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Medicare is a federal health insurance program for people who are 65 and over, for some younger people with disabilities, and for people with end-stage kidney disease.
Medicare has:
Most people who are 65 and older, some younger people with disabilities and people with end-stage kidney disease can get Medicare. Call the Social Security Administration at 1-800-772-1213 if you are not certain you can get Medicare. You’ll need to provide your Social Security number and your date of birth when you call.
If you are nearing 65, there is a seven-month period during which you can get Medicare. This is the case whether Medicare signs you up or if you need to sign up for Medicare yourself.
This seven month period includes:
The best time to sign up for Medicare is during the three months before your 65th birthday.
You can sign up for Medicare in one of two ways:
Here is an example of someone who needs to sign up:
Julia will be eligible for Medicare when she turns 65 in a few months. At 65, Julia can also start collecting full Social Security benefits. However, since she plans to work until she is 70, she has decided to wait until then to get Social Security benefits. In Julia’s case, she will need to sign up for Medicare herself.
When you sign up for Medicare, you will get Part A, which covers hospital bills. Most people do not have to pay a monthly premium for Part A. That is because they or their spouse paid Medicare taxes while they were working.
However, Medicare Part B, which pays for doctor bills, is optional. You will have to pay a monthly premium for Part B. You can sign up when you first go on Medicare, turn down the coverage, or wait to sign up at a later date.
Why would you wait to sign up for Part B? If you are working and already have group health insurance from your employer or your spouse’s employer, you might not need Part B right away.
Caution: Be aware that if you wait to sign up for Part B, the premium could go up by 10 percent for each year you could have had Part B but did not. You will pay that extra cost as long as you remain on Medicare.
You won’t have to pay more for Part B if:
If you don’t think you’ll meet these conditions, you will have to pay more for Medicare Part B when you do get it. You may want to think about getting Part B when you first sign up for Medicare.
Here is an example of someone who waited to sign up for Part B
and didn't pay more:
John turned 65 in March 2000. John still had group health insurance at 65 from his work and was paying a monthly premium for his health insurance. Because he had this coverage, John decided he didn’t need Part B at 65, but would wait until he retired at 67. When John signed up for Medicare in March 2000, he told Medicare he didn’t want Part B, only Part A.
Later, when John retired in April 2002 and was no longer covered by his employer’s health insurance, he needed Part B and signed up at that time. John didn’t have to pay more for Part B, since he signed up by December 2002 (eight months after he retired).
FYI: In some areas of the country, more than one Medicare plan is available for you to choose. You need to have both Medicare Part A and B if you want to join a Medicare Advantage plan such as a Medicare Health Maintenance Organization (HMO), a Medicare Preferred Provider Organization (PPO) or a Medicare Private-Fee-for-Service Plan (PFFS). You generally do not need a Medigap policy or Medicare prescription drug coverage if you enroll in a Medicare Advantage Plan. Make sure your Medicare Advantage Plan covers the drugs and services you will need.
All people on Medicare can enroll in this voluntary drug coverage regardless of their income, health or how they pay for prescription drugs today. You will need to enroll in a Medicare-approved prescription drug plan offered through a private insurance company.
Your costs (deductible, premiums, and copayments) will vary depending on which plan you choose. You can first join for up until three months after the month your Medicare coverage started. If you do not join when you start Medicare, you may have to pay a penalty if you decide to join during a future open enrollment period (November 15-December 31 each year).
Generally if you have creditable coverage or coverage as good as Medicare’s from an employer or union, you can keep that coverage. Later, if you discontinue or lose your drug coverage, you can join a Medicare prescription drug plan without incurring a penalty.
Many people with Original Medicare purchase a policy through a private insurance company that helps pay the “gaps” such as Medicare deductibles and copayments. Some of these policies provide additional services not covered by Medicare. In most states, a Medigap policy must be one of 12 standardized policies (Plans A-L), so you can compare them easily.
If you are 65 or older, when you sign up for Part B, you have six months to buy any Medicare Supplemental (Medigap) policy you choose, regardless of your health. This is called your open enrollment period. You only have this period once in your life. After this six month period, you may not be able to buy the Medigap policy you want because policies may exclude persons with certain medical conditions.
If you are 65 or older and have group health coverage from your or your spouse’s employer, you can save your open enrollment period until you need it. Get all the facts first from Medicare and your State Health Insurance Assistance Program (SHIP) before making a final decision about when to sign up for Part B.
As of 2006, Medigap policies cannot offer prescription drug coverage to new enrollees. Persons wanting prescription drug coverage will need to purchase a separate prescription drug plan.
AARP on Medicare
A series of articles from AARP to help you better understand your Medicare options.
Medicare Prescription Drug Coverage
This series of articles will help you sort through your drug coverage choices.
Medicare
Information on who can get Medicare and how to sign up.
Medicare Personal Plan Finder
Medicare's online tool to help you find a plan that's right for you.
State Health Insurance Assistance Program (SHIP)
How to contact your State Health Insurance Assistance Program (SHIP), an important Medicare partner. Free one-on-one health insurance counseling to people with Medicare.
Social Security Administration
Call the Social Security Administration at 800-772-1213 to find out if you can get Medicare. The Hearing and Speech Impaired TTY/TDD number is 800-325-0778.