As an “experienced” insurance professional with over 30 years in the industry, I was not prepared for just how challenging Medicare coverage is.
Then my mother’s retiree coverage changed.
- Secondary coverage through an insurer was gone
- In its place – a flat amount through a Health Reimbursement Arrangement
- Enter Medicare Advantage and Medicare supplement plans (Medigap)
I quickly discovered something. Medicare basics are not so basic.
Medicare Basics: A Beginning
In addition to the changes in my mother’s insurance coverage, there is the little issue of my own rapidly approaching eligibility in Medicare.
Perfect time for education, right?
So, a plan was born. Over the year, I’ll walk you through some of the basics of Medicare coverage.
- When you’re eligible
- The different Medicare parts
- How other coverage works
As I find good resources, I’ll share those. I may create a few of my own.
Perhaps I can spare some of you from the pain of starting from scratch. But first ~ a big disclaimer.
I am not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal, insurance or health care advice as to your specific circumstances. I recommend reviewing your options with a qualified insurance adviser.
You may be surprised to learn Medicare is not only for old people. As one of those old people, my definition of old has changed. I’ll try not to twitch at the reference.
There are multiple factors affecting your Medicare eligibility.
- End stage renal disease (ESRD)
- Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
This factor is probably the one you are most familiar with. Trust me when I tell you it arrives sooner than you think.
You may believe Medicare starts once you reach the magic age of 65 years old. However, did you know you can sign up before your birthday?
The initial enrollment period (or IEP – we love our acronyms) starts 3 months before your birthday. For example, my birthday is the end of November. I am eligible to enroll in Medicare on August 1 of the year I turn 65.
However, if I would enroll in August, Medicare is not effective until November 1 (the month of my 65th birthday).
The IEP ends three months after the end of the month of your birthday. So for me, I have between August 1 and February 28 to sign up.
Medicare.gov has a handy calculator for you to check your (or a family member’s) eligibility. I also created the chart below for your reference.
Note: The above applies the first time you or your family member sign up IF the following also applies.
- The other 3 factors shown above do not apply to you (disability, ESRD, ALS)
- You worked at least 10 years in which you paid Medicare taxes
- You live in the U.S. or one of its territories
If you or your family member has other coverage (like through an employer), it can affect Medicare coverage. We’ll discuss more about that in a future post.
To Be Continued
Deep breath. We’ll get there. In my next post, I’ll review the other 3 factors (disability, ESRD, ALS) and how each affects Medicare eligibility.
I figured baby steps may make this easier. I know too much fries my boomer brain.
Are you ready for the rest of the ride?
Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.