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Signing up for Medicare: what you need to know
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Most Americans become eligible for Medicare at age 65, but receiving the right benefits for your needs isn’t automatic. You need to sign up — and make some big choices once you do. If you’ve taken a look at the process and feel confused, you’re not alone. One study finds that nearly 29 percent of Americans aged 65 or over don’t fully understand the Medicare health insurance they rely on for coverage. Here’s an overview of the different parts of Medicare and answers to some of the most common questions pre-retirees have about coverage.
Understanding the different parts of Medicare
If you’re not already familiar with the four parts of Medicare and what each one covers, here’s a quick overview. Keep in mind that Parts B, C and D all require monthly premium payments. For a more in-depth look at all parts of Medicare, visit the official Medicare website.
Part A: Hospital insurance. This option helps pay for inpatient care at a hospital or time at a skilled nursing facility following a hospital stay, hospice care and some home health care.
Part B: Medical insurance. This helps pay for certain doctors’ services, outpatient care as well as other services and supplies that hospital insurance (Part A) doesn’t cover. It is optional coverage but late enrollment penalties apply in some situations if you decide to enroll after you’re first eligible.
Medicare Advantage: Also referred to as Part C, private companies approved by Medicare offer these plans that typically bundle hospital, medical and prescription drug coverage into one. They are another way to get Medicare Parts A and B coverage, Part D prescription drug benefits and some may include additional benefits for vision, hearing and dental. (Please note that you must have Medicare Parts A and B to enroll.)
Part D: Prescription drug coverage. Also offered by private companies approved by Medicare, these plans are available for anyone with Parts A and B to help you pay for medications prescribed by your doctor as well as many recommended shots or vaccines. Although this coverage is optional, you may pay a late enrollment penalty for as long as you have Medicare prescription drug coverage if you decide to sign up for it later.
Answers to some of the most common questions pre-retirees have about Medicare
Use this information to sign up at the right time to help get the coverage that’s best for you.
Q: When should I enroll?
A: You can enroll for Medicare as soon as you are first eligible. If you’re already receiving a Social Security payment, you are automatically enrolled in Medicare Parts A and B the month you turn 65. But if you aren’t receiving benefits yet, you will need to sign up during an Initial Enrollment Period around your 65th birthday at your nearest Social Security Administration office or at SSA.gov. If you are covered under an employer’s group health plan after age 65, you can delay signing up for Parts A, B and D without having to pay late-enrollment penalties.
Q: How do I choose the right coverage for my needs?
A: If you like automated tools, try National Council on Aging’s (NCOA) Age Well Planner, which poses a series of questions and gives you a report based on your circumstances. The State Health Insurance Assistance Programs (SHIP), which are funded by a federal grant, are another resource that provides free, unbiased Medicare information. Use the online SHIP Locator to find contact information for your state, or you can compare plans on the official Medicare website.
Q: Are there enrollment deadlines?
A: When you’re first eligible for Medicare, there is a seven-month Initial Enrollment Period (before, during and after your birthday month) to sign up for Parts A and/or B. After that, you can sign up for Part A for free any time after your Initial Enrollment Period. If you want to enroll in Part B after the Initial Enrollment Period, you can only do that during the General Enrollment Period that runs annually from January 1 to March 31.
Keep in mind, there are late-enrollment penalties for Medicare Parts A, B and D. If you don’t qualify for premium-free Part A and choose not to enroll when you’re first eligible, your monthly premium may go up 10 percent and you'll have to pay the penalty for twice the number of years you didn't sign up. The enrollment penalty for Part B is an extra 10 percent for each year you wait, which you’ll pay for as long as you have Part B. For Part D, the late enrollment penalty is an extra 1 percent for each full month you wait to enroll unless you have creditable coverage.
Q: What does Medicare cost?
A: It depends on several factors, but there are some general guidelines. Most people qualify for premium-free Part A, but there are still out-of-pocket deductibles and coinsurance. In 2023, the standard Part B monthly premium is $164.90 but may be higher for people with a higher income, and there are also deductibles and coinsurance costs associated with Part B. Medicare Advantage Plans (Part C) and prescription drug plans (Part D) are issued by private companies, and the costs vary. You can compare costs for these plans or get information from SHIP at shiptacenter.org.
Q: How can I save on premiums?
A: Shop and compare plans every year during the Open Enrollment Period from October 15 to December 7. According to the Kaiser Family Foundation, more than half of all people on Medicare do not compare their coverage options annually, and it’s common for plans to change from year to year. You may pay too much if you don’t switch plans when necessary, as costs and coverage can change every year. There are programs called Extra Help and Medicare Savings Program that can help pay the premiums and costs associated with Medicare (up to a maximum amount) for people who meet the income and asset criteria, which you can find at medicare.gov.
In addition, you should consider taking advantage of Medicare preventive services to get regular screenings and preventive medicine to detect and treat disease early. Medicare pays for flu shots, mammograms, colonoscopies, an annual wellness visit and several other services at no out-of-pocket cost.
For more information about Medicare, and before making an enrollment decision, sign in or create an account at mymedicare.gov or contact Medicare at 800-MEDICARE.
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Except where noted otherwise, the information about Medicare contained herein has been sourced from the U.S. Centers for Medicare and Medicaid Services and their website, www.medicare.gov, as of October 16, 2023. While substantial effort has been taken to ensure the accuracy of the information presented as of the time of creation, no guarantee is made as to accuracy or completeness. Details of the Medicare program are subject to change at any time without warning. For more information and to gain a better understanding of the range of options and benefits you are entitled to under Medicare, visit www.medicare.gov. Athene is not responsible for content on the U.S. Centers for Medicare and Medicaid Services’ website.