New To Medicare?

Turning 65, decisions, decisions…

A few months before you turn 65, you should learn about Medicare coverage choices and consider important enrollment times and your coverage options. You should start at least three months before you turn 65. Visit Medicare.gov or call the State Health Insurance Program hotline: 1-800-551-3191 to be assigned a counselor near you. Your initial enrollment period (IEP) is three months before you turn 65, the month of your birthday and three months after. Most people will enroll in part A because its generally premium-free if you have worked and paid Medicare taxes for the required period, usually 40 quarters or 10 years. Medicare part B has a premium. The standard cost for Medicare part B in 2023 is $164.90. Some people will pay a higher premium for their part B if they are in a higher income bracket this additional cost is call the Income Related Adjustment Amount (IRMAA).

If one is still working or is on retiree health insurance, they should contact their employer or benefits administrator before delaying enrollment in Medicare. COBRA does not meet creditable coverage standards so if you delay part B enrollment you may have a penalty if you delay enrollment in Medicare.

If you have Tricare or Champva coverage and have premium free Medicare Part A you will have to enroll in both Part A and Part B to keep your Tricare or Champva coverage.

If you have health insurance based on your or your spouse’s current employment and the employer has 20 or more employees and you do not have a Health Savings Account or High Deductible Plan, still enroll in premium free part A. You can delay Part B until you or your spouse stops working and loose the coverage under the employer group plan. Delaying part B enrollment because you have creditable employer coverage will save you paying the part B premium until you lose the employer coverage. You should apply for part B with Social Security no later than the month before you lose coverage to avoid a gap in coverage, however you have eight months total to enroll in part B before paying a penalty. If you do have a High Deductible plan or HSA, once you enroll in Medicare you can no longer contribute pre-tax dollars to the HSA. If the employer has fewer than 20 employees, you should enroll in Medicare part A and B when you turn 65. Medicare will be primary, and your employer group plan would pay secondary.

If you have health insurance through the Market Place or other private health insurance not directly offered by your employer, you should enroll in Part A and B when you turn 65. If you are not eligible for premium free part A you could remain on the marketplace plan, however, when you enroll in Medicare at a later date, you may be responsible for a late enrollment penalty.