Medicare Phases

Turning 65 Soon or New to Medicare

If you’re about to turn 65 and confused about your Medicare options, you’re not alone.

My goal is to help you understand your options and to make the decisions that are right for you.
The first decision is deciding if you need to enroll in Medicare now.

If you are turning 65 and plan to continue to work, you have two options:

If you work for a company with less than 20 employees, you MUST enroll in Part A and Part B of Original Medicare.
If you work for a company with more than 20 employees, Medicare does not require you enroll in Part A or Part B (you can delay until you retire). Contact me and we can review.

If you are turning 65 and you do not plan to continue to work, then your first step is to enroll in Part A and Part B of Original Medicare.

Original Medicare is the federal health insurance program that serves people ages 65 and older or people with qualifying disabilities. To qualify for Medicare, you must be a legal resident living in the United States for at least five consecutive years and meet one of the following requirements:

Age 65 or older
Younger than 65 with a qualifying disability (a medical or physical condition lasting, or expected to last, more than 12 months and that prevents you from working)
Any age with end-stage renal disease (permanent kidney failure requiring dialysis or kidney transplant)

Original Medicare is a fee-for-service plan managed by the federal government. When you sign up, you receive a Medicare card, which makes you eligible for Medicare-approved services.

Original Medicare allows you to choose any doctor, hospital or other facility that accepts Medicare. Original Medicare includes:

Part A (Hospital Coverage)
Part B (Outpatient / Physician Coverage)

To enroll in Original Medicare, you need to sign up during the 7-month time period that begins three months before you turn 65, includes the month you turn 65, and continues for three months afterward.

If you are already receiving Social Security benefits when you turn 65, you will be automatically enrolled in Medicare Part A and Part B. You should receive your Medicare card in the mail prior to or around your 65th birthday.

If you are not receiving Social Security benefits, you may apply for Medicare Part A and Part B 90 days prior to your 65th birthday by clicking here.

After enrolling in Part A and Part B of Original Medicare you will have the option of supplementing your Original Medicare coverage with a:

Medicare Insurance Supplement Plan
Medicare Advantage plan (Part C)

Note – Neither Original Medicare Part A nor Part B nor a Medicare Supplement plan will cover prescription drug benefits. For prescription drug coverage, you will have to enroll in a separate Part D plan.

Choosing the right Medicare coverage can feel overwhelming, but there are a variety of resources to help and I can guide you through them.

Already 65 and Retiring Soon

If you are already 65 or older and are planning to retire within the next year, it’s time to start thinking about Medicare and your coverage options.

If you are retiring from work and will no longer have insurance through your employer and you are enrolling in Medicare Part A and Part B after age 65, there are important steps you need to take to avoid a ‘late-enrollment penalty’.

When enrolling in Medicare through the Social Security office, you will need to have your employer complete the Request for Employment Information form.

This form confirms the date through which you had creditable coverage under your employer plan. This form will exempt you from the late enrollment penalty.

I can help guide you through the process to enroll in Original Medicare through the Social Security Administration.

Once you are enrolled in Original Medicare, the next step is to determine if you also want to enroll in a Medicare Supplement Insurance (Medi-gap) plan or a Medicare Advantage plan.

Please follow the links below for an explanation of the different parts of Medicare and contact me for details on the Medicare plans available to you.

Part A – Hospital Services
Part B – Outpatient / Physician Services
Part C – Medicare Advantage Plans
Part D – Prescription Drug Plans

I can evaluate your medical and prescription drugs needs and make sure you enroll in the plan suited to those needs.

Already Enrolled in Medicare

You’re already enrolled. That’s great!

Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in-network. It’s important to review these changes each year and, if necessary, change your Medicare and/or prescription drug coverage for the following year to better meet your needs.

I can help you do this.

The Medicare Advantage and Prescription Drug Plan Annual Election Period (AEP) runs from October 15th to December 7th. Changes made during AEP become effective January 1st. During this time, you can:

Switch from one Medicare Advantage plan to another
Switch from a Medicare Advantage plan to Original Medicare
Switch from Original Medicare to a Medicare Advantage plan
Change, join or drop Part D Prescription Drug Coverage

Please note – if you want to move from a Medicare Advantage plan to a Medicare Insurance Supplement plan during the Annual Election Period, you may have to complete a health questionnaire and your application is subject to approval by the insurance company.

I am contracted with the major insurance companies and can help evaluate your current needs and, if necessary, help you enroll in the plan suited to those needs.