Healthcare and Medicare Resources

Healthcare coverage can be accessed through our jobs or government programs such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or the health insurance exchange.

The 7 Month Medicare Enrollment Window

Parts A and B are the basic parts of Medicare, sometimes referred to as “Original Medicare.” Part A is hospital insurance, and Part B is medical insurance. When you turn 65, Medicare gives you a 7-month window in which to enroll. That initial enrollment window opens three months prior to the month in which you turn 65 and closes three months after the month in which you turn 65. If you fail to enroll within that 7-month period, the chances are good that you will end up paying a late-enrollment penalty for not signing up for Part B coverage on time. That penalty is permanent. You will also have to wait until the next general enrollment period (January 1-March 31) to sign up.¹

If you are still working at 65 and have employer-sponsored health coverage, you face no requirement to sign up for Medicare until you retire or that coverage disappears. This also applies if you are retired, but your spouse has employer-sponsored health coverage. Keep in mind that COBRA does not meet Medicare’s definition of employer-sponsored health insurance.²

You can apply to receive Medicare benefits even if you haven’t retired. If you’re coming up on 65 and you don’t yet receive Social Security benefits, SSDI or benefits from the Railroad Retirement Board, visit your local Social Security Administration office or dial (800) 772-1213 or go to www.ssa.gov to determine your eligibility.^3,4

If you are eligible, you have the choice of accepting or rejecting Part B coverage. If you want Medicare Part A and Medicare Part B, then you should sign your Medicare card and keep it in your wallet. If you don’t want Part B, you put an "X" in the refusal box on the back of the Medicare card form, and send the form to the address shown right below where your signature goes. About four weeks later, you will get a new Medicare card indicating that you only have Part A coverage.⁵

Other Health Care Enrollment Windows

If your Health Insurance is employer-provided, enrollment is initiated within a specific hiring window and then renewed annually. If you don’t have health insurance through your employer, the health insurance exchange in your state provides plans within an enrollment window. Outside of that window, you can’t enroll in a health insurance plan unless you qualify for a Special Enrollment Period.

Medicaid & CHIP – apply any time. There’s no limited enrollment period for Medicaid or the Children’s Health Insurance Program (CHIP).

2018 Medicare Trends

Increased Part B Premiums due to Social Security COLA: For 2018, the standard monthly Part B premium is $134 – unchanged from 2017. But due to Social Security COLA increases in 2018, many more Medicare recipients will have to pay the standard Part B premium this year, rather than a discounted rate due to the “hold harmless” statute which held Part B premium costs down for about 70% of Medicare enrollees in 2016 and 2017.

In 2018, about 42% of Medicare recipients will pay the standard Part B premium even though they are subject to the “hold harmless” provision, because the annual increase in their Social Security benefits will equal or exceed the increase in their Part B premiums. Around 28% of recipients will pay somewhat less than $134 a month for Part B, since the annual increase in their Social Security benefits will be less than the increase in their Part B premiums.⁶

When you are considering your Health Care options, it pays to shop around.

It’s always a good idea to shop around for a health plan. You have to decide what type of health coverage you want, research companies and what benefits they’re offering, and carefully evaluate your options before making a final choice. With the internet, there’s a wealth of information online to help you shop around. Cost is an important factor in any purchase, especially when it comes to health care.

You want to get the best value possible from your health care coverage. But you still need to make smart choices to get good value that meets your own health care needs. There may be dozens of Medicare plans in your area, all with different costs and levels of coverage. How much are each plan’s premiums and deductibles? How much will you pay for the benefits and services you’re likely to use? Is there a limit on what you’ll have to pay out-of-pocket for the year? If you’re currently in a plan, how does that plan stack up to the other plans that are available?

Prescription drug coverage is another part of the cost puzzle. How much will your prescriptions cost under each plan? Does the plan cover the drugs you take? Remember, thanks to the Affordable Care Act, everyone who reaches the Part D coverage gap (or “donut hole”) will benefit from a discount of 55% on covered brand-name drugs.

Only you can determine what mix of benefits and costs will work best with your needs and budget. Shopping around can make a huge difference. The Medicare Plan Finder is available online through the official Medicare Blog. It allows consumers to compare plans so they can pick a plan that meets their needs, and even call the plan administrators to get more details about their benefits and services, or check out their websites.

Contact a Medicare specialist before you enroll. Even with its user-friendly website and plenty of online third-party guides to help those new to it, Medicare remains intricate; its nuances, hard to grasp. A financial or insurance professional well versed in Medicare enrollment, benefits, and regulations may make the process simpler for you.

Citations.

1 - medicare.gov/people-like-me/new-to-medicare/getting-started-with-medicare.html

2 - fool.com/retirement/general/2016/05/14/do-i-get-medicare-when-i-turn-65.aspx

3 - www.socialsecurity.gov/pubs/10043.html

4 - www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-and-how-to-get-parts-a-and-b.html

5 - www.slhn.org/Pay-Bills/FAQ/Medicare-FAQ.aspx

6 - thestreet.com/story/14404346/1/most-people-with-medicare-part-b-will-pay-higher-premiums-in-2018.

Find more information and links to online research tools at the official Medicare blog:
blog.medicare.gov/category/open-enrollment/

Find more information and links to online research tools at the official HealthCare.gov site:
www.healthcare.gov/