Medicare
Medicare is a federal health insurance program that covers medical services and supplies in hospitals, doctors’ offices and other health care settings. You qualify for Medicare if you are age 65 or older.* Medicare has four components:**
Part A: Hospital Insurance
Part B: Medical Insurance
Part C: Medicare Advantage Plans
Part D: Prescription Drug Coverage
If you are collecting Social Security benefits at least four months before turning 65, then you are automatically enrolled in Medicare Parts A and B.
If you are within three months of turning 65 and not collecting Social Security benefits, you must enroll in Medicare one of three ways:
Online: www.socialsecurity.gov/retirement
Phone: 800-772-1213
In person: your local Social Security office
You have three opportunities to enroll in Medicare
| Definition | When Coverage Begins | |
|---|---|---|
| Initial Enrollment Period | 7 months, starting three months before you turn 65, the month of your birthdayand ending three months after the month you turn 65 | First of the month you turn 65*** |
| General Enrollment Period | January 1 - March 31 | July 1 |
| Special Enrollment Period | 60 days after group health plan coverage ends | First of the month following month you enroll in Medicare |
In that case, you may delay enrolling in Medicare without paying a penalty if your employer is registered as having over 20 employees. If you do enroll in Medicare while on your employer’s or spouse’s group health plan, your employer-based plan will generally pay first for any health care services you receive if your employer plan is an over 20 registered plan. If your employer is less than 20 registered, you MUST have Medicare.
If your employer is registered with having over 20 employees AND your enrolled plan is NOT Medicare Creditable for prescription coverage, you will owe a penalty.
For detailed information on Medicare and its many components, visit www.medicare.gov.
To find a Social Security office near you, go to www.ssa.gov/locator.
To sign up for and explore your Parts C and D options, log on to www.medicare.gov, hover your mouse over “Sign Up/Change Plans” and click on “Find health & drug plans.”
If you have a health savings account (HSA), all contributions must stop once you enroll in Medicare. However, you may continue to use existing funds to help cover qualified out-of-pocket health care expenses, including premiums for Medicare Parts A, B, C and D.
If your spouse is covered as a dependent under your group health plan and he/she enrolls in Medicare, you may continue to contribute to your HSA, as long as you are not enrolled in Medicare.
Note: If you enroll in Medicare midyear, all HSA contributions will be prorated up to the annual IRS maximum.
Meet Liz
- 64. Married. Birthday is May 15.
- Liz has a group health plan with an HSA through her employer. Here is when her Medicare coverage would start, depending on when she chooses to enroll:
- Once Liz enrolls in Medicare, all contributions to her HSA (including her contributions and her employer’s contributions) end. Her HSA contributions are prorated for the year and she is able to use her existing funds to pay for qualified health care expenses now and when she retires.
- Although Liz may no longer contribute or receive contributions to her HSA, she may continue to receive coverage through her group health plan—in addition to Medicare—as long as she remains enrolled in the plan. Her group health plan pays first for covered health care services she receives.** Medicare then pays for the remaining balance up to the Medicare-approved amount.
