When Does Medicare Start: When You Turn 65 Medicare Coverage Starts for Most Medicare Beneficiaries
I know that Medicare is a big topic. It’s also very confusing, so I wanted to break down what it means for you in the simplest way possible.
We will go over many of the common questions that are asked by Medicare Beneficiaries and some you may not have thought of yet.
If this sounds like your question then let us take a look.
Table of Contents
What Age Does Medicare Start: New to Medicare
Medicare coverage usually starts at age 65 but can be delayed if the individual is still working and receiving health insurance from an employer. If an individual is receiving Social Security benefits, they are automatically enrolled in Medicare. Otherwise, they must enroll themselves.
Original Medicare includes Medicare Part A and Part B. You must enroll in Medicare Parts A and B in order to receive full health coverage benefits. You can buy additional private insurance which includes a Medicare Supplement Plan, and Part D prescription drug plans or you may choose to enroll in a Medicare Advantage plan.
Medicare Advantage plans include most of the benefits of Parts A and B, but you must still enroll in Parts A and B and pay your monthly Part B premium.
Medicare Part A coverage is a premium-free part of Medicare for most Americans who have worked long enough.
Applying for Medicare is important because it helps to ensure that you will have health coverage as you age. It is important to understand all of your options before making a decision about which type of plan is right for you.
When Does Medicare Coverage Begin If You Enroll During the Initial Enrollment Period?
The Initial Enrollment Period (IEP) is the time when people can first sign up for Medicare. It lasts for a total of seven months and begins three months prior to turning 65 and ends three months after your 65th birthday month.
It is critical to begin the process of signing up for Medicare three months before you turn 65 to ensure you receive your Medicare card in the mail in enough time to sign up for a Medicare Supplemental plan, Medicare Advantage plan, and Part D coverage.
Medicare coverage will begin on the first of your birthday month. As an example, if your birthday is on July 18 your Medicare will start on July 1.
When does Medicare Enrollment Happen for the General Enrollment Period?
The General Enrollment Period is the time each year when people who are not already enrolled in Medicare can sign up for coverage. Coverage will start July 1 if you apply during this period.
The General Enrollment Period is primarily for those who became eligible for Medicare but did not enroll in Medicare on time. They must wait until the General Enrollment Period to sign up and will face delays in the enrollment process.
Does the Medicare Start Date Begin on your Birthday?
Medicare coverage begins on the first day of the month you turn 65. If you are born on the first of the month, your coverage will begin one month earlier.
While Medicare Part A will begin at this time you can delay Medicare Part B and Medicare Part D for those who have employer coverage.
Once you decide to no longer work or you lose your employer’s health benefits, you will qualify for a special enrollment period. You must sign up for Medicare Part B and D to avoid the late enrollment penalty.
When does Medicare Start if you sign up during a Special Enrollment Period?
If you’re not already enrolled in Medicare and have passed your initial enrollment period you may be able to do so during a special enrollment period. This is a time when you can sign up for Medicare even if it’s not during the annual general enrollment period.
Special enrollment periods usually occur if you’ve lost your health insurance coverage from another source. If you qualify for a special enrollment period, your Medicare Part B effective date will have a different effective date than your Medicare Part A effective date.
The Special Enrollment Period provides Medicare Beneficiaries with additional protections and guaranteed rights to enroll in a Medicare Supplement insurance plan without medical underwriting.
Best Time to Enroll in a Medicare Supplement Plan?
If you’re turning 65, the best time to enroll in a Medicare supplement plan is during your six-month enrollment period. This period starts on the first day of the month you turn 65. If you don’t sign up for a plan during this time, you may not be able to buy one later if you are in poor health.
Unlike Medicare Advantage plans which are required to enroll all Medicare Beneficiaries regardless of their health status, Medigap plans do not have the same requirement outside of your six-month initial enrollment period.
Your coverage will begin the first of the following month you enroll in a Medigap plan. If you apply for a Medicare Supplement plan on May 3, coverage will begin the month of June.
A Medicare Supplement plan does not replace Original Medicare but works alongside to fill in the gaps based on the plan you buy. The most popular Medigap plans are Medigap Plan F, Plan G, and Plan N.
Make sure you talk with one of our independent Medicare insurance agents about how each of these plans works to ensure you are buying the best plan for you.
What is the Medicare Effective Date for Medicare Advantage Plans?
Medicare Advantage is a type of health insurance that is offered by private insurance companies. These plans are approved by Medicare and must follow certain rules set by the federal government.
Medicare Advantage plans can offer different benefits than Original Medicare, and some plans may even include prescription drug coverage.
Enrolling in a Medicare Advantage plan is different than enrolling in Original Medicare. When you enroll in a Medicare Advantage plan, your coverage will start on the date that your plan says it will start.
Unlike a Medigap plan which is standardized by the government, Medicare Advantage plans change each year. This means the coverage you have this year may not be the same next year.
For instance, your doctors may be included in your plan this year but could be excluded from coverage the following year. Copays, deductibles, max out-of-pocket cost, and prescription drug coverage also change from year to year with Medicare Advantage plans.
Medicare Advantage plans also replace Original Medicare. While Medicare Advantage plans offer some attractive plans which are suitable for many Medicare Beneficiaries, it is critical to know what you are signing up for.
Medicare Advantage plans have an annual enrollment period that goes from October 15 through December 7th of each year. This is a time Medicare Beneficiaries must decide if they need to make a change to their coverage or not.
Depending on how much your Medicare Advantage plan changed adding or reducing health care benefits will impact if you need to find a new plan or not.
How to get Started with Medicare?
Signing up for Original Medicare is easy when you have a little help to point you in the right direction.
- Sign up for Part A and Part B – Can be done online, over the phone, or at your local social security office.
- Get your Part B effective date – If you delayed your enrollment you will need to sign up for Medicare Part B during your special enrollment period.
- Call an Independent Medicare Insurance agent – Our Agents will answer all of your questions and walk you through the coverage differences and sign you up with a plan.
- Choose between a Medicare Supplemental plan or Medicare Advantage plan.
- Sign up for a Medicare Part D plan unless it is included in your Medicare Advantage plan.
- Start using your Medicare benefits
- Keep track of your expenses – Medicare.gov provides you with an online Medicare account
- Review your coverage periodically – Talk with one of our insurance agents to review your coverages.
How to Compare Medicare Plans?
There are many ways to compare Medicare plans. The most important thing is to make sure you are getting the coverage you need at a price you can afford.
You can use the internet, newspapers, or other resources to compare plans. Make sure to look at the deductibles, co-pays, and other out-of-pocket costs.
You should also consider whether the plan covers prescription drugs and other services you may need.
It is always advisable to talk with a Medicare insurance expert as there are many different options to consider that can affect your Medicare eligibility if you attempt to do this on your own.
Integrity Now Insurance Brokers provides their clients with all of the needed Medicare information so they can make wise decisions on their health care needs
Can I start Medicare before my 65th birthday?
Most often the answer to this question is no. However, Medicare is available for individuals with disabilities and individuals with End Stage Renal Disease.
The Social Security Administration will determine if an individual is eligible for Medicare based on their disability.
For most individuals, Medicare generally will start the month they turn 65.
Do Disabled Qualify For Medicare Prior to Turning 65?
Yes, disabled individuals qualify for Medicare prior to turning 65. In order to qualify, they must have been receiving Social Security Disability Insurance (SSDI) benefits for at least 24 months.
In the 25th month of receiving SSDI, you will be enrolled in Medicare automatically. However, you will need to decide if a Medicare Advantage plan or Medicare Supplement plan is your best option while receiving SSDI.
People with ALS are automatically enrolled in Original Medicare the first month they collect disability benefits.
If you have ESRD, you must enroll in both Parts A and B to get full benefits.
When does Medicare start for People Diagnosed with ESRD?
ESRD, or end-stage renal disease, is a condition in which your kidneys can no longer function properly. If you have ESRD, you may need to start dialysis or have a kidney transplant to stay alive.
If you have ESRD, you’re eligible for Medicare coverage even if you’re not yet 65 years old. In most cases, your Medicare coverage will begin the first day of the month that you start dialysis treatments.
I am on SSDI When does Medicare Coverage Start?
There are many different types of disability benefits available through the Social Security Administration (SSA). One of these is Social Security Disability Insurance (SSDI). If you are approved for SSDI benefits, you are also automatically eligible for Medicare coverage.
Medicare coverage can begin as early as 24 months after you become disabled and start receiving SSDI benefits.
During this 24-month period, you may be able to get health insurance through your former employer. After the 24-month period, Medicare will be your primary health insurance.
Medicare insurance coverage will begin on the 25th month of receiving SSDI benefits.
Am I Required to Sign up for Medicare Part B?
You are not required to sign up for Medicare Part B. However, if you do not have creditable health insurance coverage the government will apply a late enrollment penalty if you change your mind in the future.
The late enrollment penalty increases the premium for Part B by 10% for each full 12-month period that a person could have had coverage but did not sign up for it. This penalty will remain for the remainder of your life.
What is Medicare Part D?
Medicare Part D is a prescription drug coverage plan that is separate from Original Medicare. Part D plans are offered by private insurance companies that contract with Medicare. You can enroll in a Part D plan if you have Original Medicare or a Medicare Advantage Plan (Part C).
If you are enrolling in a Medicare Advantage plan you are not allowed to enroll in a stand-alone Part D plan. However, if you remain on Original Medicare with a Medigap plan you can obtain a stand-alone Part D plan available in your local area.
Do Veterans Need to Sign up For Medicare Part B and Part D Coverage?
If you are a veteran, you may be wondering if you need to sign up for Medicare Part B and Part D coverage.
The answer is that it depends on your situation. The Veterans Administration recommends all veterans enroll in both Parts of Medicare. This allows you to receive your care either within the VA or outside of the VA from a private doctor.
You are not required to obtain Part D coverage as the VA provides creditable prescription drug coverage.
As. the VA does not provide creditable Part B coverage if you decide to enroll at a later date you will be charged a late enrollment penalty.
You will automatically be enrolled in Medicare Part A at 65, but you have the choice to enroll in Part B and D of Medicare.
I have CHAMPVA Should I Enroll in a Medigap Plan and /or a Medicare Advantage Plan?
CHAMPVA is a health insurance program for veterans and their spouses or dependents. It is administered by the Department of Veterans Affairs (VA).
CHAMPVA provides comprehensive health care coverage, including hospitalization, outpatient services, mental health care, and prescription drugs.
While you are required by ChampVA to enroll in both Medicare Part A and Part B, we do not recommend enrolling in a Medigap plan or Medicare Advantage plan. Once you turn 65 your ChampVA benefits will become secondary and will be the equivalent of a Medigap Plan F.
This means you should not have any out-of-pocket costs related to receiving health benefits.
Your annual deductible and $3,000 max out-of-pocket costs will be covered in full.
I need Help! How to work with an Independent Medicare Insurance Agent
Integrity Now Insurance Brokers is an Independent Medicare Insurance Agency with a team of Medicare experts. Here are eight things you should know about why working with an independent Medicare insurance agent is your best option:
- An independent Medicare insurance agent represents multiple insurance companies, which gives you more options for coverage.
- A Medicare insurance agent can help you compare plans and prices from different companies to find the best fit for your needs and budget.
- An independent Medicare insurance agent is required by law to have your best interests in mind when recommending a plan – not the interests of the insurance companies they represent.
- You can usually find an independent Medicare insurance agent in your local community, or online.
- When talking with one of our agents, be sure to bring all of your questions so they can help you understand your options and help you make the best decision for your needs.
- You’ll likely need to provide some personal information to the agent so they can help you find the right plan. This may include your age, health history, and current medications.
- The agent will likely ask you about your budget and what type of coverage you’re looking for in a plan. Be honest about your needs and wants.
- Once you’ve chosen a plan, the agent will help you enroll in it. They may also be able to provide assistance if you have any problems with your coverage down the road.
Working with an independent Medicare insurance agent like Integrity Now Insurance Brokers can be a great way to get the coverage you need at a price you can afford. Just be sure to do your research ahead of time and come prepared with questions so you can make the best decision for your individual needs.
We look forward to hearing from you once you are enrolled in Medicare Part B and Part A. Until you have your Medicare card we can only answer questions about Medicare but are unable to enroll you in a Medicare plan.
You can fill out our website quote request form or give us a call to get your Medicare plan all set up.