Helping a Parent or loved one with Medicare Enrollment
As fall is just around the corner, there are several important dates to remember for Medicare beneficiaries and those eligible for the first time for Medicare Part A and Part B.
First, not everyone needs to enroll in Medicare A & Medicare B.
Enrollment is NOT necessary if your loved one is:
- Getting benefits through Social Security
- Getting benefits through the Railroad Retirement Board
- Disabled and receiving disability benefits for ALS
If they fall into one of those categories, they will be automatically enrolled the first day of the month they turn 65.
If they are under 65 and receiving disability benefits from either social security or the railroad retirement board, then they will receive Medicare after 24 months of disability benefits.
If your loved one has ALS, they will get Part A & B automatically the same month their disability benefits apply.
When can my parent or loved one enroll in Medicare?
If none of the above factors apply to your parent or loved one, Medicare eligibility and when to enroll is based on several factors.
First, let’s look at the Initial Medicare enrollment period.
Assuming that your loved one is:
- Not receiving Social Security Benefits
- Not receiving Railroad Retirement Board Benefits
- Not disabled
- Does not suffer from End Stage Renal Disease
- Does not suffer from ALS
Then they will first become eligible 3 months before they month they turn 65. Their eligibility will end 3 months after the month they turn 65.
IF they enroll during the 3 months prior to your birth month, benefits will start the first day of their birth month.
If they enroll in the 3 months after your birth month, the start date will be delayed.
What if my parent or loved one missed the Initial Medicare enrollment period?
If for some reason your loved one missed the Initial enrollment period, they can sign up between January 1 and March 31, known as General Medicare Enrollment.
Benefits enrolled in during this period will begin July 1.
Note that your loved one may have pay a higher premium for enrolling during the General Medicare Enrollment versus the Initial Medicare Enrollment.
What if my parent or loved one already gets Medicare A & B but wants to make changes?
If your loved one already receives Medicare Benefits, here are the dates to pay attention to:
Open Enrollment begins: October 15
All Medicare recipients can make changes to their health and prescription drug plans for the next year.
Open Medicare Enrollment ends: December 7
December 7 is the last day you can make changes to your Medicare coverage for the next year. The plan has to get your medicare enrollment request /application by December 7 so it may be a good idea to take this into consideration when mailing.
Coverage Begins: January 1
If you switched or made changed to a plan the benefits will take effect January 1. If you don’t change your coverage any changes to benefits or costs for the new year will also begin on January 1.
Making changes to your coverage after January 1
You can leave your Medicare Advantage Plan and switch to Original Medicare. If you do, you will have until January 14 to join Medicare Part D, the prescription drug portion of Medicare.
Coverage Begins: The first of the month after your medicare enrollment form is received.
I’m ready to help my parent or loved one with their Medicare Enrollment.
I’m still confused, how can I help my loved one be sure they are getting the right benefits?
- Use the Medicare Plan Finder at Medicare.gov/find-a-plan.
- Check the most recent “Medicare & You” handbook
- Review any information from your current plan, particularly any “Annual Notice of Change” letter.
- Call 1-800-MEDICARE (1-800-633-4227), and say “Agent.” Agents are available 24 hours a day, including weekends.
- Get health insurance counseling free from your State Health Insurance Assistance Program (SHIP). To find your SHIP, visit Medicare.gov/contacts, or call 1-800-MEDICARE