When you sign up for Medicare, there are several important decisions to make. Meeting with Keystone Insurance can help you understand your choices and prevent you from being penalized for not following Medicare regulations.
Understanding Medicare Parts A and B
Eligible individuals for Medicare can decide to sign up for Medicare Part A and Medicare Part B. The federal government provides Original Medicare.
• Part A covers hospital costs.
• Part B is outpatient coverage and covers your doctor’s visits.
Who Is Eligible for Medicare?
Medicare is health insurance for people 65 or older. You may also be eligible earlier if you have a qualifying disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig’s Disease). If you are turning 65, you will generally receive Part A for $0 because you have paid Medicare taxes long enough, usually at least 40 quarters or 10 years. This is also the time you can sign up for Part B. Individuals eligible before age 65 typically have been on disability for 24 months.
Automatic Enrollment in Medicare
If you have collected Social Security benefits four months before turning 65, you will receive your Medicare card in the mail and be automatically enrolled in Parts A and B. If you have decided to delay receiving Social Security benefits, you can sign up during the three months before your birthday month, your birthday month, and three months after your birthday month. Keystone Insurance can assist you in navigating your enrollment, or you can visit the Social Security website or call 1-800-772-1213. Parts A and B will also automatically enroll you if you have been on disability for 24 months.
Medicare Enrollment Periods
• Initial Enrollment Period (IEP): Starts three months before your 65th birthday month and lasts three months after.
• Special Enrollment Period (SEP): If you or your spouse continue working past 65 and stay on group health benefits, you can sign up for Parts A and B within eight months of stopping work or your group health plan ending.
• General Enrollment Period (GEP): If you miss your IEP or SEP, you can sign up from January 1 through March 31, with coverage starting the following month. Be aware that there may be a monthly penalty for late enrollment.
Coordination of Benefits: Who Pays First?
The primary determinant is the size of your employer:
• If your employer has 20 or more employees, the group health plan pays first.
• If your employer has fewer than 20 employees and isn’t part of a multi-employer or multiple employer group, Medicare pays first.
• If your employer has fewer than 20 employees but is part of a multi-employer group, the group health plan pays first.
Other factors, such as disability or ESRD, can also influence who pays first. For detailed assistance, contact Keystone Insurance.
Supplementing Original Medicare
Original Medicare covers 80% of costs with no maximum out of pocket, which can lead to high bills. To help reduce out-of-pocket expenses, you can purchase a Medicare Supplement plan (Medigap) or a Medicare Advantage plan. Keystone Insurance will help you navigate through the complexities of signing up for Medicare and finding a plan best suited to your needs.
Contact Keystone Insurance today for more information on signing up for Medicare and learning about Medicare Medigap and Medicare Advantage plans.