As you approach age 65 you may begin wondering what you need to know about preparing for Medicare. Most people qualify for Medicare health insurance automatically when they turn 65, making this an important milestone for your healthcare and financial future.

If you or someone you love is turning 65 soon, keep reading for more information about Medicare and how to enroll in a Medicare health plan. For Medicare enrollment help, contact us to speak with one of our experienced licensed insurance agents.

How do I know if I’m qualified to start receiving Medicare? 

The main requirement for becoming eligible to receive Medicare is age-related. Most people “age in” to Medicare, meaning when they turn 65 they become eligible to enroll in a plan.

However, there can be other ways to qualify for Medicare before turning 65, such as:

• Receiving Social Security Disability Insurance (SSDI) for two years or more: Once you have received Social Security Disability Insurance (SSDI) benefits for at least two years, you become automatically eligible for Medicare and will be enrolled in Medicare Part A and Part B. You can change your coverage options after this occurs.
• Being Diagnosed with Amyotrophic Lateral Sclerosis (ALS): If you have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, you will qualify for Medicare younger than age 65 without any waiting period.
• Being Diagnosed With End-Stage Renal Disease (ESRD): If you have End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant) you can enroll in Medicare before age 65.

When should I plan to sign up for Original Medicare (Part A and Part B)? 

Upon approaching eligibility for Medicare at age 65, you can plan to enroll in a Medicare insurance plan during what’s called your Initial Enrollment Period (IEP). This begins three months prior to turning 65 and continues the month of and up to three months after your Medicare entitlement date (your 65th birthday).

• If you decide to wait to apply after your IEP, there may be a late fee if you must pay premium for Medicare Part A. The penalty is added to your monthly premium and is a lifetime penalty.
• For Part B, a 10% late fee penalty is applied for every year you could have had Part B coverage, and your monthly premium may also increase.
• If you would have qualified for premium-free Part A and don’t enroll during the IEP, you can still enroll anytime. Your coverage will be retroactive 6 months back from when you apply, or when you apply for Social Security.
• You can also wait to apply if you qualify for a Special Enrollment Period (SEP). This SEP initiates based on a qualifying life event (e.g. end of employment or moving).
• If you wait to apply for Medicare until after you stop working, you can enroll the month after employment ends and may do so for up to eight months.
• Once you have enrolled in Medicare, you will have the chance to update your coverage each year during Medicare’s Annual Election Period (AEP).

Do I need to retire to enroll in a Medicare health plan? 

No - if you’re turning 65, you don’t need to retire in order to enroll in Medicare. You may still enroll in Medicare Part A or Part B while you’re working, but here’s what you need to know first.

• If your employer (or your spouse’s) offers group health insurance benefits, you can wait to enroll in Medicare Part A, but only if you would be exempt from paying premium. Part A premium is waived if you have a long enough work history - 10 years or more of paying Medicare benefits.
• If you work for a company with 20 or less employees, you should first ask your employer about whether you should apply for Medicare. If they do require you to enroll in Medicare coverage when you turn 65, Medicare will become your primary coverage, and your employer medical plan will be second.
• You can also wait to enroll in Medicare Part B until after you stop working. By doing so, you will also delay paying premiums. You will not pay a late enrollment penalty if your employer (or your spouse’s employer) offers group health insurance coverage.
• If you are working but your employer does not offer health insurance, you will be able to enroll in Original Medicare when you turn age 65.