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Medicare enrollment

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POSTED May 18, 2012 9:56 p.m.

 

Regular readers of this column know that I don't like to get into Medicare issues. I retired in 2005 following a 32 year career with the Social Security Administration.

And despite what many people think, Medicare is not run by SSA. It is managed by a federal agency called the Centers for Medicare and Medicaid Services. But the problem is that CMMS does not have any field offices. On the other hand, SSA has a network of about 1,200 branch offices in big cities and small towns across America. So CMMS contracts with SSA to help people enroll in the Medicare program. That means that as a general rule, SSA employees (and frumpy old SSA retirees like me) know a few things about Medicare enrollment issues. But after we get you signed up for Medicare, we wash our hands of you and let private industry take over. CMMS works with insurance companies around the country to actually run the Medicare program. And good luck with that!

So I bill myself as a Social Security expert, but not much of a Medicare expert. However, when I get questions about Medicare enrollment, I am usually able to answer them. Here are a couple examples.

Q. I have been getting Social Security since age 62. I will be 65 in October. When and how should I sign up for Medicare?

A. You won't have to do anything but watch your mailbox! They used to make everyone apply for Medicare in person a few months before turning 65. But government officials realized that about 98 percent of seniors already getting Social Security benefits applied for Medicare upon reaching their 65th birthday. It dawned on them that they might as well automatically enroll all current Social Security beneficiaries in Medicare at age 65 — and let the two percent who don't want Medicare take some action to decline it.

So, about three months before your 65th birthday, you will get a "Medicare Enrollment Package" in the mail. Assuming you want both parts to Medicare (I'll explain that in a minute), you simply sign the Medicare card that comes with the package and file it away with your other important household papers. That's it. You don't do anything else. You'll be an official beneficiary of Medicare effective with October 1, 2012.

There are two main parts to Medicare. Part A, or hospital insurance, is free. Actually, you paid for it throughout your working life with the Medicare taxes that were deducted from your paychecks.

The other half of traditional Medicare, called Part B or doctors/medical insurance, isn't free. You pay a monthly premium (about $115 for most people) that is deducted from your Social Security check. Since you pay for this insurance, you have the option of declining it. But because of the way the insurance industry is structured in this country, almost everyone must take Part B. About the only people who don't need it are those who are still working and are covered by an employer's insurance plan. (See the next question.)

If you don't want Part B, you sign the back of the Medicare card that comes in the enrollment package indicating you are declining Part B. You mail that card back to the government and they send you another card that says you have Part A coverage only.

Q. I will be 65 in September. I am still working and covered by my employer's insurance. I plan to continue working as long as I am healthy. I understand I don't need to apply for Medicare at 65, is this right?

A. No, it's wrong. You need to sign up for partial Medicare coverage. And because you are not yet getting Social Security benefits, there is no automatic enrollment for Medicare as discussed in the answer to the first question. So the ball is in your court.

You should apply for Medicare's Part A coverage a couple months before your 65th birthday. As explained in the prior answer, Part A is free. So even though you will probably be fully covered by your employer's insurance and won't need Part A until you retire, you might as well apply for it now. Also, you might learn that your employer's insurance wants you to take Part A to supplement their coverage.

However, because you're working and covered by your employer's insurance, the law says their coverage is primary, so you can save $115 per month by not signing up for Medicare's Part B.

Once you retire or otherwise lose your employer's full coverage, then you must apply for Part B. And when you do so, you won't pay any delayed enrollment penalties that normally apply to folks who don't take Part B at age 65 but later decide they want it.

 

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