When Must You Sign Up For Medicare?
Medicare is a government program that provides health insurance to individuals 65 years of age and older, as well as disabled workers aged under 65 who have paid into the system. It also pays for medical costs for some people with permanent kidney failure.
Medicare has two parts: Part A and Part B. Part A covers hospitalization and other medical costs. Part B covers outpatient costs. Each part has a monthly premium and deductible. In 2014, the Part B premium is $104.90 and the Part A premium is $248.60. You must enroll in Part B when you're first eligible, which is at age 65. You can sign up for Part A three months prior to your 65th birthday, and you don't have to pay a monthly premium for it, but you'll be responsible for a deductible.
There are also three subparts of Medicare: Part C, Part D, and Part E. Under Part C, people buy private policies through what's called the Medicare Advantage program. Under Part D, private companies cover prescription drugs. Under Part E, Medicare pays for some medical services.
The Affordable Care Act requires that most people have health insurance. Those who don't will be fined. Although Medicare is insurance, it's not considered to be health insurance under Obamacare.
So, whether or not you must sign up for Medicare depends on your age and eligibility. If you're eligible for Medicare under the program's rules, you must sign up for Parts A and B. However, if you're eligible for Medicare under the Affordable Care Act rules, you must have health insurance, but you don't have to sign up for Medicare.
You may also be eligible for Medicare if you have certain disabilities or have received Social Security Disability Insurance or SSI benefits for more than 24 months. Also, certain people who receive Workers' Compensation payments are eligible for Medicare.
Those who have permanent kidney failure are eligible for Medicare. In addition, their spouses and children may also be eligible if they have certain disabilities or are receiving Social Security Disability Insurance or SSI benefits.
Certain people who are 65 or older can sign up for Medicare Part A without having to pay a premium. This is called “premium-free Part A.” They must, however, pay a monthly premium for Part B.
Medicare Part C is an alternative to traditional Medicare. It covers the same benefits as traditional Medicare, but it also has a drug plan. It's available to people who voluntarily choose it, and the premiums are the same as those for Part B.
Medicare Part D is prescription drug coverage, and it's optional. If you're enrolled in Part D and your medical plan covers prescription drugs, then you won't be able to sign up for Part D. To enroll, you have to be a member of a Medicare Advantage plan, or you can sign up directly with a Part D plan. Most Medicare Part D plans require a monthly premium.
Medicare Part E is voluntary coverage. It pays for some medical costs that aren't covered under Parts A and B.
Medicare is a complex program, and it has many rules and regulations. Here are some useful resources to help you understand it:
Medicare.gov, the official site of the Medicare program.
The Centers for Medicare and Medicaid Services (CMS) is a federal agency.
The Social Security Administration (SSA) administers Medicare.
The HealthCare.gov portal is one of many sites that provide information about the Affordable Care Act.
Medicare Part C Plans
If you aren't eligible for premium-free Part A, you can still sign up for Part A and enroll in a Medicare Part C plan. Medicare Part C plans are administered by private insurance companies that agree to accept Medicare's payment rates. A Part C plan may also include prescription drug coverage.
Medicare Part D Prescription Drug Plans
You can also enroll in a Medicare Part D plan if you have Part A and B and don't already have prescription drug coverage. In 2015, there were over 450 different Medicare Part D plans, and they vary greatly in their premiums, cost-sharing, and formularies. Medicare pays for most of the cost of covered drugs, and you pay a deductible before the plan starts paying. The plan must cover at least two drugs in every category of drugs.
What the Affordable Care Act Means for Medicare
Medicare's rules are changing under the Affordable Care Act. For example, if you have a Medicare Advantage plan, you'll stop paying a premium for Part A, except for the first month of your enrollment. Also, Medicare Advantage plans will be more competitive. Medicare Advantage plans will be able to expand their provider networks and offer more comprehensive coverage.