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How do I sign up for Medicare?

Some people get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) automatically and other people have to sign up for it. In most cases, it depends on whether you’re getting Social Security benefits.

An individual who is receiving monthly Social Security or RRB benefits at least 4 months prior to turning age 65 does not need to file a separate application to become entitled to premium-free Part A. In this case, the individual will get Part A automatically at age 65.

An individual who is not receiving monthly Social Security or RRB benefits must file an application for Medicare by contacting the Social Security Administration. For more information, contact BK Insurance Services.

What is Medicare and who can get it?

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

The Medicare program has four parts:

  • Part A—Hospital insurance
  • Part B—Medical insurance
  • Part C—Medicare Advantage
  • Part D—Prescription drug coverage

What are the different parts of Medicare?

Part A (hospital insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

The other three parts of Medicare might include premium payments, and if you do not enroll when you are first eligible, you may have to pay a late enrollment penalty for as long as you have coverage. Also, you may have to wait to enroll, which will delay coverage.

Part B (medical insurance)

Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Two types of services Part B covers are medically necessary services or supplies that are needed to diagnose or treat your medical condition, and preventive services such as health care to prevent illness.

Part C (Medicare Advantage plans)

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.

Part D (prescription drug coverage)

Prescription drug coverage helps pay for some medications doctors prescribe for treatment. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

How much does Part A cost?

You can get premium-free Part A at 65 if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board
  • You’re eligible to get Social Security or Railroad benefits but haven’t filed for them yet
  • You or your spouse had Medicare-covered government employment

If you’re under 65, you can get premium-free Part A if:

  • In most cases, you are receiving Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You have End-Stage Renal Disease (ESRD) and meet certain requirements.

How much does Part B cost?

You pay a premium each month for Part B. If you get Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t get these benefit payments, you’ll get a bill.

Most people will pay the standard premium amount. If your modified adjusted gross income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS).

To learn more about your specific Part B premiums, please contact BK Insurance Services.

When can I join a Medicare Advantage Plan?

There are specific times when you can sign up for a Medicare Advantage Plan (like an HMO or PPO) or Medicare Part D Prescription Drug coverage, or make changes to the coverage you already have:

  • During your Initial Enrollment Period when you first become eligible for Medicare or when you turn 65.
  • During certain enrollment periods that happen each year.

Under certain circumstances that qualify you for a Special Enrollment Period (SEP), like:

  • You move
  • You are eligible for Medicaid
  • You qualify for Extra Help with Medicare Part D Prescription costs
  • You are getting care in an institution, like a skilled nursing facility or long‑term care hospital
  • You want to switch to a Medicare plan with a 5-star overall quality rating. Quality ratings are available on Medicare.gov

Please contact BK Insurance Services for a list of different SEPs, including rules about how to qualify.

How can I get a Part D Prescription Drug Plan?

Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to get Medicare Part D Prescription Drug coverage when you are first eligible, you will likely pay a late enrollment penalty unless one of these applies:

  • You have other creditable prescription drug coverage
  • You get Extra Help

To get Medicare Part D Prescription Drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. Two ways to get drug coverage:

  • Medicare Part D Prescription Drug Plans. These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
  • Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.

What Is A Medicare Supplement Insurance Plan (Medigap)?

A Medicare Supplement Insurance Plan is another name for Medigap. With Original Medicare, Medicare beneficiaries must pay some of the costs (deductibles and coinsurance) of their medical care. Because of these gaps in Parts A and B coverage, private insurance companies sell Medicare Supplement Insurance Plan policies, also known as Medigap plans.

You must have Medicare Parts A and B to purchase a Medicare Supplement Insurance Plan. If you are in Original Medicare (Parts A and B) and buy a Medicare Supplement Insurance policy, Medicare will pay its portion of your medical costs first, then your Medicare Supplement Insurance policy will pay its portion.

Medicare Supplement Insurance Plan are named by letter, Plan A through Plan N. (These are not to be confused with Medicare Parts A, B, C, and D; they are different.) Medicare Supplement Insurance Plan benefits are standardized and regulated by the Division of Financial Regulation. A Medicare Supplement Insurance Plan cannot pay if you also enroll in a Medicare Advantage Plan.

If you are eligible for Medicare and concerned about paying for the costs that Medicare does not cover, like copayments, coinsurance, and deductibles, a Medicare Supplement Insurance Plan (or Medigap) policy may help.