Are you planning on retiring soon? Then you may want to know: when does Medicare start?
Does Medicare start on my 65th birthday?
You are eligible for Medicare if you are an American (or a US resident for five years) aged 65 and above, or if you are under 65 and have been receiving disability benefits for at least 24 months.
If you are already receiving Social Security or Railroad Retirement (RRB) benefits, you are automatically enrolled in Original Medicare when you turn 65.
Otherwise, you should proactively enroll in Original Medicare when you turn 65.
When does Medicare kick in for Original Medicare?
When your coverage under Original Medicare begins, you will have Part A (Hospital) and Part B (Medical) benefits.
The best time to enroll is during your Initial Enrollment Period (IEP) – a seven-month period that starts three months before turning 65.
| Signup Date | Start of Coverage |
|---|---|
| Any time in the three months before your birth month | 1st day of birth month |
| During your birth month | 1st day after birth month Note: If your birthday falls on the 1st of the month, coverage starts on 1st day of the previous month |
| One month after birth month | Two months after signup |
| Two to three months after birth month | Three months after signup |
If you missed your IEP, the nearest enrollment period is the General Enrollment Period (GEP) – January 1 to March 31. Coverage starts the month after you apply.
When does coverage start under a Medigap plan?
A Medigap plan will help in paying the out-of-pocket costs that you are required to pay under Original Medicare.
During the Medicare Supplement OEP, you have ‘guaranteed issue rights.’ This means that private insurers cannot deny coverage or charge you more based on your health condition.
| Signup Date | Start of Coverage |
|---|---|
| You can purchase a Medicare Supplement plan anytime during the year if you are on Original Medicare. Note: The Medicare Supplement Open Enrollment Period is the 6-month period starting on the 1st day your Part B coverage starts or is in effect after your 65th birthday. During this period you have ‘guaranteed issue’. | You can select the date you want to enroll. |
It may be more difficult to get a Medigap plan after this one-time guaranteed as you will need to answer health questions or pay more to cover pre-existing health problems.
What month does Medicare start if I choose a Medicare Advantage plan?
Many seniors enroll in Medicare Advantage (or Part C) plans, in part because of the additional benefits these plans offer. These are the enrollment periods:
| Signup Date | Start of Coverage |
|---|---|
| Initial Enrollment Period | Typically same as Original Medicare |
| Annual Enrollment Period (AEP) October 15 to December 7 | January 1 of the following year |
| MA Open Enrollment Period (MA-OEP) January 1 to March 31 | 1st day of the month after your request is received |
When does Medicare coverage start for Part D plans?
You may need a standalone prescription drug plan (PDP) under traditional Medicare. You can enroll during these enrollment periods:
| Signup Date | Start of Coverage |
|---|---|
| Initial Enrollment Period (IEP) | Typically same as Original Medicare |
| Annual Enrollment Period (AEP) October 15 to December 7 | January 1 of the following year |
When does Medicare coverage start if I switch plans?
You can switch plans during these periods:
| Signup Date | Start of Coverage |
|---|---|
| Annual Enrollment Period (AEP) | January 1 next year |
| MA Open Enrollment Period (MA-OEP) | 1st day of the month after your request is received |
| Special Enrollment Period (SEP) Note: Under special circumstances only | 1st day of the month after the qualifying event |
At what age does Medicare start if I continue working?
Most seniors are covered by premium-free Part A if they have contributed Medicare taxes for ten years.
If you continue working after 65, you can defer Part B enrollment (without penalties) as long as you have ‘creditable coverage.’ This term refers to a situation where you (or your spouse) have job-sponsored medical and drug insurance equivalent to Medicare.
Your next question might be – When can I start Medicare if I stop working?
If you lose creditable coverage, these are your enrollment periods:
| Signup Date | Start of Coverage | |
|---|---|---|
| Part A (if qualified for free premiums) | Anytime (no penalty) | Retroactive coverage for a maximum of 6 months if you did not get it when you turned 65 |
| Part B | Eight-month period after your employer coverage ends | 1st day of the month after you signup |
| Medicare Advantage / Part D Drug Plan | Within 63 days of losing employer coverage | 1st day of the month after you signup |
Final Words
It is important to enroll in Medicare during the correct time periods. If you miss these enrollment periods, you may face higher premiums, penalties, and fewer options.
The CoverRight team is here to help you navigate your Medicare options and find the plan that works best for you!
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