Medicare Enrollment And Election Periods: Fill & Download for Free

Medicare is available to anyone over the age of 65 who is a U.S. citizen or who is a permanent resident in the U.S. The question is what is the premium and how will it get paid.Medicare is administered by Social Security, but it is not Social Security Income. They are two separate programs, and you do not need to get Social Security to get Medicare. If you are eligible for Medicare, you must apply even if you are not getting Social Security, or risk a Medicare premium penalty or waiting period for it to start if you apply late.There are two main parts to Medicare, Part A and Part B. Part A is for Hospitalization. This is usually paid for by having money taken out of your paycheck to got toward the Medicare benefit. This is part of that “FICA” you see taken out of your paycheck. You ask the question, no doubt, because the stay at home mom did not work outside the home. If someone works and pays into the system for 40 quarters (10 years), they will be entitled to Medicare Part A on the first of the month when they turn 65, without having to pay any premium. As Ashton said, if the person does not qualify on their own, but they have a spouse who qualifies, they can “piggyback” on the spouse’s benefit, as long as they have been married for at least 10 years. For most people their Medicare number is their Social Security Number plus a letter. If the spouse does not qualify on their own, but has or had been married for 10 years, they will get a Medicare card with the SSN of their spouse, ex-spouse, or deceased spouse, plus a letter that indicates what the relationship was. (Soon, there will not be SSNs on Medicare cards, but that’s another story.)What if the mom is/was not married, or was married to someone who also did not pay into the FICA taxes? They can still get Medicare Part A, but they will have to pay for it. The 2016 premium is $411 per month. If Mom worked a few years, she may get that premium prorated for how many quarters she contributed.Part B of Medicare is called “Medical.” It covers doctors’ charges and most outpatient services. Anyone 65 or over (or is under 65 but disabled) who is a permanent resident or citizen can buy Part B. You do not have to have Part A to buy Part B. Part B has a monthly premium of $121.80 for people who get it starting in 2016 (people who had it before 2016 may have a lower rate). Medicare Part B has an annual deductible of $166 per year, then pays 80% of most Medicare covered services. If the person buying Part B has an income of greater than $85,000 per year, they will have to pay a higher premium for Medicare Part B.So as long as she is a citizen or permanent resident (at least 5 years), she can enroll in Medicare, because she is over 65. There are rules, however, about WHEN she can enroll. There are “Election Periods” related to when someone turns 65 and/or if they are covered by an employer health plan. If she does not apply during her “Election Period”, she may need to wait for a General Election Period to get her Medicare.It is best for everyone to contact Social Security/Medicare at 1–800–772–1213 about 3 months before they turn 65, and/or go to their local Social Security office and ask about what they are entitled to and what it will take to get it.

You can enroll in a Medicare Advantage plan at the same time as you are eligible to enroll in Medicare for the first time at age 65. It is called the Initial Coverage Election Period ICEP. It is a 7 months period: 3 months before you get to 65, and 3 months after. After that, you can switch plan once a year between October 15 and December 7. This is called the Annual Election Period. One more thing to clarify: Medicare advantage is the same as Medicare + Medicare supplement.

Yes, but unless you qualify for a special election period, you may have to wait for the next open enrollment period that runs from October 15 through December 7 every year, with an effective date of January 1st. There are other special elections available that will allow you to return to original Medicare sooner or go to another Medicare Advantage plan prior to open enrollment. You can call Social Security and ask if you qualify for a special election period. If you want to learn more about disenrolling from your current Medicare Advantage plan, there is a chapter in your Evidence of Coverage (plan booklet) that tells you about disenrolling from the plan. I would read that first and then contact Social Security.