Nearing age 65? What to do about Medicare

Medicare is a health insurance program operated by the federal government and benefits are available to qualifying individuals 65 or older.

Parts of Medicare

Deductible, coinsurance and copayments may apply to all of the below.

Part A
Hospital/Hospice Insurance

  • Covers inpatient hospital stays, some skilled nursing facility, hospice and eligible home health care.
  • No premium if you qualified for enough credits via the FICA Medicare payroll tax you paid during your working career!

Part B
Medical Insurance

  • Helps pay for some services and products not covered by Part A, generally on an outpatient basis.
  • Monthly premium is based on income.

Part C
Medicare Advantage Plans

  • Variety of supplemental plans to Parts A & B offered through Medicare contracted private insurance.
  • Separate monthly premium.

Part D
Prescription drug plans

  • Helps pay for prescription drug costs.
  • Separate monthly premium.

Medigap Policies
(Medicare Supplement)

  • Private supplemental policy that fills the “gaps” within the Medicare Part A & B coverage, including some of the deductible and coinsurance expenses.
  • Separate monthly premium.

If Still working and can still receive medical insurance via employer:

Employer has fewer than 20 employees:

  • Medicare is the primary provider
  • Sign up for Medicare up to 3 months prior to turning age 65 at medicare.gov

Employer has 20 or more employees:

  • Employer plan is the primary provider if IRS defined group health plan.
  • Can sign up for Part A (premium-free) when you turn age 65.
  • If you are on spouse’s employer plan, ask employer if non-working spouses can remain on plan after eligibility for Medicare.
  • Because Medicare Part B requires a monthly premium, you may choose to delay enrollment in this plan while you still are covered under you or your spouse’s employer’s plan as an active employee.
  • If you retire past the age of 65 and are coming off your employer’s group health plan, you have an 8-month special enrollment window in which you can sign up for Medicare Part B. If you do not enroll during this window, you may have to wait for coverage and will be subject to a penalty for late enrollment.

If Retired and Medicare will be the primary medical insurance:

For those already receiving Social Security retirement benefits

  • You’ll automatically get Part A & B starting the first day of the month you turn 65. You’ll receive your Medicare card in the mail about 3 months before your 65th birthday. If you don’t want one or both parts, contact Medicare.
  • Make decisions on other health coverage (Parts C, D, Medigap, or Supplemental

For those not receiving Social Security retirement benefits

  • Sign up for Medicare up to 3 months prior to turning age 65 at medicare.gov

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