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Getting the Health Coverage You Need: How to Apply for Medicare

Valencia Higuera Valencia Higuera is a writer from Chesapeake, Virginia. As a personal finance and health junkie, she enjoys all things related to budgeting, saving money, fitness, and healthy living.
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Getting the Health Coverage You Need: How to Apply for Medicare

Medicare is one of the most valuable entitlements offered by the federal government. It provides retirement-age U.S. citizens with access to affordable healthcare. Depending on the level of coverage you choose, Medicare plans may cover prescription drugs, vision, and dental. 

 Applying might seem daunting at first but it doesn’t have to be confusing, We’ll explain what you need to know to know to go forward in confidence and guide you to the right resources if you need any additional help. In this article, we’ll cover:

  1. When to Apply for Medicare
  2. Requirements for Medicare
  3. Understanding the Parts of Medicare
  4. How Medicare Plans Can Help
  5. How to Apply for Medicare

When You Should Apply for Medicare

First, understand that in most cases, that you can’t apply for Medicare until you’re nearing 65. If you don’t apply in the seven months surrounding your 65th birthday, which we’ll explain in further detail below, you could be required to pay a late fee. If you’re receiving Social Security benefits or benefits from the Railroad Retirement system, you’ll automatically be enrolled in Medicare Parts A and B during the month you turn 65. There is nothing you need to do in this case. If you are not receiving Social Security or Railroad Retirement benefits, you’ll need to enroll on your own. 

Do You Meet the Requirements to Apply for Medicare?

In order to apply for Medicare, you’ll need to meet the requirements. These are relatively simple, and they include the following:

  • You must be turning or have turned 65 OR meet specific disability requirements if you are younger than 65
  • If you have end-stage renal disease (ESRD), you can apply for Medicaid no matter your age

There are other requirements that you’ll need to meet, but you can use Medicare.gov’s online eligibility checker to do that quickly and easily. You can also find someone to talk to about your options and eligibility requirements at your local Social Security office. The Social Security Administration also offers an online tool to locate the closest office to you by zip code.

Understanding the Parts of Medicare

Part of what can make Medicare so confusing is that it is broken into several different components. Do you need Medicare Part A? What about B? Is D required? Below, we’ll explain the various parts and help you understand your options.

  • Part A – Medicare Part A is free, and mandatory. If you sign up for Medicare, you must at least have this coverage. It is designed to help pay for hospitalization costs. The chance of being hospitalized increases dramatically as we age and those costs can be incredibly high. Part A helps offset the costs of hospital treatment, so you can get the healthcare you need without incurring crippling medical debt.
  • Part B – Medicare Part B is optional and not completely free, but it provides a lot of value. It’s designed to cover the costs of doctor visitsIf you already have coverage through an employer-sponsored plan that you’re happy with, you have the option to  opt out Be aware though that if you don’t opt to get Plan B coverage, it will amount to a 10% premium hike for every year you continue to deny Part B coverage. Then, you may run into an instance where you need Part B, but the premiums are much more expensive.  When and if you do elect to get Part B coverage, you’ll pay a small premium per month that will vary depending on the plan you end up choosing.
  • Part D – Medicare Part D covers some of your prescription drug coverage. Unlike Parts A and B, it’s not offered by the government but instead Part D is made available through private insurers.. Note that Part D is not free, and the costs can vary a lot. You’ll need to compare plans offered in your geographic area to make an informed decision for you. 

How Medicare Advantage Plans Can Help

Medicare Advantage plans fall under Part C. Like Part D, these plans are not offered through the government. but made available by private insurers.  Still, only those who qualify for Medicare Parts A and B will qualify for Medicare Advantage plans. 

Understanding The Initial Enrollment Period

When you apply for Medicare, you must do so within what’s called an Initial Enrollment Period, or IEP. This begins three months before you turn 65 and ends three months after you turn 65, which gives you a seven-month window to apply. If you do not apply for Medicare during this window, you’ll face a penalty. Again, you only need to apply for Medicare Part A during  this time. If you have insurance through your employer, you may not need Part B. However, you must apply for Part B within eight months of retirement, or you’ll face another penalty.

How Do You Apply for Medicare?

You can apply for Medicare in several ways. The first is online. The Social Security Administration offers an online signup form. Note that you can also apply for Social Security benefits at the same time if you want.

The second option is to call or visit your local Social Security office. You can work with someone in their office to determine if you’re eligible and choose the coverage that works for you . If you’re not sure where your local SSA office can be found, they have an online tool to locate the nearest office.

Once you apply for Medicare, the SSA will review your application. If more information is needed, they’ll contact you directly When they have the necessary information and have reviewed it, they’ll make a decision regarding your eligibility and notify you by mail. If you’re approved, you’ll get a Welcome to Medicare packet. If you’re not approved, you’ll also be notified. 

If You Miss Your Initial Enrollment Period

We know things happen and important dates get missed. If you do end up missing your seven month window around your birthday explained above, you’ll need to wait until the next Medicare open enrollment period, which will start the following October 15 and end  December 7. Unfortunately, you will be charged a late enrollment penalty if that happens, so be prepared for that.

In Conclusion

Getting this valuable entitlement does not have to be as hard now that you are armed with this toolbox Just make sure to try to apply during the Initial Enrollment Period and take an informed approach to choosing your plan by reviewing this article and thinking about your needs.  

 

 

 

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