Are you one of the more than 11,000 people, each day, in the United States who will become eligible for Social Security and Medicare by turning 65 this year? If so, don’t wait for your birthday to pass before signing up! Applying for Medicare three months prior to your 65th birthday is the best possible way to enroll; doing so can even be a money-saver and get you covered sooner.
Ways you can apply for Medicare
The Medicare application process is a fairly simple one and can be accomplished in one of two ways:
1.) By applying online through Medicare Health Insurance @ Medicare.gov or the Social Security Agency @ SocialSecurity.gov or
2.) Through this website, HealthNetwork.com.
We feel that the best option for anyone seeking to enroll or modify their plan is to do so with the assistance of a Medicare professional. Connect with one simply by calling our toll-free number or searching through our directory of agents.
Or, if you do not have access to a computer or simply prefer to apply in person, you may do so by stopping into your local Social Security Administration (SSA) office in person. However, the local SSA office does suggest, and it is highly recommended, to call for an appointment. That’s because calling ahead for an appointment is the most time-efficient manner to apply in person.
Social Security (SS) does not publish the phone number for its numerous local offices. But you can call the main toll-free number, (800) 772-1213, between the hours of 7a.m. to 7p.m., Monday through Friday, to speak with a live Social Security representative. They will help you locate the nearest local SS office that you can make an appointment with.
Applying for Medicare online
Before you begin any application process for Medicare, whether it be with the SSA or the federal government’s Medicare Program, there are a few suggestions you may find helpful:
- Find out if you qualify for benefits for Medicare first. You can find out if you have accumulated enough credits from working and paying into Social Security through your payroll taxes at the Medicare or Social Security websites. There is an easy-to-use calculator app to determine exactly what your status is. Look for the link on the applicable website.
- Gather all the necessary information that you’ll need to complete your application. That way, you won’t have to save your application and come back to it later when you do have the information. You can review a Social Security Retirement and Medicare checklist by typing this into your browser: http://www.ssa.gov/hlp/isba/10/isba-checklist.pdf.
- Medicare.gov has links to a number of different companies, although we feel that our network (HealthNetwork.com) is the very best option for one specific reason. We focus entirely on Medicare, and we are not licensed agents or brokers. As such, we have no alliance with them.
You can use our website to enroll with an agent.
Applying through the Social Security Administration
The application process to apply for retirement or Medicare (only) will take about 30 minutes or less of your time. The application does give you the ability to save your application and come back to it at any time if you need.
Once your application is completed, the Social Security Administration will contact you with the status of your application or any questions they may have regarding the information you provided.
After you have completed your application, you can find out the current progress and status of your pending application. Simply click on the Social Security Web link, titled “Application Status.”
Applying through Medicare
When signing up for Medicare, there are some choices you will have to make. Specifically, these involve what type of healthcare coverage is best suited to your particular health care needs, both in the present and future.
The first choice you will be making is determining if you want to enroll in Original Medicare Part A and Part B or an alternative insurance plan, known as a Medicare Advantage Plan (Part C).
In order to make that decision, you will need to consider which portion (or portions) of Medicare coverage you need. If you have concerns about not fully understanding how these Medicare programs work or what the coverage entails, you may receive free counseling on Medicare choices from the State Health Insurance Program (SHIP).
Who doesn’t need to sign up for Medicare?
Some people will be enrolled in Medicare automatically. If so, they’ll receive their Medicare card in the mail three months prior to their 65th birthday, or if disabled, on their 25th month of disability. Typically, the people automatically enrolled are individuals who:
- Are on disability
- Are retired and receiving Social Security
- Have amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease)
- Live in Puerto Rico and are receiving benefits from Social Security
- Are receiving benefits from the Railroad Retirement Board (RBB)
Who needs to sign up for Medicare Part A and Medicare Part B?
You will be required to sign up for Medicare Part A and Part B if:
- You are not receiving Social Security or Railroad Retirement benefits.
- You have end-stage renal disease (ESRD)
- You are residing in Puerto Rico and want to enroll in Medicare Part B (you automatically receive Part A)
When do I sign up for Medicare Part A and Part B?
You are first eligible to sign up for Medicare during a seven-month enrollment window; this is called your “Initial Enrollment Period” (IEP) window. Your IEP window begins three months before your 65th birthday and ends three months after you have turned 65.
But what if, for some reason, you have not signed up for Medicare Part A and Part B during your IEP or do not sign up at all? There is a General Enrollment Period each year from January 1 through March 31, during which you can always apply. It should be noted that when you sign up using General Enrollment, your coverage will not begin until July 1. You also may have to pay a higher premium for late enrollment in Part A, as well as a higher premium for enrolling late in Part B.
There is a special circumstances enrollment period for those who are signing up late because they were already covered by employer paid coverage during their “Initial Enrollment Period.” The special circumstance enrollment is called “Special Enrollment Period” (SEP) and gives you a window of eight months to get signed up. This window begins the month after your employment ended or group insurance ends (whichever ended first). There typically is no increased premium for your late enrollment because you actually had coverage through your employer during your IEP.
Choosing “other” Medicare health plans
Medicare offers alternative health insurance plans that are offered by private companies. These companies contract with Medicare to provide Part A and Part B benefits to those who choose to enroll in their own plan, rather than Original Medicare.
Medicare Advantage Plans
A Medicare Advantage plan (MAP) is one particular type of Medicare health plan you can choose from. Basically, you sign up with a private company that contracts with Medicare to provide you with all the benefits of Medicare Part A and Part B. When you enroll in a Medicare Advantage Plan, your Medicare services, such as hospital stays, doctor visits, outpatient care and usually prescription drugs, are paid for by your plan and not Original Medicare.
Enroll in a Medicare Advantage Plan
Before joining any Advantage plan, you will need to compare the available plans in your area. This enables you to be certain that you’re getting the best possible coverage for your healthcare needs. It also helps you fully understand what the coverage provides, its rules for enrollment and how much it will cost.
Once you have decided which plan meets your healthcare needs, you can join a Medicare Advantage Plan by doing one of the following:
- Use Medicare.gov’s Plan Finder
- Go to the insurance plans website to see if you can enroll online
- Explore our website, HealthNetwork.com
- Call the insurance company that provides the plan you want
- Call (800) MEDICARE (633-4227)
When you are looking into which plan is right for you, do not give your Medicare number or any other enrollment information unless you are joining the plan of that company. When inquiring about a healthcare plan, no insurance company should ask you for your financial information, such as credit card or bank account numbers.
Only when you have chosen a plan should you give your Medicare number. At that point, you can also provide the date your Medicare Part A and Part B coverage began.
Insurance companies are not allowed to solicit you for enrollment unless you have given them explicit consent to call you or come to your home. If any company violates these laws, contact Medicare to report the insurance company; just call (800) MEDICARE (633-4227). Remember, it is ONLY when you are going to actually enroll in a plan with your chosen insurer that you will be asked for your Medicare number and the date your Medicare coverage started (this information is found on your Medicare card).
Should you have any questions, please do not hesitate to contact Medicare at (888) 228-MEDI (6334).