
Turning 65 What Do I Need To Know About Medicare – A licensed insurance professional has reviewed this page for accuracy and compliance with the CMS Medicare Communications and Marketing Guidelines (MCMGs) and Medicare Advantage (MA/MAPD) and/or Medicare Prescription Drug Plans (PDP) career guidelines.
The mission is to provide seniors with resources that help them make important financial decisions that affect their retirement. Our goal is to arm our readers with knowledge that will lead to a healthy and financially sound retirement.
Turning 65 What Do I Need To Know About Medicare
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If you meet the eligibility requirements, you can apply for Medicare three months before your 65th birthday—even if you don’t plan to retire right away.
If you are new to Medicare, you can enroll in Medicare through the Social Security Administration (SSA), and Medicare enrollment takes as little as 10 minutes online. After enrollment, benefits are administered by the US Centers for Medicare & Medicaid Services (CMS).
Your first opportunity to enroll in Medicare is the initial enrollment period, which lasts for seven months. This period starts three months before your 65th birthday month, includes your birthday month and ends three months after.
Outside of the initial enrollment period, there are certain times each year when you can change or enroll between different Medicare plans.
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During the general enrollment period, which runs from January 1 to March 31 each year, you can sign up for Medicare Part A and/or Medicare Part B coverage if you did not do so during your initial enrollment period.
There is also the Medicare Open Enrollment period that runs from October 15th to December 7th every year. Open enrollment is the annual opportunity for Medicare beneficiaries to assess their current benefits and switch plans if needed. Changes made during open enrollment will take effect on January 1 of the following year.
There may be some circumstances that qualify you for a special enrollment period. Qualifying events include moving somewhere outside the coverage area of your current Medicare Advantage plan, leaving your employer’s health insurance plan, or ending Medicare’s contract with your current Medicare Advantage provider.
Medicare enrollment is automatic only if you are already receiving Social Security benefits. If you have not received Social Security benefits, you must sign up for Medicare online, by phone, or in person at your local Social Security office.
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Most people do not pay a monthly fee, or premium, for Plan A coverage because they paid into Medicare during their working years through payroll taxes.
If you or your spouse worked at least 40 calendar quarters in any job where you paid Social Security taxes in the United States, you qualify for premium-free Part A.
It is important to evaluate your overall health when considering a Medicare plan to fit your needs. Many expenses are not covered by Original Medicare (Parts A and B) and if your health dictates they are necessary, they must be covered elsewhere.

The biggest potential expense not covered by Medicare is long-term care, also called long-term care. Long-term care includes help with daily activities such as bathing, dressing, using the toilet, preparing meals and moving around the house. It may also include services such as meal delivery, adult day care and transportation to and from health appointments.
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If your health declines or if you have reason to believe you will need long-term care in the future, consider a separate long-term care insurance policy.
Maximize your Medicare savings by connecting with a licensed insurance agent. Annual registration is open until December 7th.
Unlike Original Medicare, Medicare Advantage plans are not the same across the country. Different areas will have different plan options available. This means that your coverage is also likely to be limited to the region where you purchased your plan.
Consider your lifestyle and travel habits when choosing a Medicare plan. For example, if you spend months out of the year traveling across the country in an RV, a Medicare Advantage plan that is tied to one region probably isn’t the best choice for your lifestyle.
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Another important consideration is whether you plan to move during retirement. It may not make sense to choose a plan that is tied to one state if you have plans to move to another.
When you initially enroll in Original Medicare, you sign up for Medicare Part A hospital insurance. If you have worked and paid Medicare payroll tax for at least 10 years, there is no premium.
You will also be given the opportunity to sign up for Medicare Part B medical insurance. Part B covers things like doctor visits for preventive care and medically necessary services, like ambulance transport.
Original Medicare suffers from coverage gaps and high deductibles, making it difficult for the average beneficiary to afford. To avoid large unexpected costs, some people decide to buy a supplemental plan called Medigap.
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Medigap is a private insurance plan that can help cover your out-of-pocket costs, including deductibles, coinsurance or copayments.
There are 10 types of supplemental insurance plans to choose from, and each is designated by a letter. Each of these plans is priced differently, and because these plans are administered by private companies, policy prices tend to vary widely.
These private plans also help cover out-of-pocket medical expenses such as copayments, coinsurance and deductibles. However, unlike Medigap plans that supplement Original Medicare, Medicare Advantage plans exist as an all-in-one alternative to Original Medicare.
By law, Medicare Advantage plans are required to cover everything covered by Original Medicare, but they can also bundle additional benefits into a single plan.
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If you stay with Original Medicare, you can choose stand-alone prescription drug coverage through a Medicare Part D plan. Otherwise, Medicare Part D is often included in a Medicare Advantage plan.
Part D plans cover a wide range of prescription drugs from brand name to generic. All Medicare drug plans generally cover at least two drugs per drug category, so people with various medical conditions can get the prescription drugs they need.
Learn what your options are if you are eligible for Medicare from Anne Novak, who is licensed in Life and Annuities, Sickness, Accident and Health by the Nebraska Department of Insurance.
Medicare star ratings are an objective way for consumers to compare private Medicare Advantage and Part D prescription drug plans based on quality and performance ratings.
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The Center for Medicare and Medicaid Services (CMS) implemented the star rating system in 2008 to help enrollees compare plans available in their area and to encourage providers to strive for excellence. CMS releases updated star ratings annually.
You can use the CMS Plan Finder tool or call 1-800-MEDICARE to compare contract ratings and find the best plans in your area.
Medicare is a complex health insurance system, and it can be difficult to grasp all of its intricacies without studying how different parts work. Don’t hesitate to talk to someone who is able to explain some things you don’t understand.
Learn why cost is a common concern for people choosing between Medicare Advantage or Supplement plans from William Howery, a Medicare expert who has a decade of experience in the insurance industry.
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You are not alone on your Medicare enrollment journey. When you turn 65, there’s no reason to feel like you’re on an island.
Many groups exist to help people along the path of Medicare enrollment. One such group is the State Health Insurance Assistance Program (SHIP), which works with state offices, local agencies and community providers to build community-based networks of counselors who offer help and education about Medicare.
Yes, you can be dually eligible for full Medicare and Medicaid or for one of the four Medicare savings programs.
No, Medicare enrollment is automatic if you are already receiving Social Security benefits. Your Medicare card should arrive three months before your 65th birthday without any extra work on your part.
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No, Medicare is not mandatory when you turn 65 if you have health insurance through your or your spouse’s employer.
If the employer has 20 or more employees, you can delay enrollment in Medicare until your current health coverage ends without penalties. You have an eight-month special enrollment period to sign up for Medicare when your employer-sponsored coverage ends.
But if the employer has less than 20 employees, the company may require you to enroll in Medicare instead of using the company’s health insurance.
If you miss your initial or special enrollment periods, you can still enroll in Medicare during the next open enrollment period. However, you may add additional monthly penalties to your Medicare Part B and Part D premiums.
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Savannah Pittle is an experienced writer, editor and content marketer with over 16 years of writing, editing and research experience across various industries.
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