New to Medicare? Aaagh!
So, this is the year I reach age 65 and go on Medicare. What am I supposed to do now? Is this an automatic thing that will just happen, or do I need to make all kinds of preparations and plans? Will my doctor still see me, or do I need to find a new one? What about prescriptions? Is Medicare all I will need, or do I need to carry additional coverage? Do I need to take Medicare Part B? What are Parts C & D?
Relax and take a deep breath. Help is here.
Do I Qualify for Medicare?
There are only two conditions you need to meet to qualify for Medicare benefits:
You must have paid money (taxes) into the Medicare system for at least ten years.
You must be age 65 or older, unless you have a disability or permanent kidney failure.
If you meet the above criteria, you are eligible for both Medicare Parts A & B. Part A will not cost you anything (the money you have paid into FICA over the years was for this).
Do I need Parts A & B?
Part B, however, is optional and does have a premium. The cost of Part B is dependent upon your income. Medicare looks back 2 years, so if you made less than $97K ($194K for couples) in 2021, your premium would be $164.90 (in 2023). If your income is above those thresholds, your premium will be higher.
Whether you are retired or still working, you should sign up for Medicare Part A when you first become eligible. For most people, there is no premium required (you already paid for it in your taxes). It might help pay some of your group deductibles or co-insurance if you are hospitalized.
Almost everyone who is eligible for Part B should enroll. There are a few exceptions (i.e., either you or your spouse is still working, and you have group coverage with a minimum of 20 employees). If you don’t sign up for Part B when you are first eligible and change your mind later, you will possibly have a late enrollment penalty. If you are covered under your or your spouse’s group health insurance plan, you will not have a late enrollment penalty. Not all group plans are a better option than signing up for Medicare Part B. You should consider what the cost is to you (for premiums) and what the deductibles and out-of-pocket exposure are.
What is Traditional Medicare?
If you intend to enroll in traditional Medicare (meaning you don’t plan to enroll in a Medicare Advantage Plan), you should enroll in a Medicare Supplement Plan.
Before purchasing a Medicare Supplement, you should obtain a “Guide to Health Insurance for People with Medicare.” This publication is put out by the National Association of Insurance Commissioners, and anyone who attempts to sell you a Medicare Supplement must provide you with a copy of the guide. If you would like a copy, contact me, and I will see that you get one.
If you currently have a primary care physician, you should contact him/her to be sure he/she will continue to see you if you go on traditional Medicare. You might also ask which Medicare Advantage Plans he/she will accept.
Finally, if you have access to a computer, you should go to https://mymedicare.gov/ and sign up for MyMedicare.gov.
Mymedicare.gov/ is a secure online service where you can access your personal Medicare information 24 hours a day, every day. Here’s what you can do with MyMedicare.gov:
- Complete your Initial Enrollment Questionnaire (IEQ)
- Track your health care claims
- Order a duplicate Medicare Summary Notice (MSN) or replacement Medicare card
- Check your Part B deductible status
- View your eligibility information
- Track your preventive services
- Find information about your Medicare health or prescription drug plan, or search for a new one
- Keep your Medicare information in one convenient place
- Sign up to get the “Medicare & You” handbook electronically
You can find a plethora of other information about Medicare and your rights options and entitlements from my website https://medicareclassroom.com/.
If you don’t find an answer to your question, you may contact me, and I will try to find the answer for you.
I can be reached at (303) 690-3280, or you can email me at [email protected].
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
I am not affiliated with the U.S. Government or the federal Medicare program. This is a solicitation for insurance.