Turning 65? Here’s What You Need to Know About Medicare

Turning 65 soon? Congratulations! While we hope you're planning a big party to celebrate, we also want to make sure you're planning for another important marker of turning 65: Medicare enrollment. Of course, planning for Medicare isn't nearly as fun as planning a celebration, but we're here to make it as easy as possible. In this article we cover everything you need to know about Medicare when you turn 65.

Medicare Eligibility Begins 3 months Before Your 65th Birthday

If you have questions regarding your eligibility for Medicare coverage, the Medicare age limit, or about the program in general, then you’re not alone. Many seniors are inundated with Medicare information, yet still left with questions. The first thing you need to know is that Medicare eligibility begins three months before your 65th birthday.

Medicare is generally available for any individual approaching or at the age of 65. Though, in some cases, people under the age of 65 might qualify because of specific disabilities. You can check your eligibility using our Medicare Eligibility Check.

If You Miss Your Initial Enrollment Window, You Could Experience a Gap in Coverage

It is imperative that you enroll in your Medicare benefits during your Initial Enrollment Period (IEP). The IEP is the seven-month window around your 65th birthday (three months before and the three months after your birthday month).

If you miss your window, you could face gaps in health insurance coverage, incur late enrollment penalties, and have to wait for another enrollment period such as the Annual Election Period or Open Enrollment Period, which occur at specific times of the year.

Some specific instances allow an individual to qualify for a Special Election Period (SEP), such as losing employer coverage or moving. But those circumstances are limited – so it’s best to make sure you’ve enrolled within your specific window.

Medicare Has Multiple Parts

You might be wondering precisely what Medicare is. Essentially, it is a federal health insurance program with multiple types of coverage.

• Medicare Part A is for hospital insurance and covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and home health care.
• Medicare Part B is for general medical insurance and covers certain doctors’ services, outpatient care, and preventative services.
• Medicare Part D covers prescription drugs and is often offered by insurance companies and other private companies approved by Medicare. It essentially adds prescription drug coverage to Original Medicare and other Medicare-related plans.
• These parts can be, and often are, combined through Medicare Advantage Plans or Medicare Part C. Medicare Advantage plans are offered by private insurers approved by the Center for Medicare & Medicaid Services.

Did You Know That Some Individuals Qualify for Medicare Premium-Free?

You can get Part A Medicare premium-free if you meet one of the following requirements:

• You are eligible to receive Social Security or Railroad benefits
• You (or your spouse) had Medicare-covered government employment
• You are under the age of 65, but you have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months
• You are a kidney dialysis or kidney transplant patient
• If you do not qualify based on any of these requirements, but you are over the age of 65, then you might be eligible to simply buy it.

There is a premium for Parts B & D, but this can be deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.

Original Medicare Might Not be the Best Option for You 

Medicare Advantage is basically an all-in-one alternative to Medicare itself. Medicare Advantage plans are a simple way for you to gain more out of Medicare. If you choose to enroll in a Medicare Advantage Plan, you’ll still have Medicare while receiving access to additional coverage such as dental, vision, and more.

In addition, the plans have a history of the higher average quality of health outcomes in participants. As a result, they have been strongly supported by the Medicare Trust Fund and others who legislate our healthcare nationally.

Click here to learn more about what Medicare Advantage plans cover. 

Need a set of reminders to help make sure you don't forget about your Medicare enrollment window? We've got your back! Click here to see our top reminders for seniors turning 65.

We hope this information aids you as your make plans to enroll in Medicare. Nevertheless, it's not uncommon to have questions about Medicare. That's what we're here for! Find a local advisor who can help you understand your Medicare options today.