Enrolling In Medicare When Turning 65

Am I Automatically Eligible For Medicare When I Turn 65?

 

Yes, most people qualify for Original Medicare (Parts A and B) when they turn 65. But the rules about Medicare eligibility and when you should enroll for Medicare Parts A and B can be complicated. They're based on your age, if you are a U.S. citizen or legal resident, and whether you're retired or still working. If you are already receiving Social Security or Railroad Retirement Board benefits, you'll be automatically enrolled in Original Medicare Part A and Part B when you turn 65.

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Turning 65: Your First Steps

 

Your first step is enrolling in Original Medicare, Medicare Parts A and B. Here’s what you need to know to get started with Medicare.

 

 

Enrolling In Original Medicare When Turning 65

 

The best time for you to enroll in Original Medicare is during your Initial Enrollment Period, which is the three months before your 65th birthday month, the month you turn 65, and the three months thereafter. But there are some exceptions. We'll help you understand Medicare eligibility, and when you should enroll in Original Medicare. Then we'll help you complete the rest of your coverage.

 

Are you still employed?

YES

NO, I’M RETIRED

You're probably still enrolled in the healthcare plan you have with your employer. That's great, but you can still check out whether using parts of Medicare could save you money even while you work. Explore our Medicare plans and call us before you retire.

Now is the time to sign up for Original Medicare. If you just turned 65, you can sign up in the three months after your 65th birthday month and avoid late enrollment penalties. Call us now and we can help coordinate enrollment in one of our plans for additional coverage over Original Medicare.

How To Enroll In Original Medicare When Turning 65

 

Are you receiving Social Security?

YES

NO

If you already receive Social Security or Railroad Retirement Board benefits, you do not need to sign up for Original Medicare. You'll be automatically enrolled in Original Medicare (Part A and B) when you become eligible. 

If you haven't signed up for Original Medicare yet and don't have healthcare coverage from an employer or other source, be sure to do it. You can go to www.ssa.gov for more information and to sign up.

 

Need more information about when and how to sign up for Medicare, Medicare Advantage (Part C), Medicare Prescription (Part D), and Medicare Supplement? Check out our Sign Up for Medicare article.

Things To Know If You're Still Working Past 65

 

If you plan to keep working, and have healthcare coverage from your employer, here are some important things to know about Medicare.

 

How many people are in your company?

 

 

20 or more

 

When you work for a larger employer, you have choices. You should always check with your company’s benefits administrator before making any changes as in some instances, you may not be able to return to your company’s plan.

If you work at a large company, you can keep your employer’s plan even after turning 65. If you like your health plan and it’s affordable, you can wait to receive Medicare benefits until you retire. When you do retire, you will likely be eligible for a Special Enrollment Period. Interested in learning about Original Medicare, when you become eligible, plus when and how to sign up? Learn More.

Even though you’re still working, using parts of Medicare could save you money. Some employer plans cost more to cover things like hospital coverage, prescription drugs, dental, vision, or hearing. Adding Original Medicare and an Anthem plan, in addition to your employer plan, could cover these extras at an affordable price. Check out what Original Medicare does and doesn’t cover on our Original Medicare: Parts A & B page.

Sometimes the best option is to enroll in Medicare when you turn 65, even if you're still working. You may be able to save money on hospital and medical insurance with Original Medicare, Parts A and B. On top of those savings, you can save on coverage for prescription drugs, vision, dental, and hearing with our Anthem Medicare plans. First, you'll want to sign up for Original Medicare during your Initial Enrollment Period, which is the three months before your 65th birthday month, the month you turn 65, and the three months thereafter Then you can add all the additional coverage you'll need right here with us.

Fewer than 20

 

In most cases, switching to Medicare will be your best option. Medicare is designed to help you save money on all your healthcare needs, so there are lots of good options when you switch. First, you'll want to sign up for Original Medicare during your Initial Enrollment Period, which is the the three months before your 65th birthday month, the month you turn 65, and the three months thereafter. Then talk to us about Anthem Medicare plans with benefits that include prescription drug coverage, dental, vision, and hearing.

 

 

Self-employed

 

If you're self-employed or on an individual plan, chances are you'll want Medicare when you turn 65, even if you're still working. The good news is, it should save you money on your health insurance. Medicare is designed to help. Sign up for Original Medicare during your Initial Enrollment Period, which is the three months before your 65th birthday month, the month you turn 65, and the three months thereafter to avoid late fees and gaps in your coverage. Then you can find the right health plans here with us to add more coverage for things like prescription drugs, dental, vision, and hearing. Our plans can save you money on the copays, coinsurance, and deductibles of Original Medicare.

 

Original Medicare Costs 

 

Monthly Premiums

 

For most people the monthly premium for Part A is $0 and the monthly premium for Part B is $174.70.

 

For Part A you may pay more if you or your spouse did not contribute to social security via payroll taxes for at least 10 years. For Part B you may pay more based on your current income.

 

Copays, Coinsurance, and Deductibles:

 

There are also co-pays, coinsurance, and deductibles with Original Medicare Parts A and B.

 

For Part A, there is a $1,632 deductible per benefit period. This is not an annual deductible. A benefit period starts when you’re admitted to a hospital or inpatient facility and ends 60 days after your release. There are also copays with Part A. Your copay for the first 60 days in a hospital is $0. For days 61-90, your copay is $408 per day. For days 91 and beyond, the copay is $816 per day.

 

For Part B, the annual deductible is $240. You will also pay 20% coinsurance for doctor visits or other outpatient care.

 

Original Medicare Parts A and B do not cover prescription drugs and there is no annual maximum for your out-of-pocket costs.

 

We offer plans with $0 or low monthly premiums, no medical deductibles, prescription drug coverage, and annual maximum out-of-pocket protection. They also cover services and expenses Original Medicare doesn’t. There are programs available if you need more help affording the costs of Medicare. Learn more about Medicare costs.

 

 

What Disabilities Qualify For Medicare Under 65?

 

If you’re permanently disabled and you’ve been receiving Social Security Disability Insurance (SSDI) benefits for at least two years, you’re eligible for Medicare and you’ll be automatically enrolled in Medicare Parts A and B.

 

If you have End-Stage Renal Disease (ESRD), you’ll qualify for Original Medicare (Parts A and B) no matter how old you are. You’ll need to sign up for Medicare when you first become eligible, as enrollment is not automatic. Contact Social Security or visit your local Social Security office for more information on signing up for Medicare if you have ESRD.

 

If you have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease, you’ll be automatically enrolled in Medicare Parts A and B the month your disability benefits begin — whatever your age is.

 

 

Is Medicare Mandatory At Age 65?

 

Enrolling in Medicare is not mandatory, but you might have gaps in coverage or will have to pay late enrollment penalties if you don’t enroll when your first eligible. If you’re already receiving Social Security or Railroad Retirement Board benefits, you’ll be automatically enrolled in Medicare Parts A and B when you turn 65. If you’re not enrolled in Social Security and you decide not to sign up for Medicare Part B when you’re first eligible, you may have to pay some late-enrollment fees.

 

 

Is There A Penalty For Not Signing Up For Medicare At Age 65?

 

Yes. If you don’t enroll in Medicare Part A, Part B, and Part D when you're first eligible, your monthly premium may go up by as much as 10% for each year you were eligible but didn't sign up. In most cases, you'll have to pay this penalty each time on your monthly premiums, for as long as you have Medicare.

 

 

Making Sure Your Loved Ones Are Covered

 

It’s important to think about any dependents you have on your current health insurance plan. When you sign up for Medicare, your dependents will no longer be covered under that plan or under your new Medicare plan if you’re the primary insurance holder on your plan. Your dependents can purchase a separate individual or family health plan from a private insurer, like us.

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Anthem Blue Cross and Blue Shield is a Medicare Advantage plan with a Medicare contract. Anthem Blue Cross and Blue Shield is a D-SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal.

 

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal.