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How to Get Medicare When Turning 65

Your 65th birthday is a big milestone. It’s the age when you can finally take advantage of retirement benefits, senior discounts and, of course, Medicare.

But 65 isn’t necessarily a magic number. If you plan to rely on Medicare, it takes more than just the flip of a switch to get coverage — and you’ll need to do some legwork to find coverage tailored to your individual needs when aging in to Medicare eligibility.

Do I automatically get Medicare when I turn 65?

It’s true that Medicare coverage automatically kicks at 65 for many Americans. What it comes down to is whether they are already collecting Social Security benefits.

If you are receiving Social Security checks:

Anyone receiving disability or retirement benefits from the Social Security or Railroad Retirement Board at least four months before turning 65 will automatically get Part A coverage. That’s because the application for these benefits doubles as the application for Medicare. Anyone approved for these benefits will automatically receive free Part A coverage after qualifying for Medicare. Once you’re approved, you will also receive Part B coverage. Should you choose to keep it, you will pay a monthly premium for this coverage.

If you don’t receive Social Security checks:

Individuals qualify to sign up for Medicare three months before turning 65. Even though you’re not receiving benefits from Social Security or the Railroad Retirement Board, you’ll still need to apply through one of the two to see if you qualify for Medicare.

Is Medicare free at 65?

For some people, there’s an expectation that turning 65 means gaining access to free health care for the rest of your life.

You may be wondering: Is Medicare free at age 65? Or does this sound too good to be true?

When people talk about “free” Medicare, they’re usually referring to premiums for hospitalization coverage. For most people, there is no monthly premium for Medicare Part A, which provides coverage for hospital stays, hospice and skilled nursing. You could get premium-free Part A coverage if you paid Medicare taxes for at least 10 years, or if you are a kidney dialysis or kidney transplant patient.

However everyone who chooses to get Medicare Part B, which covers doctor visits, does have to pay a monthly premium, which gets deducted from your Social Security or Railroad Retirement check.

If you don’t qualify for premium-free Part A coverage, you might be able to purchase Part A coverage, but you will need to buy Part B as well.

Along with these premiums, you also will have to cover expenses like deductibles, copays and drug costs.

Is it mandatory to go on Medicare when you turn 65?

Even though Medicare eligibility starts at 65, you don’t have to enroll if you don’t want to. But you’ll risk having to pay penalties if you wait too long to sign up.

Medicare provides a seven-month window for you to enroll, beginning three months before the month of your 65th birthday, and ending three months after it.

What happens if you don’t sign up for Medicare Part B at 65?

After the sign-up window closes, you could face a 10 percent surcharge on your Medicare Part B premiums for each year you go without coverage. There are some exceptions, though.

You may be able to delay enrollment as long as you are still working at age 65 and enrolled in your employer’s group health plan. If your employer has at least 20 employees, you can rely solely on the group plan instead of Medicare for coverage without facing any Medicare penalties.

Medicare offers an eight-month special enrollment period if you leave your job or your private coverage runs out. As long as you sign up during that period, you won’t have to pay any premium surcharges.

There’s no reason you can’t enroll in Medicare while you’re still on your employer’s plan, as Medicare may be able to cover expenses your private plan doesn’t.

And you may need to enroll anyway. If your employer has fewer than 20 employees, your workplace may no longer provide coverage for individuals over 65, so you will need to rely on Medicare Part A and Part B for your primary coverage.

If you do sign up for Medicare and your employer’s plan, the one caveat is that Medicare participants are not allowed to contribute to a health savings account.

What Medicare plans are required at 65?

Although you don’t have to enroll in any Medicare plan if you don’t want to, Plan A is the bare minimum you will need to sign up for if you choose to get Medicare. Part B is optional, as is Part D, which covers prescription drugs.

That said, your employer may require you to get Medicare to stay on the company’s health plan.

And if you want to avoid financial penalties, you will need to enroll in Parts A, B and D when you first become eligible, or during a special enrollment period.

Can you get Medicare if you are under 65?

Although age 65 is the standard threshold for Medicare eligibility, younger individuals with certain conditions may be able to get it. If you are under 65 and need to find medical insurance coverage, we can help!

If you have a disability, end-stage renal disease or ALS, also known as Lou Gehrig’s disease, you may qualify for early Medicare.

After you have received Social Security Disability Insurance checks for more than 24 months, you will be automatically enrolled in Medicare. Individuals with ALS will start receiving Medicare benefits the first month Social Security benefits start.

Individuals who qualify for Social Security disability benefits may be able to get Medicare after getting dialysis treatments or a kidney transplant.

Can you get a Medicare supplement plan before age 65?

Even if you qualify for Medicare before you turn 65, you may have limited access to Medigap policies, which supplement original Medicare.
Some states require insurance companies to sell Medicare supplement insurance to qualifying members of the under 65 set. But there is no federal law requiring insurers to sell Medigap policies to anyone under 65. If you do find a policy, it may cost you more, and it may not be the one you want.

Can someone under 65 get a Medicare Advantage plan?

Individuals under 65 can enroll in a Medicare Advantage plan through a private insurer, and they may even qualify for assistance to pay for it. Some assistance options include:

• Medicaid: This joint state and federal program can help cover medical expenses for low-income individuals.

• Supplemental Security Income: This is a monthly Social Security benefit for disabled or blind individuals with limited income. This benefit is not to be confused with Social Security retirement or disability benefits.

• Medicare Savings Programs: These are state programs that help pay premiums, deductibles, coinsurance, copays and prescription drug costs.

How to Sign Up for Medicare Part A and Part B

If you’re getting ready to blow out those 65 candles, now’s the time to get the enrollment process started. There are a few different ways to apply for Medicare:

  • Let our licensed agents at insuranceQuotes help walk you through the process on finding a medicare health policy.
  • Call 1-800-772-1213. Those who are hearing impaired and rely on a teletype device can call 1-800-325-0778.
  • Contact your local Social Security office.
  • Former railroad employees and their spouses can contact the Railroad Retirement Board at (877) 772-5772.

You can choose to sign up for Medicare coverage only, or you can opt for Social Security and Medicare. After you’re approved, you’ll receive a welcome package with a Medicare card.

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