FAQ

When should you start the process of planning to go on Medicare? We recommend at least 120 days (four months) prior to your 65th birthday. Why four months? Because you can officially apply for Medicare on the first of the month that is three months prior to your birth month.Example: Say your birthday is June 8. Your birth month is June, so the three months prior to June are March, April, and May. This means you can apply for Medicare beginning on March 1st.  It doesn’t matter what day in June your birthday falls; you would still be able to apply for Medicare on March 1st.

While you don’t have to apply on March 1st, we recommend you do so as soon as you are eligible. This gives you most amount of time to work out any bugs or problems that might be encountered in the application process.

Exception: If your birthday falls on the 1st of the month, then you are treated as though your birthday fell in the month prior, so you can apply one month earlier than everyone else with a birthday in the same month as yours.

Example: Suppose your birthday falls on November 1st. In this case, you are treated as though you have an October birthday. This means that you can apply for Medicare on July 1st rather than August 1st. Everyone else who has a birthday in November that does not fall on the 1st of the month must wait until August 1st to apply.

Once you have applied for Medicare, your effective date of coverage will be the 1st of your birth month. Using our previous example, if your birthday is June 8 and you apply for Medicare in March, your Medicare coverage will take effect on June 1st.

Exception: If your birthday falls on the 1st of the month, your coverage will begin on the 1st of the month prior to your birth month. Using our earlier example, suppose your birthday falls on November 1st. You apply for Medicare in July. Your coverage will begin on October 1st rather than November 1st because your birthday falls on the 1st.

Reminder: Delaying or opting out of Part B can be very costly in penalties! Do not delay or opt out of B unless you have considered all of the potential ramifications.

Once you’ve decide to sign up for Medicare, you can do so via one of the following options:

• Apply online at Social Security.
• Visit your local Social Security office.
• Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
• If you worked for a railroad, call the RRB at 1-877-772-5772.

You will want to apply as soon as possible after you become eligible, in order to give the wheels of government adequate time to process your application. You should receive your card within about three weeks of applying. If you do not, contact the Social Security office promptly to get an update on the status of your application.

A Medicare Advantage plan is an insurance plan from a private insurance company that is contracted with the Federal government to deliver Medicare services. Many of these plans are zero premium, so there is often no additional monthly premium beyond your Part B premium. Medicare Advantage plans usually utilize networks to reduce costs, and often include ancillary benefits such as dental, vision, hearing, gym memberships, etc. In addition, Medicare Advantage plans often include prescription drug coverage, so no additional drug plan is needed. Unlike Medicare Supplements, however, Medicare Advantage plans usually require co-pays for various medical services. For example, a visit to your primary care physician might be $0, $5, or $10 depending on the plan. A visit to a specialist might be $25, $35, or $50 depending on the plan.In general, a Medicare Advantage Plan is a good choice if you have a limited budget and are in reasonably good health.

Like the name suggests, a Medicare Supplement (also known as Medigap) pays for some or most of the 20% that Medicare does not. In other words, it supplements original Medicare. However, you have to pay extra for a supplement, so some Medicare recipients may find it out of their budget.In general, a supplement is a good choice if you a) can afford an extra $100-200 premium per month, and b) have health issues or a family history of health issues. When first applying for Medicare, you cannot be denied a supplement based on pre-existing health issues, and once signed up, cannot be dropped for any reason other than non-payment of premium. However, if you decline a Medicare Supplement when you are first eligible (i.e., turning 65), you may have to pass underwriting to be accepted at some later point.

If you do decide to purchase a Medicare Supplement, you will also need to purchase a prescription drug plan (PDP) because Medicare Supplements do not include drug coverage. A typical drug plan premium is $15-50 per month. If you don’t select a drug plan (Part D) when you are first eligible, you will be subject to a lifetime penalty if you ever sign up for one later. You may not take any drugs now, but no one knows what the future holds.