Open your calendar — there are some key dates you need to know if you are on Medicare or turning 65 this year. Knowing when you need to do things can be confusing, but understanding the basics of Medicare can help keep you — and your coverage — on track.
Medicare Parts A and B
You can sign up for Medicare Part A and B three months before and up to three months after the month you turn 65. Coverage can’t start earlier than the month you turn 65.
Part A is hospital insurance and helps cover inpatient care in hospitals, skilled nursing facility care, hospice care and home health care. Part B is medical insurance and helps cover outpatient care, home health care, durable medical equipment (wheelchairs, walkers, hospital beds and other equipment, for example) and many preventive services (such as screenings and vaccines).
Even if you don’t think you’ll need Medicare, it is important to understand the program, what it offers and how to apply.
“If you will have medical coverage through your employer, a spouse or other source after you turn 65, you may not need Medicare, but you should know about all your options,” says Meredith Ramsey, a New Orleans-based insurance consultant.
Diane Omdahl, a Wisconsin-based registered nurse and co-founder of 65 Incorporated, says, “Even if you plan to work beyond age 65 and will have coverage, don’t make assumptions about coverage after retirement. You could get tripped up if you do.”
It’s important to explore your options and how to pursue Medicare after retirement. Don’t wait until the last minute to do this, and don’t count on things like coverage through the Consolidated Omnibus Budget Reconciliation Act. COBRA enables people who lose their health benefits the right to continue coverage through their group health plan for a limited period of time. While this is a popular stop-gap measure, premiums can be high.
Omdahl suggests that if you continue to work past age 65, you’ll need to sign up for Medicare within eight months of leaving your job or health plan to avoid penalties. These penalties are based on a number of factors, including how long you went without coverage.
Regardless of employment status, anyone can sign up for Medicare during the general enrollment period between Jan. 1 and March 31 each year. You can apply for Medicare even if you have health coverage from another source. In the past, if you enrolled during this time, coverage didn’t start until July 1. But, in a significant change for 2023, coverage kicks in the month after you sign up.
Medicare Part D Deadline
Medicare Part D prescription drug coverage has the same initial enrollment period as Medicare Part A: the three months before and three months after your birth month.
A late enrollment penalty is applied if you go 63 or more days without prescription drug coverage from Medicare Part D or another source (such as an employer’s plan or veterans benefits) after becoming eligible for Medicare.
[See: 9 Rewards of Caregiving.]
Medicare open enrollment runs from Oct. 15 to Dec. 7 every year. During this time period, current Medicare enrollees can make changes to their Medicare Advantage plans. You also can reevaluate your Part D prescription drug plan coverage and choose another option during this time. You can switch from Medicare Advantage to original Medicare (and possibly a Medigap plan), as well. Changes made during this period will take effect on Jan. 1 of the following year.
“Toward the end of September, look for your annual notice of changes to your plan. This is extremely important because it will tell you about what your coverage will be in the coming year,” says Omdahl. “If you ignore this, you could be in for some unpleasant surprises. Know about any changes to your plan, and compare and contrast with others so you can make sure you have the best one for your needs.”
If you want to make any change to your plans, this open enrollment period is the time to do it.
Medicare Supplement Insurance Plan Deadline
Medicare Supplement Insurance plans, or Medigap, can be used to pay for some of Medicare’s cost-sharing requirements as well as services that traditional Medicare sometimes doesn’t cover.
The Medigap enrollment period is different than the other parts of Medicare. It’s a six-month period that begins when you are 65 or older and have enrolled in Medicare. During this open enrollment period, private health insurance companies are required by the government to sell you a Medicare Supplement Insurance plan, regardless of your health conditions. This is often the plan of choice for those with chronic conditions and/or those anticipating significantly greater health care needs.
However, while Medicare beneficiaries can sign up for a Medicare Supplement Insurance plan after this enrollment period, insurance companies are allowed to use medical underwriting to decide how much to charge for the policy. They can even reject individuals they don’t want to cover.
“This is one reason that it is important to assess your needs and seek the best and most appropriate coverage,” says Ramsey. “Don’t wait until you get sick to make decisions or attempt to make changes because it might be too late.”
Miss a Deadline? Don’t Panic
If you miss a deadline, you may have to wait up to a year to apply for coverage or make a change in your plan. However, it’s important not to panic.
Instead, Ramsey suggests, “talk to an independent insurance agent or someone else with expertise in Medicare.”
They may be able to help you find or keep coverage, or make changes. Even if you have to deal with penalty fees or higher premiums, it may be worth the investment. However, the best move is to put these key dates on your calendar now and plan ahead.
More from U.S. News
Update 01/18/23: This story was previously published at an earlier date and has been updated with new information.