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Can I get Medicare at age 65?

Just the essentials...

  • You must sign up for Medicare at age 65 or risk paying a higher premium for the rest of your life

  • If you are still covered under an employer’s health plan, you may not be required to pay a higher premium when you sign up

  • When you use Medicare, you will have out-of-pocket expenses, some of which can be covered by a Medicare supplement plan, which is called Medigap

Can I get Medicare at age 65? - Medicare Balloons

Many people approaching retirement have questions about Medicare. One of the most common questions is whether you can get Medicare at age 65. The short answer is that if you are eligible, you can enroll in Medicare at 65, and you should. If you delay signing up for Medicare beyond age 65, you could end up paying a higher premium once you do sign up.

You are eligible for Medicare if you or your spouse receive or are eligible to receive Social Security or railroad retirement benefits. You are also eligible if you or your spouse worked in a government job and paid Medicare taxes.

The age at which you sign up for Medicare is 65. Even if your Full Retirement Age (FRA) for Social Security is 66, 67 or 68, you should still sign up for Medicare at 65.

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What is Medicare?

Can I get Medicare at age 65? - Medicare Diagram

Medicare is health insurance provided by the government for people aged 65 and over, people with certain disabilities, and those with permanent kidney failure or ALS.

There are four parts to Medicare, and each part covers different things.

– Part A

Part A is hospital insurance. It pays for your care when you are staying in a hospital, and may pay for skilled nursing care after you have been in the hospital. It also may also pay for home health care and hospice care. There is no charge for Medicare Part A. When you sign up for Medicare, you must get Part A.

– Part B

Part B is medical insurance. It pays some of the costs of visits to the doctor, care outside a hospital, home health care, and some preventative services like checkups and screenings.

It also pays some of the cost of durable medical equipment like wheelchairs and walkers. The amount of your premium for Part B depends on your income.

– Part C

Part C is also known as Medicare Advantage. This optional program lets you get your Part A and Part B services through a private insurance company.

If you have Medicare Part A and Part B, you can sign up for a Medicare Advantage plan, which may have additional benefits. Medicare Advantage plans can be managed care plans, preferred provider plans, fee-for-service plans, or specialty plans.

– Part D

Part D is prescription drug coverage. It helps to pay for part of the cost of medications your health care provider prescribes. There are several Part D plans to choose from, and they have different premium costs.

If you do not currently have a creditable prescription drug plan, you will pay a higher premium for Part D if you don’t sign up when you are first eligible. A creditable plan is one that pays at least as much as Medicare’s standard prescription coverage.

When can I sign up?

Can I get Medicare at age 65? - Medicare Enrollment Form

If you are already getting Social Security or railroad retirement benefits, you should get information in the mail shortly before you turn 65, and you will be enrolled automatically in Part A and Part B. You can decline Part B if you choose.

If you are not yet receiving Social Security or railroad retirement benefits, you should contact Social Security three months before you turn 65. Even if you have no plan to retire, you should still enroll in Medicare.

Your initial enrollment period in the seven months around your 65th birthday. If you turn 65 in July, for example, your initial enrollment period starts in April and goes until October. It includes the three months prior to your 65th birthday, the month of your birthday, and the three months following your birthday.

If you do not sign up for Part B Medicare during this seven-month initial enrollment period, you may have to wait until an open enrollment period, held once a year in January through March, to sign up.

In addition, you will pay a higher premium for your coverage when you do sign up. This higher premium will be in effect for as long as you have Medicare coverage. Your premium will go up 10% for each year you were eligible but didn’t sign up.

If you sign up during the three months prior to turning 65, your coverage will start in the month you turn 65.

If you sign up the month you turn 65, your coverage will start the following month. If you sign up one month after your birthday, your coverage will start two months after you enroll.

If you sign up two or three months after your birthday, your coverage will start three months after you enroll.

What if I have health insurance through my job?

Can I get Medicare at age 65? - Medicare Policy

If you are still employed and you have health coverage through a plan offered by your employer, you can delay enrolling in Part B without being subject to the late enrollment penalty.

You can sign up for Medicare Part B while you are still covered by an employer’s plan, or within the eight-month period that follows after your employment or your group coverage ends, whichever comes first.

Once you enroll, your coverage can begin on the first day of the month in which you enroll, or on the first day of any of the three subsequent months, as long as you enroll while you are still covered by your employer’s plan or in the first full month afterward.

If this applies to you, contact the Centers for Medicare & Medicaid Services to make sure you qualify to postpone enrollment in Part B without having the pay the penalty for late enrollment.

What about costs Medicare doesn’t cover?

Can I get Medicare at age 65?

There are some medical costs Medicare does not cover. In order to pay for co-pays and services that are not covered, many people purchase a Medicare supplement insurance policy from a private insurer.

These are sometimes referred to as Medigap policies. It pays to compare Medigap policies to determine which one best meets your needs.

If you have a Medicare Advantage plan, you cannot have a Medigap plan because Medicare Advantage covers many of the same costs as a Medigap plan.

It’s important to note that nursing home care is not covered by Medicare, Medicare Advantage or Medicare supplement insurance, with the exception of stays of up to 90 days following a hospitalization.

If you are confined to a nursing home, you will have to pay the cost out of pocket, or with a long-term care insurance policy.

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  1. https://www.ssa.gov/, “Social Security,” Nov 1, 2016.
  2. https://secure.rrb.gov/, “U.S. Railroad Retirement Board,” Nov 1, 2016.
  3. https://www.medicare.gov/sign-up-change-plans/get-drug-coverage/get-drug-coverage.html, “How to get drug coverage,” Mar 15, 2018.
  4. https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-how-to-sign-up-for-part-a-and-part-b.html, “How do I get Parts A & B?,” Mar 15, 2018.
  5. https://www.cms.gov/, “Centers for Medicare & Medicaid Services,” Mar 15, 2018.
  6. https://www.medicare.gov/what-medicare-covers/index.html, “What Medicare covers,” Nov 1, 2016.
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