Written by Mike Layden, CPA
President, Health & Life Solutions, Inc.
Overview of Medicare Parts A and B
Are you ready to take the first step towards enrolling in Medicare Parts A and B? Understanding the basics of these programs is crucial for those approaching retirement age. Medicare Part A covers hospital stays, skilled nursing facility care, hospice care, and some home health care services. On the other hand, Medicare Part B helps cover medically necessary services like doctor's visits, preventive services, and outpatient care. Enrolling in both parts is essential for comprehensive healthcare coverage during your golden years. But how do you enroll in Medicare Parts A and B and avoid the late enrollment penalty? Let's break it down.
Benefits of enrolling in Parts A and B
Are you approaching age 65 or considering retiring soon? Enrolling in Medicare Parts A and B can offer a wealth of benefits to ensure you receive the healthcare coverage you need. Medicare Part A covers hospital stays and some skilled nursing facility care. Part B covers medical services like doctor visits and outpatient care. By enrolling in both, you can have peace of mind knowing you are protected against expensive healthcare costs. By enrolling in both parts, you can access a wide range of healthcare services and protect your physical and financial well-being. Don't wait until it's too late - enroll in Parts A and B today to secure your future health.
When can I enroll in Medicare Parts A and B?
1. When you're turning 65. Your Initial Election Period lasts seven (7) months. You can enroll the three months prior to your birth month, the month of your birth month, and the three months following your birth month.
2. After 65 and you've been covered by an employer group health plan
This is a "Special Enrollment Period," and there are no penalties if you sign up or add Part B during this time.
If you or your spouse have health insurance through your job, you can sign up:
Any time while working and still covered by the group health plan.
Within 8 months of the day you or your spouse stop working, even if your group health plan continues for a time.
Within 8 months of the group health plan ending while you or your spouse continue to work.
Your coverage begins the month after you sign up. Because of the financial risk associated with this decision, we recommend you call us to get clear guidance.
3. When you miss the other periods (likely penalties involved)
This is the "General Enrollment Period," and there is typically a life-long penalty if you sign up during this time.
If you have not filed during the other periods, you can still sign up between January 1 and March 31 each year.
Your coverage begins the month after you sign up.
Gathering Required Information
Personal information necessary for enrollment in Medicare Parts A and B
Basic information about yourselfHealth insurance informationFor Part B only
Social Security number
Where you were born (city, state, country)
Start and end dates for any current group health plans
Start and end dates for any group health plans after age 65
Valid email address
Your existing Medicare number
Current health insurance coverage information necessary for enrollment in Medicare Parts A and B
In order to enroll in Medicare Parts A and B, you will need to provide the following information about your current health insurance coverage:
The type of health insurance plan you currently have (e.g. employer-sponsored insurance, COBRA, TRICARE, etc.)
The name of the insurance company that provides your current coverage
The policy number for your health insurance plan
The dates of coverage for your current health insurance plan
It is important to note that you will still be eligible for Medicare even if you have other health insurance coverage. The rules for how Medicare works with other insurance can vary. It is recommended that you speak with a Medicare expert at Health & Life Solutions to determine how your current coverage will interact with Medicare Parts A and B.
Enrolling in Medicare Parts A and B
Applying online for Medicare Parts A and B
Applying online for Medicare Parts A and B is a convenient option to ensure you have access to essential healthcare services as you near age 65. By visiting the Social Security website, you can easily navigate the online application process to enroll in these important parts of Medicare. With just a few clicks, you can complete the necessary paperwork and get one step closer to securing the healthcare coverage you need. Don't wait until it's too late - take advantage of the online application for Medicare Parts A and B today. The website address to enroll online is https://www.ssa.gov/medicare/sign-up
Applying by phone for Medicare Parts A and B
If you prefer to apply for Medicare Parts A and B over the phone, you can do so by calling the Social Security Administration. Their representatives can guide you through the application process, answer any questions you may have, and help ensure you have all the necessary documentation. Applying by phone is a convenient option for those who may not have easy access to a computer or prefer speaking with a live person. Just make sure to have all your personal information handy and be prepared to provide any necessary details to complete the application efficiently. Available in most U.S. time zones Monday – Friday 8 a.m. – 7 p.m. in English and other languages.
Call +1 800-772-1213
Applying in person for Medicare parts A and B
If you're getting ready to apply for Medicare Parts A and B, choosing to do so in person can be a great option. When you apply in person, you can have your questions answered right away and get assistance with filling out the necessary paperwork. Additionally, you can ensure that you have all the required documents with you to make the process smoother. By applying in person, you can feel confident that you are on the right track to getting the healthcare coverage you need. So, don't hesitate to visit your local Social Security office or Medicare office to apply for Parts A and B today. You can visit the following website to locate the closest local office: https://secure.ssa.gov/ICON/main.jsp#officeResults
What's your situation?
I want to sign up for both Part A & Part B or only Part A when I turn 65
Apply online (at Social Security) – This is the easiest and fastest way to sign up and get any financial help you qualify for.
You’ll create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online.
I already have Part A & want to add Part B because I’m losing my job-based coverage
Apply online to sign up for Part B if you already have Part A.
Have the employer fill out form CMS-L564.
CMS-L564 is a form used by Medicare beneficiaries to authorize the release of their personal health information. This form allows Medicare to disclose important medical information to designated individuals or organizations, ensuring that necessary healthcare decisions can be made on your behalf.
Send the completed form to your local Social Security office by fax or mail.
I want to sign up for Part A & Part B, but I missed my chance when I turned 65
You can only use a special enrollment period in certain situations.
If you believe you have an extenuating reason why you were not able to enroll when you turned 65, give us a call and we will assist you with filing the appropriate documents.
I have Part A already & want to add Part B (only available Jan 1 – March 31)
Fill out form CMS-40B.
Form CMS-40B is a crucial form for those who are enrolling in Medicare Part B. This form allows individuals to apply for medical insurance coverage under Medicare, ensuring that they have access to important healthcare services. It is important to fill out Form CMS-40B accurately and submit it on time to avoid any delays in receiving Medicare benefits. Additionally, providing all necessary information on this form is essential to ensure that individuals receive the coverage they need. Don't forget to carefully review Form CMS-40B and reach out to the appropriate resources for any assistance in completing it.
Send the completed form to your local Social Security office by fax or mail.
Contact Social Security to submit your forms or get help:
Send completed forms to your local Social Security office by fax or mail.
Call 1-800-772-1213. TTY users can call 1-800-325-0778.
If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
Important Reminders to enroll in medicare part A and B
When transitioning to Medicare coverage, it is important to follow these steps to ensure a smooth process:
Plan ahead: Start researching your Medicare options well before you turn 65 or become eligible for Medicare. This will give you enough time to understand the different plans available and make an informed decision.
Enroll on time: Make sure to enroll in Medicare during your Initial Enrollment Period, which starts three months before you turn 65 and ends three months after your birthday. If you miss this window, you may face penalties or delays in coverage.
Understand your options: Medicare offers different parts, such as Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage plans), and Part D (prescription drug coverage). Make sure you understand what each part covers and select the plan that best fits your needs.
Coordinate with your current insurance: If you have existing healthcare coverage, such as through your employer or a retiree plan, make sure to coordinate with them to ensure a smooth transition to Medicare. You may need to inform them of your Medicare enrollment and make any necessary changes to your coverage.
Review your coverage annually: Medicare plans and costs can change each year. It is important to review your coverage annually during the Open Enrollment Period (October 15 to December 7) to make sure you have the best plan for your needs.
By following these steps and being proactive in your transition to Medicare coverage, you can ensure a smooth and seamless process. Consulting with a Medicare Advisor at Health & Life Solutions, Inc. (217-290-1768) can also help you navigate the complexities of Medicare and make informed decisions about your healthcare coverage.
Medicare Late Enrollment Penalty Calculator
Avoid late enrollment penalties
It’s important to sign up for Medicare coverage during your Initial Enrollment Period, unless you have other coverage that’s similar in value to Medicare (like from an employer). If you don’t, you may have to pay an extra amount, called a late enrollment penalty.
Late enrollment penalties:
Are added to your monthly premium.
Are not a one-time late fee.
Are usually charged for as long as you have that type of coverage (for most people, that’s a lifetime penalty). The Part A penalty is different.
Go up the longer you wait to sign up – they’re based on how long you go without coverage similar to Medicare. Find out when you should sign up to avoid penalties.
Part B late enrollment penalty
Generally, you won’t have to pay a Part B penalty if you qualify for a Special Enrollment Period. Learn more about Special Enrollment Periods.
You’ll pay an extra 10% for each year you could have signed up for Part B, but didn’t.
You may also pay a higher premium depending on your income
Part D late enrollment penalty
Generally, you won’t have to pay a Part D penalty if:
You havecreditable drug coverage (coverage that’s similar in value to Part D) OR
You qualify for Extra Help
You’ll pay an extra 1% for each month (that’s 12% a year) if you:
Don’t join a Medicare drug plan when you first get Medicare.
Go 63 days or more without creditable drug coverage).
You may also pay a higher premium depending on your income.
After you join a Medicare drug plan, the plan will tell you if you have to pay a penalty and what your premium will be.
Missing your Initial Enrollment Period (IEP): The IEP for Medicare Parts A and B typically starts three months before your 65th birthday month and ends three months after your birthday month. Missing this enrollment period could result in delayed coverage and potential penalties.
Not enrolling in both Part A and Part B: Some individuals may mistakenly believe they only need one part of Medicare. However, it is recommended to enroll in both Part A (hospital insurance) and Part B (medical insurance) to ensure comprehensive coverage.
Assuming you're automatically enrolled: While some individuals are automatically enrolled in Medicare Part A if they're receiving Social Security benefits, this may not always be the case for Part B. Make sure to confirm your enrollment status and take action if necessary.
Not exploring available coverage options: Medicare offers various supplemental plans, such as Medicare Advantage (Part C) and prescription drug coverage (Part D). Failing to explore these options could result in gaps in your coverage or higher out-of-pocket costs.
Depending solely on employer-sponsored coverage: If you're still working and covered by an employer-sponsored health plan, you may have the option to delay enrolling in Medicare without facing penalties. However, it's essential to understand the rules and potential consequences of delaying enrollment to make an informed decision.
Not understanding the costs and coverage of Medicare Parts A and B: Before enrolling, take the time to familiarize yourself with the costs, coverage limitations, and potential out-of-pocket expenses associated with Medicare Parts A and B. This will help you make informed decisions about your healthcare coverage.
Failing to update your coverage as needed: Life circumstances can change, and your healthcare needs may evolve over time. Be proactive about updating your Medicare coverage as needed to ensure you have adequate protection and access to necessary medical services.
By avoiding these common mistakes and staying informed about your Medicare options, you can make the enrollment process smoother and ensure you have the coverage you need for your healthcare needs. The Medicare experts at Health & Life Solutions are available to help you work through the scenarios above. Your healthcare is too important to leave to chance. Give us a call today!
