Frequently Asked Questions from Medicare Participants

Assuming you just started using Medicare, you may be confused about the available options. Here are some questions that many older adults have when approaching retirement.

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If you or your spouse has paid Medicare taxes during your working hours and you receive social security contributions, you will receive a Medicare card by mail three months prior to your 65th birthday and you will be automatically registered in Part A (hospital insurance) on your birthday account. If you do not receive social security benefits because you are still working, you will need to go directly to Social Security to register for Medicare during the first registration period (three months prior to your birthday and three months thereafter). If you have not paid any Medicare taxes while working, you will need to contact Social Security directly to buy Part A.

If you are an automatic Part A participant, you will automatically be enrolled in Medicare Part B – Medicare’s medical insurance component – on the first day of the month you reach the age of 65. Part B costs a standard amount for almost everyone. If you are not an automatically enrolled participant and you do not sign up for Part B, if you are applying for Part A because you or your spouse are still working, you can do so during the general registration period (January 1 through March 31), coverage starts every year on the 1st of July or in the special registration period. The special registration period allows you to enroll for Part B, within the eight-month period after that employer-based or employment coverage terminates or at any time while you have employer-based group coverage (whichever comes first). If you sign up as part of the General Registration Period, you may receive a late enrollment deadline if you did not enroll when you were first eligible.

Medicare supplement plans are standardized and therefore have the same benefits, regardless of which carrier you refer them to. During your open registration period (the first six months you are both 65 years old and enrolled in Medicare Part B), an insurance company can not refuse you Medigap policies that it sells and let you wait for the insurance to commence or You will be charged more due to a precondition. These plans vary, but include benefits such as the first three quarts of blood when you are hospitalized, part B overrun and skilled nursing facility care co-insurances.

Medicare Advantage are private insurance plans that contract with the government for Medicare (including medical and hospital supplies). Often they include Part D (prescription drug) coverage in addition to traditional benefits and usually require an out-of-pocket premium. Some of these plans – like PPOs and HMOs – limit the services you can use to their provider networks. However, they can often lower your healthcare costs. You can enroll in a Medicare Advantage plan when you first come to Medicare or between November 15-31st December or 1st of January-31st March each year.