Will I be automatically enrolled in Medicare?

As most individuals approach age 65 they should begin thinking about when and how to enroll in a Medicare health plan. From Original Medicare to Medicare Advantage plans or Medicare Supplement plans, knowing what type of coverage will best meet your needs is critical, especially if you want to avoid significant out-of-pocket costs down the line.

Contact us for free one-on-one assistance from an experienced Licensed Insurance Agent ready guide you through your Medicare options.

Who is eligible for Medicare?

First and foremost, it’s important to know when you are eligible for Medicare. Most individuals will become eligible for Medicare at age 65. Additionally, those under age 65 with certain disabilities, those who have collected Social Security Disability Insurance (SSDI) benefits for 24 months, and those with End-Stage Renal Disease (ESRD) are also eligible for Medicare. Contact Aevo if you want to speak with one of our experienced teammates about your Medicare eligibility, or any other Medicare questions you have.

What does Medicare cover?

Medicare is a federal health insurance program that is divided into different parts, each covering specific healthcare services, including some specialty services like eye exams, dental cleanings, and more. Qualified individuals may be automatically enrolled in Original Medicare (comprised of Part A and Part B Medicare health plans). It’s important for everyone who qualifies for Medicare understand the different parts of Medicare in order to find the best Medicare coverage for them.

• Medicare Part A (“hospital insurance”) helps cover inpatient care in hospitals as well as skilled nursing care facilities, hospice care, and home healthcare.
• Medicare Part B (“medical insurance”) covers doctor visits, outpatient visits, other medically necessary services, and preventive care.
• In addition to Original Medicare, once you turn 65, you can consider purchasing Medicare Part C, also known as Medicare Advantage. Medicare Part C is an alternative to Original Medicare that combines coverage from Part A, Part B, and often Part D, into a single plan, with coverage provided by private insurance companies. Many Medicare Advantage plans also offer additional benefits like dental, vision, and hearing coverage.
• Finally, Medicare Part D (Prescription Drug Coverage) is an option that is offered through private insurance companies approved by Medicare to cover the costs of various drugs and medications.

Is Medicare enrollment automatic?

You are automatically enrolled in Medicare Part A if you meet one of the following conditions at age 65:

• You are already receiving Social Security benefits.
• You receive Railroad Retirement Board benefits.

Under both requirements, you must be receiving these benefits for at least 4 months before you turn 65.

In addition, you will be automatically enrolled in Medicare Part A if you have a qualifying disability and/or have received Social Security disability benefits (SSDI) for 24 months.

For those who are enrolled in Social Security or Railroad Retirement Board benefits, you’ll also be automatically enrolled in Part B (unless you live in Puerto Rico or outside the U.S.). Medicare Part B requires a monthly premium, so this is optional and you can choose to decline the coverage.

How do I know if I’ve been automatically enrolled in Medicare?

If you’ve been automatically enrolled in a Medicare health plan, you will receive a Medicare card and welcome package in the mail three months before your 65th birthday. You will also receive a welcome letter that outlines decisions you should make about your Medicare coverage (Part A and/or Part B) before it starts.

If you don’t receive anything prior to turning age 65 or are unsure about your Medicare enrollment status, contact the Social Security office.

What if I don’t qualify for automatic Medicare enrollment?

If you don’t qualify for automatic enrollment in Medicare Part A or Medicare Part B, you will need to understand when and how to enroll in Medicare to avoid late enrollment penalties and ensure uninterrupted healthcare coverage.

There are three time periods in which you can sign up for Medicare if you do not qualify for automatic enrollment, detailed below. If you still have questions or feel unsure about when to enroll in Medicare, contact Aevo – we’re here to help.

Initial Enrollment Period

Medicare’s Initial Enrollment Period (IEP) is a 7-month period that starts three months before the month in which you turn 65, includes the month of your 65th birthday, and ends three months after you turn 65.

Special Enrollment Period

After your Initial Enrollment Period (IEP) ends, you may still sign up for Medicare Part A (if you have to buy it) and Medicare Part B during a Special Enrollment Period. A Medicare Special Enrollment Period is an opportunity to make a change to your existing Medicare coverage in the event of special life circumstances, such as moving to a new state, losing your existing healthcare coverage, experiencing a change in income status, and more. You may also utilize a Special Enrollment Period if you or your spouse (or family member, if you’re disabled) are covered under a group health plan through an employer or a union. During a Special Enrollment Period, you can enroll in as Medicare Advantage Plan or a Medicare Supplement (Medigap) Plan get a plan if you have Medicare Part A and B in place.

General Enrollment Period

If you don’t sign up for Medicare Part A and/or Part B when you’re first eligible and you don’t qualify for a Special Enrollment Period, you may have to wait until the Medicare General Enrollment Period (GEP), which runs from January 1 – March 31, to enroll in Medicare. You also may need to pay a late enrollment penalty for as long as you have a Medicare Part B health plan if you sign up during the General Enrollment Period.