Applying for Medicare

If you are approaching retirement age, or will be turning 65 years of age soon, then you may be wondering about how to apply for Medicare.

Most will not have to worry about enrolling in Part A as most workers who have put in at least 10 years or 40 quarters into working in the United States will be automatically enrolled. However, that still leaves many more decisions to be made. Will you enroll in Part B as part of Original or Traditional Medicare, or will you opt for the expanded offerings of a Part C Advantage Plan? Will all of your medications be covered?

These types of questions are typical when trying to navigate and understand the vast program that comprises the Medicare system in the United States. Applying for Medicare can be done in one of several ways, either by phone, online or through a licensed agent. In each instance you will need some documentation in order to complete the forms. Use the following information to compile all of the information you will need to complete the necessary forms, as well as learn more about what to apply for when it comes to Medicare programs.

Where to Apply

If you wish to apply for Medicare in person, then you will need to seek out your local Social Security office. If you are not sure where that is, go online to the Social Security Administration’s main website and type in your zip code. A list of offices close to you will be listed.

Applying Online

One of the fastest ways to apply for Medicare is to do so online. You can do this even if you will not be retiring for another few years, but you have turned 65 or will soon turn 65 years of age. The process will take no more than fifteen minutes. There are no forms you will have to sign and no fees to pay. After the form is submitted, the Social Security office will begin processing your application. If it needs more information about something it will contact you through the mail. The SSA office will never contact you over the phone.

Applying by Phone

If it is difficult for you to get out, and you do not have access to a computer, you can call the SSA office and a representative will be happy to fill out the forms for you. You can call 1-800-772-1213 between 7:00 a.m. to 7:00 p.m., Monday through Friday. If you are hard of hearing or are deaf call 1-800-325-0778.

Documentation Required to Apply for Medicare

In general, most of the information asked of you is probably already information you have memorized. You will be required to provide the following information:

  • Where you were born and when
  • Medicaid number and start dates, if applicable
  • Current health insurance, including start and end dates of employment
  • Marriage and Divorce dates with names and where each took place
  • Names of children who are still dependent
  • Military service, including branch and service period dates
  • If self-employed, tax returns for the previous two years
  • Banking information for direct deposit

When should you apply for Medicare?

You can sign up for Medicare at least three months prior to your 65th birthday. Most believe they need to wait until they have retired, but the retirement age and the age of eligibility for Medicare are no longer the same. Therefore, you can apply for and receive Medicare even if you are still employed.

When you initially apply, you will be asked to select the type of coverage you want. Medicare is divided into four parts:

  • Part A covers hospitalization: Nursing care and some home health services. For most who paid into the payroll taxes over their work years, there is no cost to be enrolled into Part A. In essence, if you met the work requirements, you have already paid for it.
  • Part B covers medical expenses: Such as doctor’s visits, medical equipment, rehabilitation, x-rays, mental health services, home health care and outpatient procedures, among other services.
  • Part C- Advantage Program: This is an expanded program that also includes vision and dental benefits.
  • Part D- Prescription Drug Coverage: Any medications not covered by Part B, or Part C will be covered by the Part D plan.

While you will be automatically enrolled in Part A, you will have to select your Part B coverage. If you decide not to take Part B, or if you delay your enrollment in Part B, then you can add it on later. However, your coverage could be delayed, and the price per month might be higher. In fact, for each year you are eligible for Part B but do not elect to take it, you will see your premium go up by 10 percent, unless you qualified for a special enrollment period. Special enrollment periods are generally offered to those workers who are still employed and covered under their employer’s health care coverage.

Drawbacks of Applying for Part D

Shortly after its introduction, it was discovered that Part D often left beneficiaries in a hole. In other words, beneficiaries were finding themselves in a situation where all benefits were used up and coverage for drugs was no longer offered. Beneficiaries were having to pay for their drugs out of pocket. To counter this, in 2011, a new law stipulated that when you reach the combined cost of your prescriptions paid by both your insurer and you, then prescriptions after that point will be offered at a 50 percent discount for name brand medications. Once you have reached the threshold of $5,000, then you will qualify for catastrophic coverage and the discount is applied.

Applying for Medicare Supplement Insurance and Medigap

If you elect to enroll in traditional Medicare, which is a combination of Parts A and B, then you may find that not all of the costs for medical procedures and medications may be covered. Sometimes traditional Medicare will not cover copayments, deductibles or coinsurance. This is where Medigap insurance comes in. This is not made available through the federal government but is offered by your local insurance agent. Shop around because prices can vary from one insurance agency to the next. The advantage of Medigap is that it will also cover you if you travel outside the U.S. and have medical issues arise.

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