As I gained more experience with the elder law field, I’ve found that most people know the basics, that they become eligible for Medicare at the age of 65. What I have come to realize, however, is how intricate and arduous the process of enrolling in Medicare truly can be. It’s best to start at the beginning. Upon turning 65, there is a seven month window, called your enrollment period, in which you must apply for Medicare. Conveniently, the registration period begins three months before turning 65.
The date of your birthday can make a large difference in terms of the start date of your Medicare coverage. If your birthday is on the first of the month and you enroll in the any of the 3 months before your birthday month, your coverage will begin the first day of the prior month. So, if your birthday is July 1st and you register in April, May, or June, your Medicare coverage will begin June 1st. If your birthday is not on the first, your coverage will begin the first day of your birthday month. There are different rules should you register in your birthday month or any of the three subsequent months. Remember that it is extremely important to register timely to avoid any potential penalties, especially because these penalties may last for as long as you have Medicare.
Speaking of penalties, if you do not enroll timely in a Part B plan, a 10% penalty will be assessed against your monthly premium for every full year you fail to register. For failing to enroll in a drug plan, you will be assessed a 1% penalty for each full, uncovered month. Keep in mind that if you wish to also enroll in a COBRA plan, there are different rules governing whether you may have both COBRA and Medicare depending on which plan you enrolled in first.
Lastly, it will be important to assess your specific needs as to whether to enroll in a traditional Medicare plan, which is funded by the state, or a Medicare Advantage Program, which is offered by private companies. One of the biggest benefits to having a traditional Medicare plan is that you can see any doctor in the United States that accepts Medicare, rather than having to choose from a network of providers. On the other hand, a Medicare Advantage Plan may be best for you if you prefer to put a cap on your out of pocket spending, rather than paying a portion of the cost of all your health services in any given year.
There are numerous considerations to keep in mind when embarking on your Medicare enrollment. These can include when to enroll and what type of plan, out of the many available, best fits your needs. Just remember, before enrolling in a Medicare plan, a comprehensive assessment of your health needs can make the process much more manageable.
Kristen R. Matthews works closely with individuals on a wide variety of estate and trust planning and administration matters. She is an experienced elder law attorney and assists clients with matters including advance and crisis Medicaid planning, guardianships, special needs trusts, and Veterans Pension benefits. To learn more about Kristen’s practice email her at [email protected], or call her at 610-840-0272.
