A Timeline for Medicare Enrollment
by Ardis Black, JD
As you begin to think about turning 65, you might also begin to think about enrolling in Medicare. At https://www.medicare.gov/ you will find a wealth of information, including where to get help for Medicare decisions near your home. Below are critical dates to keep on your radar, so to speak, some basics that will be helpful to understand, and some important resources to note.
Part A coverage goes back (retroactively) 6 months from when you sign up (but no earlier than the first month you are eligible for Medicare.
In general, if you are employed and have employer-sponsored health care coverage, you should likely enroll in Medicare Part A at age 65, even if you delay enrolling in Part B until later -- unless you are actively saving into a Health Savings Account (HSA).
Tax rules prohibit contributions to an HSA if you are enrolled in Medicare Part A. In fact, to avoid a tax penalty, you should stop contributing to your Health Savings Account (HSA) at least 6 months before you apply for Medicare Part A.
One of the first issues to consider is whether you will be employed and receiving health care benefits from your employer on your 65th birthday.
The Initial Enrollment Period (IEP) is the seven-month window that opens 3 months before your 65th birthday and remains open through your birthday month and the three months following that month. If you enroll during the three months prior to your 65th birthday, coverage starts on the first day of your birthday month. If you do not enroll during the IEP and are not eligible for a Separate Enrollment Period (SEP), you will face lifelong penalties and a delay in being able to apply to get medical coverage.
If you are eligible, an eight-month Separate Enrollment Period (SEP) to sign up for Medicare Part A and/or Part B starts the month after your employment coverage ends.
A SEP may be granted to those who are employed and covered by eligible employer health coverage during their IEP; however, don’t just assume you will be eligible for the SEP, contact Medicare to verify your employer-provided health insurance meets Medicare requirements. https://www.medicare.gov/forms-help-resources/contact-medicare .
Once your employer-provided coverage ends:
Medicare Advantage, also known as Part C, is coverage provided through an HMO, PPO, or PSO under contract with the Medicare program.
Medicare Part D, Medicare’s Prescription Drug Coverage
Annual Open Enrollment.
Minnesota: Senior LinkAge https://www.seniorlinkageline.com/
Georgia: Georgia Cares https://www.mygeorgiacares.org/
New Hampshire: Service Link Aging and Disability Resource Center https://www.servicelink.nh.gov/
Wisconsin: State Health Insurance Program https://www.shiptacenter.org/about-medicare/regional-ship-location/wisconsin
Medicare Part A, Hospital, is premium free for those who have paid Medicare tax and are eligible for Social Security or Railroad Retirement income benefits.
If your employer has more than 20 employees, and you have group health plan coverage (as defined by the IRS) you may be able to delay Part A and Part B while avoiding a lifetime late enrollment penalty if you enroll later.
The size of the employer and type of plan determines whether you may be able to delay Part A and Part B without having to pay a penalty if you enroll later.
Drugs administered at an outpatient facility, such as chemotherapy, dialysis, or other medicines that are injected or given intravenously are covered by Part B, not D.
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