than 8 months after you stop working, regardless if you still have credible coverage from your work plan.
  • You can have dual coverage, and Medicare would be considered the "first payer". This is normally reserved for people with VA Benefits, or Union insurance coverage. If you give up your Union coverage (terminate it to get onto Medicare), you may not be able to get it back.

Moving From Another County or State

Important Dates / Deadlines:

  • You only have 63 days after you "officially" move in order to switch your plan, or enroll into Medicare part B. During this period, you cannot be denied coverage (this is a "Guaranteed Issue" period). The clock start "ticking" once you alert the Social Security Administration of your move (or when they find out through some other means - they can back date it if they suspect fraud).

Permanently Disabled At Any Age

Important Dates / Deadlines:

  • You must wait two years after you are diagnosed as Permanently Disabled in order to qualify for Part B.
  • Once the two year waiting period is over, you may apply for Medicare Part B.
  • You automatically receive Part A when you are diagnosed.
  • You have up to 3 months after your Part B effective date to sign up for a Medicare Advantage Plan or Medicare Prescription Drug Plan.
  • You have up to 6 months after your Part B effective date to sign up for a Medicare Supplement Plan.​​

Please contact us to discuss your situation at: 888-939-7383