Medicare Checklist: What to Do in the Months Before You Turn 65

Turning 65 is a milestone that often marks the beginning of retirement, new adventures, and, for many, enrollment in Medicare. As you approach this significant age, it's crucial to plan ahead and understand the steps that need to happen in the year leading up to your 65th birthday. In this blog post, we'll guide you through the essential preparations to ensure a smooth transition into the world of Medicare.

Understand Medicare Eligibility
The first step is understanding WHEN you become eligible. In most cases, you're eligible for Medicare at age 65. However, if you have a disability or specific medical conditions, you may qualify for Medicare before turning 65. Make sure to verify your eligibility and the enrollment rules applicable to your situation.

Decide Between Original Medicare and Medicare Advantage
Medicare comes in two primary parts: Original Medicare (Part A and Part B) and Medicare Advantage (Part C). Take the time to explore the differences between these options and decide which one aligns better with your healthcare needs and budget. Original Medicare provides hospital (Part A) and medical (Part B) coverage. “Medicare Advantage” plans are offered by private insurance companies and often include additional benefits like prescription drug coverage (Part D) and dental or vision care.

Plan Your Enrollment Month

Your Initial Enrollment Period (IEP) typically begins three months before your 65th birthday and continues for three months after that date. Planning when you want your Medicare coverage to start during this seven-month window is crucial. Your choice will affect when your benefits start, so consider factors like your current health coverage and when you want to retire.

Review Your Current Coverage
If you're currently covered by an employer's health plan, take a close look at how it will work with Medicare. You may want to delay enrolling in certain Medicare parts if your employer coverage is sufficient. However, it's essential to understand how your employer plan and Medicare interact to avoid any coverage gaps or penalties down the road.

Enroll in Medicare Part A (and Part B if Needed)
Most people are enrolled in Medicare Part A (hospital insurance) automatically when they turn 65 if they're receiving Social Security benefits. If not, you can sign up for Part A online by visiting a Social Security office or calling them. If you decide to enroll in Medicare Part B (medical insurance), you'll need to do so during your Initial Enrollment Period. Remember – failure to enroll on time may result in late enrollment penalties.

Consider Supplemental Coverage
Original Medicare doesn't cover all your healthcare costs, and out-of-pocket expenses can add up quickly. To help mitigate these costs, consider purchasing Medicare Supplement Insurance (Medigap) plans. Medigap plans are designed to cover some of the expenses that Original Medicare doesn't, such as copayments, deductibles, and coinsurance.

Explore Prescription Drug Coverage
If you choose Original Medicare and don't have prescription drug coverage through another source (like an employer or union plan), you should consider enrolling in a Medicare Part D prescription drug plan. These plans help cover the cost of your medications and are available through private insurance companies.

Mark Your Calendar for Medicare Part D Enrollment
Enrolling in a Medicare Part D plan is a critical step to ensure you have access to necessary medications. The Initial Enrollment Period for Part D is the same as your Initial Enrollment Period for Medicare Part B. Missing this window could result in penalties unless you have prescription drug coverage from another source.

Stay Informed About Enrollment Periods
Medicare has various enrollment periods, including the Initial Enrollment Period, the Annual Enrollment Period (AEP), and Special Enrollment Periods (SEPs). It's essential to understand these timeframes and the circumstances that may allow you to make changes to your coverage outside of the standard enrollment periods.

Get Professional Assistance
Navigating the complexities of Medicare can be overwhelming, but you don't have to do it alone. Consider seeking advice from a knowledgeable Medicare advisor who can provide personalized guidance based on your unique situation.

Turning 65 and enrolling in Medicare is a significant life event that requires careful planning and consideration. Understanding your eligibility, reviewing your coverage options, and enrolling in the right plans at the right time can help ensure a smooth transition into the world of Medicare and set yourself up for a secure and healthy retirement. Remember, the year leading up to your 65th birthday is the perfect time to start this journey, so take the necessary steps to make the most of your Medicare benefits.