For many of us, there are certain milestones we look forward to. A sweet 16 birthday, high school graduation, or finally turning 21 and becoming an “adult.” From there, those benchmarks could include getting married or buying your first home. Hopefully, we reach the age of retirement and can spend the rest of our lives enjoying the good life.

Part of the good life is knowing you’ll be taken care of if a medical issue arises. That’s where Medicare coverage comes into play. At the age of 65, we’re able to enroll in Medicare health insurance, which can cover hospital stays, doctor services, medical supplies, and even a prescription drug plan. 

There are a few circumstances when you can be eligible for Medicare before turning 65. This includes certain disabilities and those with End-Stage Renal Disease that includes permanent kidney failure requiring dialysis or a kidney transplant.

Initial Enrollment Period (IEP)

Reviewing Medicare Plan options on a laptopAs you get closer to your 65th birthday, there is a seven-month span in which you can sign up for part or parts of Medicare. The three months before your 65th birthday, the month you turn 65, and the three months after your birthday. 

However, if your birthday falls on the first of the month, the whole timeline is pushed forward a month. For example, if your birthday falls on August 1, the IEP runs from April 1 through October 31. In either case, the sooner you enroll when you are eligible, the better. If you wait too long, your coverage may be delayed.

If you sign up for Medicare during the first three months of the IEP, coverage begins the first day of your birthday month (or the previous month if you were born on the first). If you sign up during your birthday month, coverage starts at the beginning of the next month.

Coverage will be delayed if you sign up during the three months after your birthday month. If you are receiving Social Security benefits during the IEP, you will be automatically enrolled in Original Medicare Parts A and B via Social Security. However, you can decline Part B without penalty (and the monthly part B premiums) if you have other creditable coverage.

When you enroll in Part A, inpatient stays at hospitals, skilled nursing facilities, or critical access hospitals are covered after a deductible. You are not covered for long-term or custodial care, although in some circumstances hospice or home health care is included. 

During the IEP, you may also sign up for Medicare Part D, which covers prescription drugs. You don’t have to sign up for Part D if you already have creditable drug coverage, via your employer through group coverage, retiree benefits, a union, or the VA.

There are a whole host of other circumstances that may affect your coverage or how you enroll in Medicare when you turn 65. Depending on what insurance agency you use, the plans they offer, and what plans are accepted in your area, the choices can be overwhelming.

Other Considerations

  • If you are currently employed or receiving health benefits from a previous employer or another group, check with them to find out what their policy is regarding employees/retirees and their families when you are turning 65. Many employers and other group plans discontinue health insurance once you are eligible for Medicare.
  • If you have been working, you are probably already enrolled in Part A (hospital insurance). However, unless you are already receiving Social Security benefits, you will need to enroll in Part B (medical insurance). To do this simply call your Social Security office. For additional information on Part A and Part B, please review Medicare Basics.
  • Attend a seminar to learn all you can about the different types of Medicare insurance plans available to you. Seminars are often put on by insurance companies or independent insurance agencies. You will receive more unbiased information if the seminar is conducted by an independent agency such as VibrantUSA. To see if we are holding a seminar in your area, please review Seminars.
  • Prepare a list of your physicians. Not all physicians accept all insurance plans. You will want to find a plan that your doctors will take.
  • Prepare a list of your prescription drugs. Medicare prescription drug plans (Part D) vary greatly in the drugs they cover and the price they charge. VibrantUSA can help you determine a plan that works best for you.
  • Take into consideration traveling you plan to do. Some insurance plans will not allow you to be out of the service area for more than a specified amount of time. Some provide better coverage while traveling than others.

Work With a Specialist

VibrantUSA is an independent insurance agency that specializes in Medicare insurance plans for clients that are just joining Medicare or those who have been on Medicare for years. In addition to initial enrollment periods, there are general enrollment periods, special enrollment periods, annual enrollments, and more.

Since 2003, we’ve been working with clients just like you that need guidance through this important time. In addition to keeping you aware of and helping you through the different enrollment periods, we offer more than 50 plans from 30 different regional and national carriers.

This means we can help you find the best plan to fit your needs, wants, budget, and lifestyle. Why waste your time trying to figure this out on your own or going through an agency that can’t give you the level of service we can? This is your time now – you should be enjoying it! Let VibrantUSA do the heavy lifting for you.