I'll Be 65 Soon

Way to go. You made it!

Before doing the happy dance, there are a few things you need to know. Let's go over the basics, like what you get from the government and what you need to get on your own.

On the month of your 65th birthday you can start using your Medicare benefits. That's the good news.

The bad news is that what you get from the government is not full coverage. It was never designed to be full coverage and never will be. So, let's cover what you get and what you need to do.

The government offers Original Medicare, commonly referred to as Medicare Part A and Medicare Part B. This is your guaranteed benefit. You also have options. The options are Medicare Part C and Medicare Part D. Let's go over the "Parts".

Medicare Part A is inpatient insurance for your hospital care. For most of us there’s no cost to sign up. That’s because it’s funded through payroll taxes.

If you filed for Social Security benefits at age 62, you will be enrolled in Medicare Part A automatically on the month of your 65th birthday. If this is your situation, you’ll need to enroll in Part B.

If your 65th birthday is right around the corner (within 90 days) and you haven’t filed for Social Security benefits, you need to get cracking and apply for Medicare Part A. Do this even if you plan to continue working past age 65.

Medicare Part B is medical insurance. It pays for your doctor visits, lab tests, and preventative care. You'll pay a monthly fee (premium) for Part B. How much you pay is based on your annual income.

Most people enroll in Medicare Part B as soon as they qualify. If you're still working, and have full coverage, your situation may be different (see: I Want to Keep My Employer Health Insurance).

IMPORTANT: If you don’t sign up for Medicare Part B when you're first eligible (and don’t have coverage through an employer), you’ll have to pay a hefty late enrollment penalty.

Medicare Part C, better known as Medicare Advantage, is a private health plan (e.g., HMO, PPO, etc.) option. The "advantage" is that plans must offer everything in Part A and Part B, but they may also include additional service, such as prescription drug coverage. We keep an up-to-date catalog of Medicare Advantage plans.

Medicare Part D is prescription drug coverage. This is critical coverage because Medicare Part B does not pay for outpatient prescriptions. And, as we all know, prescriptions are expensive. Plus, here's another gotcha. As with Part B, you will be penalized if you don't join a Part D plan when you are first eligible. Here's where you shop for your Medicare Part D plans.

IMPORTANT: If you’re within 90 days of your 65th birthday and you have not received a Welcome to Medicare packet in the mail, it means you were not automatically enrolled. In this case, visit https://www.ssa.gov/medicare/ and get your enrollment started.

NEXT: The next step is to read our Turning 65 Guide. It will help you fully understand Original Medicare and why it's critically important to have additional coverage. Plus, you need to know how the decisions you make now can impact what you pay for healthcare for the rest of your life.

I’m Already 65

Medicare gives us an Initial Enrollment Period (IEP) that last a total of 7 months. For example, if you're eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

• Begins 3 months before the month you turn 65
• Includes the month you turn 65
• Ends 3 months after the month you turn 65

PART A: If you didn’t sign up for Medicare Part A during you’re your IEP, it may not be too late. If you sign up for Part A after you turn age 65, your Part A start date can be made retroactive, but only for up to 6 months.

PART B: Your IEP for Part B is CRITICAL. If you miss it, the longer you wait the more you will pay in penalties. You don’t want to delay on this important enrollment.

If you are older than the age range of your IEP, you cannot sign up for part B online. In this case, call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048. To enroll online visit https://www.ssa.gov/medicare/.

NEXT: The next step is to read our Turning 65 Guide. It will help you fully understand Original Medicare and why it's critically important to have additional coverage (including Medicaid, if you qualify). Plus, you need to know how the decisions you make now can impact what you pay for healthcare for the rest of your life.

I'm Under 65 and Qualify for Medicare

If you’re under 65 and qualify for Medicare due to disability or End-Stage Renal Disease you will have to enroll yourself in Original Medicare. However, in some cases you may automatically be enrolled (i.e., if you have had Social Security for disability for 24 months). Check with Medicare to see if you qualify.

Medicare Advantage and Medigap have specific rules about eligibility for enrollment for people under age 65. Call Medicare directly for assistance.

I Want to Keep My Employer Health Insurance

If you have heath coverage from an employer, and plan to continue working past age 65, you should sign up for Medicare Part A anyway. There’s no downside, as you've already paid for this benefit through payroll taxes.

If you have health insurance through a company with more than 20 employees, you might want to delay starting your Medicare Part B benefits. These benefits are likely to have limited value to you while you're enrolled in a group health plan. The reason is that your group health plan is the primary payer of your medical bills.

The most important reason to delay taking your Part B benefits is that doing so would initiate your 6-month Medigap open enrollment period. This is a critical enrollment period, because you can't be turned down, for any reason. You'll want to protect this important benefit until you're ready to use it.

IMPORTANT: If your employer charges you a fee for healthcare, it's important to compare your employee group coverage fees and benefits vs. those offered by Medicare before coming to a final decision. The amount Medicare charges you for Part B benefits is based on your annual income. The standard Part B premium for 2017 is $134 (for people earning $85,000 or less).

It's a good idea to speak with your company's health benefits administrator before making any decision regarding health benefits. If your employer has 20 or fewer employees, Medicare is the primary payer and your group health insurance is the secondary payer. For this reason, if you work for a small business, you should enroll in Medicare Part B when you turn 65.

The next step is to read our Turning 65 Guide. It will help you fully understand Original Medicare and why it's critically important to have additional coverage. The decisions you make now will impact what you pay for healthcare for the rest of your life.

I have Already Enrolled in Medicare

Congratulations!

You have already taken the most important step. You are now qualified and ready to research and enroll in a federally regulated Medigap plan or Medicare Advantage plan.

CRITICAL: Once you start your Medicare Part B benefits, you have a 6-month window to sign up for Medigap with guaranteed issue rights. During this period you can't be turned down, for any reason. However, if you allow this window of time to pass you will be subject to a health review and higher premiums.

Next, take a few minutes and read through our Turning 65 Guide. It will help you to better understand Original Medicare and why every senior needs additional coverage (Medicaid, VA, Medigap, etc).

I Need More Coverage

Before you select a Medicare Advantage plan or a Medigap plan you must first sign up for Medicare Part A and Part B.

Medicare Advantage plans are private health plans that, by law, must offer the same basic benefits provided by Medicare Part A and Part B. When you choose a Medicare Advantage plan, a private company will manage your healthcare benefits, not the government. Some plans are available at no additional cost. Others may offer additional benefits, such as prescription coverage, dental, vision and hearing, and charge an additional monthly premium.

Medigap plans are Medicare supplement insurance policies that fill in the coverage gaps (deductibles, co-payments, co-insurance, etc.) of Original Medicare. Any doctor who accepts Medicare accepts Medigap coverage. They are in lock-step and work hand-in-hand.

Next up, review our Turning 65 Guide. You may not know it, but the decisions you make now will impact what you pay for healthcare for the rest of your life. Our T-65 guide will help you fully understand Original Medicare and your options for additional coverage.

I Have a Different Situation

What can we say? We tried.

There are some unique situations we didn't cover in our overview. If you have specific Medicare enrollment issue, we recommend calling Medicare directly at 1-800-633-4227.