Understanding Medicare Enrollment
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There are 2 main ways to get your Medicare coverage— Original Medicare(Part A and Part B) or a Medicare Advantage Plan (Part C). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap).
Do you want Original Medicare or a Medicare Advantage Plan?
When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B and could have a gap in your health coverage.
You can sign up for Part A and/or Part B during the General Enrollment Period between January 1–March 31 each year if both of these apply:
- You didn’t sign up when you were first eligible.
- You aren’t eligible for a Special Enrollment Period (see below).
You must pay premiums for Part A and/or Part B. Your coverage will start July 1. You may have to pay a higher premium for late enrollment in Part Aand/or a higher premium for late enrollment in Part B.
Most people should enroll in Medicare Part A (Hospital Insurance) when they’re first eligible, but certain people may choose to delay Medicare Part B (Medical Insurance). In most cases, it depends on the type of health coverage you may have.
Make sure you review the scenario above that applies to you so that you understand how dropping Part B would affect you. If you want to drop Part B, here’s how to do it:
Your Medicare hasn’t started yet
If your Medicare hasn’t started yet, there are 2 ways to drop Part B:
- If you were automatically enrolled in both Part A and Part B and sent a Medicare card [JPG], follow the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums.
- If you signed up for Medicare through Social Security, contact Social Security.
Your Medicare has already started
If your Medicare has started and you want to drop Part B, contact Social Security for instructions on how to submit a signed request. Your coverage will end the first day of the month after Social Security gets your request.
Do you want prescription drug coverage (Part D)?
Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to get Medicare drug coverage when you’re first eligible, you’ll likely pay a late enrollment penalty unless one of these applies:
- You have other creditable prescription drug coverage
- You get Extra Help
To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.
2 ways to get drug coverage
- Medicare Prescription Drug Plan (Part D). These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
- Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.
Do you want supplemental coverage?
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.