You are eligible as soon as you turn 65. However, if you are still working and your company provides benefits, you can delay signing up until you are ready to leave the company. If your company has under 20 employees, let us explain.
Medicare Part A and Part B
As you approach within 4 months of your 65th birthday, you will begin to receive materials from many Medicare Prescription Drug, Advantage and Supplement carriers telling you about their products. It can be very confusing. We will happily explain it clearly and help you make your decision.
There are two paths to comprehensive coverage once you are eligible for Medicare.
The most common approach is to sign up for Medicare Part A and Part B, then apply for a Supplement Plan and a Prescription Drug Plan (PDP). Another option is to set up a Medicare Advantage plan, which combines the administration of your Medicare benefits in an HMO arrangement including your hospital insurance, medical insurance and prescription drug coverage.
First, know that Medicare is a good thing. It is inexpensive compared to the insurance you are used to and covers much more. This, in combination with a supplement, can pay 100% of your Medicare covered expenses. An Advantage plan takes the place of Medicare. It costs less but you pay copayments when you visit the doctor or obtain other services.
Part D is the drug plan. You must buy a Part D plan. If you do not, you will not have coverage for prescription drugs. Furthermore, you will pay a penalty on an ongoing basis if you decide to buy it at some point in the future. Also, you can only purchase this once per year and it is effective on January 1st.
You can learn all about Medicare in the government-provided “Medicare and You” Handbook.
For an overview of tips on choosing a Medicare Supplement Plan, you may want to read “Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare”.
If you are a high-income individual, you may want to read “Medicare Premiums: Rules For Higher-Income Beneficiaries”.
Medicare Advantage Plans
- Advantage Plans replace Medicare and the need for a drug plan.
- In some locations these plans are free, but costs generally range from $30 to $147. Kaiser Permanente’s Advantage plan costs around $80.
Some people age 65 are not eligible for Medicare but they may be eligible for Covered California or to buy Medicare. We can help with that too. Please know that it is very important to time entry into the Medicare Market and purchase of Supplements and Advantage plans. Please contact us between 3 months before your 65th birthday (this is best) and, at the very latest, 5 months after.