If You’re Turning 65, This is a Must-Read Checklist for Enrolling in Medicare

Let the solicitations begin!
So you are turning 65? Get ready to begin getting bombarded with information from all angles. You will get countless phone calls and enough mail to build a small origami house. First off, understand that the “noise” will not likely stop until you have turned 65 and all of the insurance salespeople feel that they have missed their opportunity to “sell you”. It is public information that you are turning 65 and those of us in the insurance business buy lists that show us who is turning 65.
Why you may ask. Well, unless you are still getting your insurance through your employer you will need to sign up for Medicare and likely choose an insurance plan to compliment Medicare. All of us insurance agents know that you will be shopping for insurance and the race is on to see who can obtain your business.


Preparing to go onto Medicare

In this article I am going to point out to you some key dates that you need to pay attention to. There will be some homework on your part to familiarize yourself with the different parts of Medicare. In my 17 years of being in the Medicare Insurance world I find it best when new clients are informed. After all, you want to buy and insurance program, not be sold one by a slick willy insurance agent. So get out there and arm yourself with knowledge!


6 months before turning 65

Even though you are a ways out from being able to enroll into Medicare, it is time to get to work. The solicitations will usually pick up around this time so it is time to up your knowledge so as to be able to understand what is being thrown at you.
Learn you’re A,B,C’s again….

Medicare Part A

Part A is generally referred to as hospital insurance because it pays for your care when you are in the hospital. It also pays some of the cost if you stay in a skilled nursing facility or if you
qualify to get healthcare at home. Lastly, Medicare part A covers hospice care for those who are terminally ill.

Medicare Part B

Part B is the portion of Medicare that is used most frequently. This part of Medicare pays if you see a doctor or need screenings and lab tests. Part B also covers outpatient hospital care and some home health care that is not covered by Medicare part A.

Medicare part C

More commonly referred to as Medicare-Advantage plans. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans” are offered by private companies approved by Medicare.
If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare. Many of these plans include prescription drug coverage as well as things that are not covered by Medicare like dental, vision and Silver Sneakers gym memberships.

Medicare part D

Simply put this is the prescription coverage aspect of Medicare. You generally only need to obtain Medicare part D coverage if you choose a Medicare-Supplemental plan for your doctor/hospital coverage.

Programs to Help You Pay

Many people will qualify to receive some sort of financial assistance in paying for their Medicare. This can come in the form of help paying for you part B cost ($134 standard premium in 2018) or lower co- pays for your medications. If you receive a PURPLE, YELLOW or GREEN notice from Medicare you are automatically qualified (do not lose this notice). Use the following links to get more information.

Part D Extra Help

For those with Medicare Part D making $18,456 or less yearly ($24,936 for married couples)* and meet certain resource limits.

MO HealthNet

Missouri’s Medicaid Program.

Medicaid Spend-Down

For those who nearly qualify for MO HealthNet, but earn too much.

3 months until age 65- get enrolled into Medicare

Enrollment into Medicare part A + B (3 months out from your 65th birth month)
If you are drawing social security prior to turning age 65: you will be automatically enrolled into Medicare parts A+B (Lucky you). It will start the first day of the month that you turn 65 (unless your birthday is on the 1 st of the month, then they bring it back a month. If your birthday is June 1 st your Medicare will start May 1 st ).
If you are not drawing social security: you will need to enroll on your own. The timeline:
 Begins 3 months before the month you turn 65
 Includes the month you turn 65
 Ends 3 months after the month you turn 65
To enroll you can:
2. Visit your local Social Security Office
3. Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778)
4. Complete an application for Enrollment in Part B (CMS-40B) https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS017339.html

Now it is time to choose a Medicare Insurance Plan

There are truly only two types of insurance that you need to choose between. Granted there are dozens of insurer’s who sell these types of plans, but big picture you should start by determining which style of coverage that you like.
 Choose a Medigap policy: A Medigap policy is private health insurance that helps supplement original Medicare. This means it helps pay some of the healthcare costs that Original Medicare doesn’t cover (like copayments,coinsurance, and deductibles). These are “gaps” in Medicare coverage. These plans typically have higher premiums and less out of pocket cost to you. Another positive to this option is that you can go to any doctor or hospital in the US that accepts Medicare.
 Choose a Medicare Advantage plan: administered by private insurance companies approved by Medicare to offer benefits. These plans can set their own rules and guidelines for members. They will determine the amount of copayments and coinsurance you will pay for covered services, and they may require you to use certain providers for your health care. You will see many of these plans advertised with a low or even $0 premium.
*Do yourself a favor and find an independent insurance agent that can help you compare all of the plans. I do not say this because I am one, I say it because it will save you a ton of troubles! We are paid commission by the insurance companies and it in no way affects the coverage or price that you pay. You specifically want an agent that will do annual reviews that takes into consideration your medications and doctor preferences. If an agent is truly independent you will not be given any cheesy sales pitches.
My meetings typically end with a client choosing a plan after we have went over all available options. I never say “So what can I do to get you into this shiny new Medicare plan.”

You made it through the enrollment process, now what?

Now that you are officially a Medicare recipient you can schedule your “Welcome to Medicare” physical. This exam is a one-time preventive physical exam Medicare covers within the first 12 months that you have Medicare Part B. The visit will include a thorough review of your health, along with education and counseling about the preventive services you need, like certain screenings, shots, and referrals for other care. This exam will be free of charge regardless of which type of insurance you have.

Fill Out Your Basic Info to See Your Medicare Plan Options

Jeremy works with Medicare clients to answer questions, assist with enrollment, and run plan comparisons to find the right one for your needs.

He’s also an expert in Dual Enrollment for those on both Medicare and Medicaid.

Not sure whether to choose a Medicare Advantage or Medicare Supplement Plan?


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