Get Started with Medicare

A step-by-step guide to understanding Medicare

GET STARTED WITH MEDICARE

Whether you’re approaching age 65, delaying retirement, or just researching options for the future, it’s important to understand how Medicare enrollment works. Here are some key steps so you can move forward with confidence no matter where you are in your Medicare journey.

1. Learn the Basics of Medicare

• Medicare is a federal health insurance program primarily for people aged 65 and older. However, your path to Medicare may vary based on your situation:
  • You may qualify for Medicare before age 65 if you have a disability and have received Social Security disability benefits for 24 months, or if you have ALS (Amyotrophic Lateral Sclerosis) or End-Stage Renal Disease (ESRD).
  • If you’re still working after age 65 and have employer-sponsored health coverage, you may be able to delay Medicare Part B without penalty.
  • If you’re covered by a Marketplace plan, you’ll still need to enroll in Medicare when you’re first eligible to avoid coverage gaps or late enrollment penalties.
• Medicare has four main parts, and understanding what each cover is essential to choosing the right coverage:
  • Part A (Hospital Insurance)
  • Part B (Medical Insurance)
  • Part C (Medicare Advantage – offered by private insurers and includes Part A and B, often Part D)
  • Part D (Medicare drug coverage)

2. Find Out When to Enroll in Medicare

• Knowing your Medicare enrollment timeline is important for effective planning. Enrolling too late could lead to a gap in health coverage and potential late enrollment penalties.
• The Medicare Initial Enrollment Period starts 3 months before the month you turn 65 and lasts for 7 months. However, timing may vary depending on whether you have employer-sponsored health insurance or another coverage.
• If over the age of 65 and have employer health coverage, you may be eligible to delay enrolling in Medicare. You will be able to enroll during a Special Enrollment Period once your employer health coverage ends.
• If you’re contributing to a Health Savings Account (HSA), you’ll need to stop making contributions before your Medicare coverage begins to avoid potential tax penalties.

3. Enroll in Medicare Parts A and B through Social Security

• To get started with Original Medicare, you’ll first enroll in Parts A and B through the Social Security Administration:
  • Online at gov/medicare
  • By calling 1-800-772-1213
  • Or visiting your local Social Security office

4. Choose Additional Medical Coverage

• Once you have Original Medicare (Parts A and B), you can add extra coverage that fits your needs:
  • Medicare Advantage (Part C): Combines Parts A, B, and often D in one plan.
  • Medicare Supplement (Medigap): Helps pay for costs not covered by Parts A & B.
  • Part D Medicare drug coverage): Standalone plans to cover medications.

5. Shop and Compare Medicare Plans

• Once you know what kind of coverage you need, it’s time to compare Medicare plans available in your area. Things to consider:
  • Monthly premiums
  • Doctor and hospital networks
  • Coverage