Top Things You Need to Know About Medicare Enrollment

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4. The Time to Enroll in Medicare

Medicare Enrollment Form

You can enroll in Medicare Part A any time after you reach the required age or during the Initial Enrollment Period (IEP). Also, you might be eligible for premium-free Part A if your spouse has paid their Medicare taxes during work. When eligible for part A, the coverage starts six months after the date that you apply.

However, to enroll in Medicare Part B (medical insurance) or the premium Part A, you will only have limited periods of time.

For initial enrollment, you have a seven-month period when you first become eligible for Medicare. If you are eligible due to age, then you will have three months prior to turning 65, which includes the month you turn 65, and then three months following your 65th birthday.

If you become eligible because of a disability, you will have three months before the 25th month prior to your disability payment, which includes the 25th month. It will end three months after. Your coverage start date will vary depending on the month that you enroll and could be delayed up to three months.

3. General Enrollment for Medicare

Open Enrollment Announcement

From January 1 to March 31, open enrollment starts. Your coverage begins on July 1. In some circumstances there are special considerations, such as if your spouse is still working. In such a circumstance coverage begins the month after enrollment and might be delayed by up to three months.

Others who are eligible for enrollment might obtain eligibility based on their spouse’s current employment or that of another family member. They also could be eligible if the employer has more than 100 employees.

2. Do You Qualify for Special Enrollment?

Fall Open Enrollment

Part B is employer-based insurance and is dependent on if you currently have insurance with your current employer. If you are still working or your spouse is working, then most employers have sponsored Group Health Plan coverage. They can delay Part B and enroll you later.

There are other special rules involved. If you have a disability or ESRD, then you will face different rules.

1. Who Pays: Medicare or Another Health Insurance Plan?

Insurance Plan

Certain rules will apply depending on whether Medicare or a different insurance plan is faced with paying the same claim.

When Medicare and another health insurance plan are responsible for paying the same medical claim, coordination of benefits rules determine how Medicare works with other health coverage.  When someone is considering delaying or declining Part B, it’s important for the beneficiary to know.

Usually, an employer with 20 or fewer employees will require you to enroll in either Part A or Part B. Your employer will advise you in advance of the situation so you can sign up for Part B when eligible.

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