If you are not receiving Social Security (Retirement or Disability) Benefits, or Railroad Retirement (RRB) you will need to apply for Medicare.

There are 3 circumstances where you will automatically be enrolled in Medicare Part A & B:

1) If you are receiving benefits from Social Security or the Railroad Retirement Board (RRB), your Part A and Part B benefits begin the first day of the month you turn age 65. (If your birthday is on the first day of the month, Part A and Part B go into effect on the first day of the prior month.)  

2) If you are under age 65 and have Disability Benefits from Social Security or certain disability benefits form the RRB, you get Part A and Part B after 24 months.

3) If you have ALS (amyotrophic lateral sclerosis, also called Lou Gerig’s disease) you get Part A and Part B the month your Social Security disability benefits begin.

If you currently do not have a Medicare Card, you should file for it 3 months prior to 1st of the month you are turning 65. 

The website to apply for Medicare is SocialSecurity.gov.

Meeting with an experienced Medicare independent agent is most beneficial to you. There is no cost savings to go direct to an insurance carrier. The benefit in speaking with an experienced agent is to have options provided with multiple carriers to see which best fits your needs. We suggest you set up a meeting at least two months prior to the 1st of the month you turn 65 to discuss options. It usually requires a few meetings. Our first meeting we will outline all of the options available to you . You should then take time to compare and analyze the options that best meets your personal needs.  The second meeting we will summarize your options and you can ask any additional questions. If you are comfortable making a decision, we will apply for your Medicare insurance. (this step requires you have a Medicare ID to file).  Although we do not charge a consultation fee,we would expect you to apply for insurance through us. By doing so, we will continue to provide ongoing support to you as your Servicing Agent of Record.

Most people will choose to keep Part B. The Guide to Medicare that is sent with your card explains how to opt out of Part B.  Read this carefully to make a decision on opting out.

Your Medicare card will arrive in the mail 3 months prior to your 65th birthday or 25th month of disability benefits if you are receiving Social Security or RRB benefits (see #1 above).

If you are covered under your or your spouse’s employer insurance, you may want to stay covered by that plan. Please note that if the employer has less than 20 employees, Medicare is the primary payer and the employer plan is the secondary payer.

If the employer’s insurance plan has 20 or more employees, you may want to review and compare the benefits and costs of Medicare and additional insurance with your employer plan.

Medicare Part A is almost always premium-free. (Refer to “Medicare Amounts and Premiums” document under “Resources” for more information.)

There is a charge for Medicare Part B.

Refer to “Medicare Part B Enrollment Checklist” under “Resources”.

If you do not have a special circumstance (i.e. staying in an employer insurance plan, etc. ) Medicare Part B premium may go up 10% for each full 12 months in the period that you were eligible for Part B but did not sign up.)

Medicare Part A is considered Hospital Insurance. It helps cover:

Inpatient care in hospitals

Skilled nursing facility care

Hospice Care

Home health care

Medicare Part B is considered medical insurance (outpatient). It helps cover:

Doctors and other health care provider services

Outpatient care

Durable medical equipment (wheelchairs, walkers, hospital beds and other equipment

Many preventative services

Medicare Advantage Plans (MA plans) offered by Medicare-approved and contracted private insurance companies that must follow the rules set by Medicare. Most MA Plans include prescription drug coverage. In most plans, you will need to use health care providers who participate in the plan’s network.

Medicare Part D helps pay for prescription drugs. Even if you don’t take prescription drugs now, be sure and consider it now. If you decide not to get it when you are first eligible, AND you do not have other prescription drug cover (like drug coverage form an employer or union) or get Extra Help, you will likely have to pay a late enrollment penalty if you join later.

There are 2 ways to get Medicare Drug Coverage:

1.  Medicare drug plans offered by insurance companies, Medicare Cost Plans, some Medicare Advantage Private Fee-for-Service plans and Medicare Advantage Medical Savings Account plans.

2. Medicare Advantage Plans or other Medicare health plans with drug coverage.

Your insurance provider’s Customer Service is your best friend for questions!

Is my drug covered under my plan? Is my doctor in network? Can I change my mode of premium payment?  My expense was not covered, why?  Can I order my medications by mail? Which pharmacies are preferred in my plan?  I lost my card, can I get another one?  Where can I get a book with all my benefits?  These are but a few of frequently asked questions. 

The Customer/Member Services and Provider’s toll-free numbers are always on the reverse side of your insurance card if you want to talk to a live person.  If you register your account on line with your insurance company, you can get most of your questions answered. In addition, information regarding claims, reward programs, copy of your card, etc. 

Medicare insurance plans are available by state/county/zip code. If you are moving from the current location, you will need to look in to transferring your existing insurance to one available in the area you are moving to.  Contact us to ensure your plan is available in that area and remains the best plan for you.  This applies to Medicare Advantage, Medicare Supplement and Prescription Drug Plans.  You have two months in which to notify your insurance provider of your change and apply for coverage in the new location