Frequently Asked Questions

Automatic Enrollment in Medicare

If you are currently getting Social Security benefits you will get Part A and Part B automatically starting on the first of the month you turn 65. Your Red, White, and Blue Medicare card usually arrives about 3 months before your birthday.

Note: If you have not started taking your Social Security payments, but plan on starting them, you must contact Social Security. At this time you may also enroll in Medicare. You may call Social Security, go to your local Social Security office, or enroll online.

You’re Not Automatically Enrolled …. If you are not getting or plan on delaying your Social Security benefits.

You can still enroll in Medicare during the Initial Enrollment Period – This is the 7 month period beginning 3 months before you turn 65, the month you turn 65 and 3 months after your turn 65. Your effective dates are determined by when you enroll. Medicare will bill you quarterly for your Part B premium.

Special Enrollment Period

If you didn’t enroll when you were first eligible because you were covered under a group health plan and the plan ends (for example you’re covered by an employer group plan and you stop working), you have 8 months to sign up for Part A and Part B.

Enrollment in Part C or Part D is not automatic. If you want either of these you must enroll with the insurance carrier of the Part C or Part D plan you want. A licensed insurance agent can assist with enrolling.

• Part A – You usually don’t pay a premium for Part A if you or your spouse paid Medicare taxes while you were working.
• Part B – You do pay a premium for Part B each month. Most people pay $135.50 per month. This is usually deducted from your monthly Social Security benefit payment. Premiums could be higher depending on your income.
• Part C – Medicare Advantage Plans. Premiums for these plans are determined by each insurance carrier.
• Part D – You do pay a monthly premium for Part D prescription drug plans. The amount you pay is based on the plan you choose.  Premiums could be higher depending on your income.

• Part A – Helps pay for hospital and other inpatient stays. Medicare Part A has a hospital deductible for each inpatient stay. The deductible for 2019 is $1364 per admission.
• Part B – Helps pay for doctors and other outpatient services, such as labs and x-rays. Part B has a deductible and coinsurance for the doctor and other outpatient services. The annual Part B deductible for 2019 is $185. Medicare then pays 80% of allowed charges leaving you with the 20%. Medicare does not have a limit to the 20% you pay. Medicare Supplement plans cover some or all of these deductibles and coinsurance amounts.
• Part C – Medicare Advantage Plans – Plans approved by Medicare offered by private insurance companies that cover all Medicare services. Some offer prescription drug coverage and extra benefits such as dental and vision. Plans are usually HMO or PPO type plans. They may include copays, coinsurance and out of pocket limits. Talking with a licensed professional can help you decide if this is a good option for you.
• Part D – Helps pay for prescription drugs. Offered by private insurance companies approved by Medicare, may have deductibles and copays.

Individual 65 and over, persons under 65 receiving Social Security disability for 24 months, and certain individuals with end stage renal disease.

Medicare is health insurance that covers certain medical expenses. It has deductibles and co-insurance.