Ask the Medicare Specialist
QUESTION:
When should those of us turning 65 start to plan for Medicare? What steps do we need to take?
ANSWER:
That can be different depending on your circumstances and personality. Let’s start with someone who is already retired and collecting Social Security. In this case a Medicare card with Parts A and B will be automatically mailed about 100 days before the first day of the month one turns 65. There are no forms or application to fill out. Those who are turning 65 in September will get their cards in the mail mid to late May.
Others who aren’t currently collecting Social Security but still want to go on Medicare at age 65 do need to act. These folks must apply for Medicare Parts A and B. That can be done up to 90 days before the first day of the month one turns 65, which means those with birthdays in September can apply as soon as June 1st. And I advise doing that asap because it takes up to 30 days to get a Medicare card. The easiest way to apply is online at SocialSecurity.gov. You have to first create an account by clicking on “Sign up” in the right-hand corner of the page, then on “My Social Security” on the next page, and lastly on “create new account” before you can enroll. Be advised, in the notes section at the end of the online application, make sure you type in what dates you would like your Medicare A and B dates to start. Applying online also allows you to get your Medicare claim numbers in just a week or so as opposed to 30 days. Those who aren’t internet savvy or prefer to apply in person can also go to their local Social Security office. You can call to set up that appointment but be prepared to wait on hold about an hour anytime you call the 800 number. I suggest walking into your local office, going straight to the window and requesting an appointment. It’s common for the first available to be up to a month or longer out, therefore, I suggest calling or walking into Social Security 120 days prior to the first day of the month one turns 65. So, those with September birthdays would want to do that around May 1st. The third group of people I want to discuss are those who plan on working past age 65 and get health insurance from their employer. I recommend they also take action four to six months prior to the first day of the month of their birthday. So, those turning 65 in September should start doing their homework between March 1st and May 1st. Many people have no idea how much they are contributing to the cost of their employer provided benefits. Find that out during this time. In addition, if your spouse is also being covered and turning 65, or will be soon as well, ask what his or her cost is individually. Often, employers will pay more for the employee than they do for a spouse. On several occasions I have advised the employee to remain on their plan at work, while recommending the spouse go on Medicare. In order for me to make a final assessment, I also need to know what the plan deductible is, what the coinsurance (percentage of medical bills one is responsible to pay after the deductible has been met) is, and what the Maximum out of Pocket (MOOP) is. Those who are better off to stay on an employer plan, including spouses, DO NOT NEED TO ENROLL IN PART B!
As far as when you want to start researching Medicare options and plans, that’s where one’s personality comes in. We meet people all the time who want to sit down and get educated on the two types of medical plans, Advantage and Supplement, and an idea of what those cost as much as a year in advance of turning 65. Others wait until the month before. I suggest starting the process around 90 days prior to your Medicare Part B goes into effect, which is the soonest you can enroll in a Part D or Advantage Plan.
In case you’re unaware, what we do at The Health Insurance Store is help people with the process of choosing a Medicare plan and offer no-cost consultations. We start by educating prospective clients on how original Medicare works as well as the differences between Supplements (aka Medigap) and Advantage Plans, which are several. We go over the costs, coverages, access to providers, the pros, and cons of both. We ultimately guide each person we meet to the company and plan(s) that best meet their financial and medical needs. As brokers, we are appointed to provide plans from every competitive company on the market, which ensures unbiased advice.
Now let me give some additional advice to those turning 65 soon. Be aware of what you are receiving in the mail, what is a solicitation, and what isn’t. There are companies who will send out official looking documents that resemble those from Social Security or Medicare. If you sign and return one, you have agreed to allow sales agents to contact you and the phone will ring incessantly. In addition, watch out for your Medicare card in the mail. It can easily get lost in all the junk you’re going to receive.
If you aren’t able to use our services, don’t buy a plan over the phone from someone who isn’t local. They normally aren’t contracted to provide plans from our regional providers. And make sure you’re given the option to purchase both Advantage Plans and Supplements.
Lastly, and most importantly, you need to understand all the differences between Advantage Plans and Supplements. Failure to do so can affect you for the rest of your life. Literally.
As always, if you have any questions regarding this column or any other Medicare topic, or would like to make an appointment, call one of our offices. Be advised, those who are being cautious about going out in public as we deal with Coronavirus, we can discuss plans and options over the phone or on the computer in a virtual appointment.