A little planning can make a big difference when it comes to Medicare enrollment. If you have what you need – and know when to enroll – it will help you avoid any penalties or gaps in health care coverage.
Enrolling in Medicare is easier than you may think. You can sign up online, by phone, or in person at any Social Security office. But there are a few things you’ll need to have ready before you enroll.
You’ll need an approved form of ID, and some personal, military, and employment information to get started. Print out this checklist from the Social Security Administration to make sure you have exactly what you need.
This is the period during which you can enroll in Medicare for the first time. It is unique to the month you turn 65. Use this to find your personal Initial Enrollment Period.
If you miss your Initial Enrollment Period, you can sign up for Parts A and B during the General Enrollment Period, which is every year from January 1 to March 21. However, because you missed your Initial Enrollment Period, you may have to pay a late enrollment penalty.
This is the period during which you can enroll in a Medicare Advantage (Part C) or Prescription Drug (Part D) Plan. Important: You must enroll in Medicare Parts A and B first.
Every year, the Annual Enrollment Period gives you the chance to switch to a different Medicare plan for the following year. Because your health care and/or financial needs may change from year to year, the Annual Enrollment Period is a good time to review your options. That way, you can make sure the coverage you have is still the coverage that works best for you.
If you have a retiree group Medicare plan, the Annual Enrollment Period is set by your employer or benefit administrator. If you have multiple plan options, this period gives you the chance to switch to a different Medicare plan for the following year.
While some people do encounter penalties, there are quite a few exceptions to the rules. If you’re currently covered by a workplace plan with 20 or more employees, provided by Blue Cross and Blue Shield of New Mexico, you aren’t likely to incur a penalty. But it’s always good to know what might cause a penalty so you can avoid them.
Most people qualify for free Medicare Part A. They won’t have to worry about a late enrollment penalty because they have the 10 years of work history needed.
Here are the guidelines. If your workplace has:
But, if you don’t qualify for free Part A and you don’t buy Part A as soon as you are eligible for Medicare, you will have to pay a late enrollment penalty. That means your Part A premium will be 10% higher for twice the number of years you delayed your Part A enrollment. Even if you plan to work past age 65, you may want to go ahead and enroll in Part A during this time.
Part B requires everyone to pay a premium, regardless of how long they worked and paid Medicare taxes. Part B late enrollment carries a significant penalty. Your Part B premium will be increased by 10% for each full year you were eligible but did not enroll.
There is an important exception to the Part B late enrollment penalty: if you are still employed and/or covered by an employer health plan, there is no penalty. If you plan to work past age 65, you can wait to enroll in Part B until you retire. Once you retire, you’ll have an 8-month Special Enrollment Period to enroll in Part B and make other important choices. But you’ll want to plan ahead and contact Social Security before your employer coverage ends, so you don’t have a gap in coverage.
Unless you qualify for an exception, if you don't sign up for Part D coverage within 3 months of becoming eligible for Part D, you'll have to pay a penalty. It’s a little tricky to explain, but here’s an example to follow.
There is an exception to the Part D late enrollment penalty. You may not have to pay a penalty if you have creditable prescription drug coverage when you first become eligible for Medicare Part D. Creditable prescription drug coverage is coverage that’s expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage (Part D). This includes group or individual plans that cover prescription drugs.
The most likely exception is that you are still working and have coverage through your current workplace plan with Blue Cross and Blue Shield of New Mexico. You may also have coverage through your spouse’s workplace when you turn 65. In those cases, you can sign up for Part A and B, along with additional coverage, during your Special Enrollment Period. Learn more about Special Enrollment Periods.
A Medicare Advisor can help you through the enrollment process. They’ll make sure you avoid any unnecessary penalties. Call us at 1-800-000-0000 (TTY 711).
You can keep your Marketplace plan until your Medicare coverage begins.
Important: Don’t cancel your Marketplace coverage until the date your Medicare coverage begins. Once you end Marketplace coverage, you can’t re-enroll until the next Annual Enrollment Period or Open Enrollment Period, unless you qualify for a Special Enrollment Period. Learn more about enrollment periods.
To learn how to cancel your Marketplace plan without a penalty, use this tool on the federal government’s website, Healthcare.gov.
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