Next Steps: A Practical Guide to Planning for the Best Half of Your Life
The authors of a nationally syndicated newspaper column on elder law have written a book based on decades of experience helpi...
Read moreThe first of the 78 million baby boomers turned 65 on January 1, 2011, and some 10,000 boomers a day will reportedly reach that milestone between now and 2030. If you are about to turn 65, be certain to take some time to think about Medicare.
You become eligible for Medicare at age 65, and delaying your enrollment can result in penalties, so it is important to act right away.
Numerous options are available to consider when signing up for Medicare. Medicare consists of four major programs, each of which pertains to different types of covered services:
In addition, Medigap policies offer additional coverage to individuals enrolled in Parts A and B.
Medicare enrollment begins three months before your 65th birthday and continues for a total of seven months. If you are currently receiving Social Security benefits, you don't need to do anything. You will become an enrollee in Medicare Parts A and B effective the month you turn 65.
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If you do not receive Social Security benefits, then you will need to sign up for Medicare. You can contact the Social Security Administration to do this by calling at 800-772-1213 or visiting the SSA website. Take care of this as early as possible so your coverage begins as soon as you turn 65.
If you are still working and have an employer or union group health insurance plan, it is possible you do not need to sign up for Medicare Part B right away. You will need to ask your employer whether the employer's plan is the primary insurer. If Medicare, rather than the employer's plan, is the primary insurer, then you will still need to enroll in Part B.
Even if you aren't going to sign up for Part B, you should still enroll in Medicare Part A, which may help pay some of the costs not covered by your group health plan. Any person who reaches age 65 and is entitled to Social Security benefits qualifies for Medicare Part A without charge. (People who do not qualify for free Medicare Part A can buy an Affordable Care Act plan when they turn 65.)
Learn more about Medicare coverage while continuing to work.
You may not have an employer or union group health insurance plan. Or, that plan may be secondary to Medicare. If so, it is extremely important to enroll in Medicare Part B during your initial enrollment period.
Note that COBRA coverage does not count as a health insurance plan for Medicare purposes (Learn more about this). Neither does retiree coverage or VA benefits.
Just because you have some type of health insurance doesn't mean you don't have to sign up for Medicare Part B. The health insurance must be from an employer where you actively work. Even then, if the employer has fewer than 20 employees, you will likely have to sign up for Part B.
If you do not sign up for Part B right away, then you will incur a penalty. Your Medicare Part B premium may go up 10 percent for each 12-month period that you could have had Medicare Part B, but did not take it. In addition, you will have to wait for the general enrollment period to enroll. The general enrollment period usually runs between January 1 and March 31 of each year.
Even if you are postponing enrollment in Part B because your current coverage is primary, it's a good idea to inform Medicare of your decision so you don't risk incurring premium penalties later.
With all the deductibles, copayments and coverage exclusions, Medicare pays for only about half of your medical costs. Much of the balance not covered by Medicare can be covered by purchasing a so-called “Medigap” insurance policy from a private insurer. You can search online for a Medigap policy in your area.
Medicare also offers Medicare Part C, or Medicare Advantage. You must enroll in Medicare Parts A and B to join a Medicare Advantage plan. (Medicare Advantage is the name for private health plans that operate under the Medicare program.)
If you join a Medicare Advantage Plan, the plan will provide all of your Part A and Part B coverage. It also may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most such plans include Medicare prescription drug coverage.
Finally, Medicare offers prescription drug coverage under Medicare Part D. If you are not going to sign up for a Medicare Advantage plan with prescription drug coverage, then you will want to enroll in a prescription drug plan at the same time you enroll in Parts A and B. For every month you delay enrollment past the initial enrollment period, your Medicare Part D premium will increase at least 1 percent.
You are exempt from these penalties if you did not enroll because you had drug coverage from a private insurer, such as through a retirement plan, at least as good as Medicare's. This is called “creditable coverage”; your insurer should let you know if their coverage will be considered creditable.
Visit the Medicare website to find a drug plan in your area.
After you've signed up for Medicare Part B, you can schedule a free “Welcome to Medicare” exam with your doctor.
For more help with the decisions involved in signing up for Medicare, try these resources:
The authors of a nationally syndicated newspaper column on elder law have written a book based on decades of experience helpi...
Read moreIf you are paying for your own insurance, you may think you do not need to sign up for Medicare when you turn 65. However, no...
Read moreAre you approaching age 65 and currently covered by a marketplace health care plan under the Affordable Care Act (aka "Obamac...
Read moreIn addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.
READ MORETo be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.
READ MORESpouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.
READ MOREIn addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.
READ MORETo be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.
READ MORESpouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.
READ MORECareful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.
READ MOREIf steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.
READ MOREThere are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.
READ MORECareful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.
READ MOREIf steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.
READ MOREThere are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.
READ MOREMost states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.
READ MOREApplying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.
READ MOREMedicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.
READ MOREMost states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.
READ MOREApplying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.
READ MOREMedicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.
READ MOREDistinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.
READ MORELearn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.
READ MOREUnderstand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.
READ MOREWe need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.
READ MOREDistinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.
READ MORELearn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.
READ MOREUnderstand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.
READ MOREWe need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.
READ MOREUnderstand the ins and outs of insurance to cover the high cost of nursing home care, including when to buy it, how much to buy, and which spouse should get the coverage.
READ MORELearn who qualifies for Medicare, what the program covers, all about Medicare Advantage, and how to supplement Medicare’s coverage.
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READ MOREUnderstand the ins and outs of insurance to cover the high cost of nursing home care, including when to buy it, how much to buy, and which spouse should get the coverage.
READ MOREWe explain the five phases of retirement planning, the difference between a 401(k) and an IRA, types of investments, asset diversification, the required minimum distribution rules, and more.
READ MOREFind out how to choose a nursing home or assisted living facility, when to fight a discharge, the rights of nursing home residents, all about reverse mortgages, and more.
READ MOREGet a solid grounding in Social Security, including who is eligible, how to apply, spousal benefits, the taxation of benefits, how work affects payments, and SSDI and SSI.
READ MORELearn how a special needs trust can preserve assets for a person with disabilities without jeopardizing Medicaid and SSI, and how to plan for when caregivers are gone.
READ MOREExplore benefits for older veterans, including the VA’s disability pension benefit, aid and attendance, and long-term care coverage for veterans and surviving spouses.
READ MOREGet a solid grounding in Social Security, including who is eligible, how to apply, spousal benefits, the taxation of benefits, how work affects payments, and SSDI and SSI.
READ MORELearn how a special needs trust can preserve assets for a person with disabilities without jeopardizing Medicaid and SSI, and how to plan for when caregivers are gone.
READ MOREExplore benefits for older veterans, including the VA’s disability pension benefit, aid and attendance, and long-term care coverage for veterans and surviving spouses.
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