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Chapter 3: Enrollment

Chapter 2: The Current State of Health Insurance

The Centers for Medicare & Medicaid Services is the agency in charge of the Medicare program. However, when it is time for you to enroll, you do so through the Social Security Administration website:

https://www.ssa.gov/benefits/retirement/

or call: 1-800-772-1213

Two Categories for Enrollment

Category One Those who are 65 and are receiving Social Security benefits (or Railroad Retirement)

Category Two Those who are 65 and not receiving Social Security benefits

Category One Those who are 65 and are receiving Social Security benefits (or Railroad Retirement)

If you are receiving Social Security at age 65, you do not have to do anything; enrolling in Medicare Parts A and B is automatic and your coverage begins the month you turn 65.

Enrolling in Parts C and D is not automatic because they are sold through private insurers. You must sign up for Parts C and D on your own, regardless of whether you are receiving Social Security at age 65.

When to Enroll

If you are not receiving Social Security benefits at age 65, you have the 3 months before you turn 65, the month you turn 65, and the 3 months after you turn 65 to enroll in Medicare. This is true for all Medicare Plans.

Category Two Those who are 65 and not receiving Social Security benefits

If you are not receiving Social Security benefits at age 65 and you are covered by a large group plan, which consists of 20 or more employees, you do not have to enroll in Medicare. You can, but it is not mandatory.

Again, enrolling in Part A is free, but not required. Keep in mind, however, that if your employer plan has an HSA that you are currently funding (HSA refers to Health Savings Account), the moment you enroll in Medicare Part A, you become exempt from your HSA funding going forward.

If you work for an employer with 20 or more employees that provides an HSA, you might want to reconsider enrolling in Medicare Part A.

When to Enroll

If you are not receiving Social Security benefits at age 65, plan to continue working, and are covered by a large group plan – or you are retired and covered by a large group plan through your spouse— you qualify for what’s called the Special Enrollment Period.

The Special Enrollment Period allows you to enroll in Medicare any time between prior to your group coverage ending and the 8-month period after your group coverage ends.

Remember, if you retire and need medical attention, but have not enrolled in Medicare yet (still in the 8-month period after your group coverage will end), benefits ARE NOT retroactive.

Bottom Line: You have no coverage UNTIL you enroll. It is important to know when your group coverage will end so you can coincide that with the beginning of your Medicare coverage.

Chapter 4: Two Kinds of Medicare