If you are starting your Medicare journey in 2023, you’ll realize how complex it can be. It’s better to start early, even though it may seem daunting. You can start with the basics and then move on to the different plans. However, your insurance is an important decision, and there can be costly mistakes if you miss an enrollment or don’t pay close attention to your plan details.
Medicare’s coverage can be quite different from your previous insurance. You may consider getting some services before Medicare, such as an annual physical because Medicare does not cover your typical yearly physical. Instead, it covers a Welcome to Medicare visit. You may want to know what to expect from your Welcome to Medicare Visit to determine if you’d wish to have an annual physical before you begin Medicare.
If you’re wondering what your next steps are, here is how you can get ready for Medicare in 2023.
Will you be automatically enrolled in Medicare?
You’ll be automatically enrolled in Medicare Parts A and B if you receive Social Security benefits at least four months before your 65th birthday month. This means you don’t have to apply manually. Your Medicare card should arrive in the mail about 3-4 months before your birthday month. Once you have your card, you can set up your MyMedicare account, which you can use to track claims and payments.
Some people qualify for Medicare before 65 if they’ve been receiving Social Security Disability Income for at least 24 months, have ALS, or have End-Stage Renal Disease and need a transplant or dialysis. If you fit those criteria, you will automatically be enrolled in Medicare.
Enrolling in Medicare
You are given a 7-month Initial Enrollment Period window that starts three months before your 65th birthday month and ends three months later. If you are not automatically enrolled in Medicare, you can enroll in Medicare during this window. It’s important to know that if you apply during the three months before, your Medicare benefits will start the 1st of your birthday month, and if you apply during the three months after, they will start the 1st of the following month.
If you miss this window, you may accrue a late enrollment penalty. However, there is an exception.
Working past 65
If you or your spouse actively work for an employer with 20 or more employees and that insurance covers you, you can delay Medicare past your Initial Enrollment Period. You will not be penalized for delaying Medicare in this situation. You can wait until retirement to set up your Medicare.
However, if you work for a small employer with fewer than 20 employees, you will want to enroll in Medicare during your Initial Enrollment Period to avoid the late enrollment penalty.
Retiree coverage, Tricare for Life, and VA benefits
Retiree coverage, Tricare for Life, and VA benefits are not creditable for Medicare, so enrolling in Medicare during your Initial Enrollment Period is critical. If you fail to enroll in Medicare when you’re first eligible, you will have a late enrollment penalty. You must wait for the General Enrollment Period from January 1st to March 31st to apply.
Paying for Medicare
Before you start Medicare, knowing how to pay for it is essential as that can make a difference in your budget. When you receive Social Security benefits before you start Medicare, you’ll see your premiums deducted monthly from your Social Security check once Part B is effective.
You will be billed quarterly for your Part B premium when enrolled in Part B but not receiving Social Security benefits. This can be a hefty bill, so putting money aside is a good idea if you are anticipating a bill.
Research the basics
To prepare for Medicare in 2023, you should start with the basics. You should know what Medicare Part A and B cover so you know what to expect. Part A helps cover your inpatient hospital costs, while Part B helps cover your outpatient medical expenses. The federal government provides these two parts to beneficiaries.
When you understand Medicare Parts A and B, you can dive into the additional plans such as Part C, Part D, and Medicare Supplement (Medigap). Insurance companies provide these options and can vary by zip code. Most people enroll in these plans because Original Medicare Part A and Part B do not cover 100% of your costs or retail drugs.
Many free resources are available to beneficiaries that help break all of this down.
Enrollment windows for additional plans
You must have Parts A and B to enroll in a Medigap or Medicare Advantage plan. The time to enroll in one of these additional plans depends on the plan type. For example, you are given a one-time 6-month Open Enrollment window to enroll in a Medigap plan with no underwriting. This window is based on your Part B effective date.
With Medicare Advantage plans, you can use specific election periods to enroll in a plan. Your first election period is around your 65th birthday month. If you miss that window, there is another election period each year that allows you to enroll in a plan or change plans.
Understanding these windows is necessary so you don’t miss an opportunity to get a plan that best fits your needs.
Getting ready for Medicare in 2023 can seem overwhelming, but you don’t have to figure it out alone. Give yourself time to research your options and connect with a licensed Medicare agent to help you along the way.