Q: I am turning 65 later in 2012 and wondering how I join Medicare? Does it happen automatically?
A: First, I must say this is the most frequently asked question lately. I recently heard a statistic that says there are 10,000 individuals turning 65 every day in America. I guess a lot of them are in Chautauqua County! I appreciate people paying attention to this event and all the media coverage of Medicare issues.
Medicare coverage eligibility begins at age 65 (some individuals get Medicare coverage earlier due to a disability). Individuals who have worked 40 quarters (10 years) are usually eligible for Medicare at age 65. Historically, at 65 individuals also became eligible for full Social Security benefits. Many now understand that Social Security benefits have changed. You can continue to receive early retirement benefits from Social Security at age 62. To receive full benefits you now have to be older. If born in 1943 to 1954, you must be 66 years of age in order to receive full Social Security benefits. Due to this Social Security change, Medicare has changed its policies. If you are collecting Social Security in some form (widow's benefits, early retirement benefits, disability or other types) then Medicare will start automatically at age 65. Medicare will send you a packet of information with your Medicare card about three months before your 65th birthday. If you accept the benefits you do not need to act to have your benefits begin. You simply tear off the card, sign it and put it in your wallet. Your coverage will begin automatically the first of your birthday month.
If you do not want to enroll in Medicare Part B (which costs $99 monthly in 2012) you send back the card and have just Medicare Part A. To return the card, you must sign the refusal statement on the back prior to mailing it back to Social Security Administration. You would only refuse Medicare Part B if you had insurance coverage already from yourself or your spouse from a current employee plan. Please do not refuse Medicare Part B if you are using a retiree plan, COBRA-type coverage or similar situation not requiring employment.
If you are not collecting Social Security benefits, then you must contact the Social Security Administration to begin receiving Medicare benefits at age 65. This is a change for those of you close to age 65. If you do not enroll when originally eligible, you will have some restrictions as to when you can enroll and also may have premium penalties when you enroll.
When you contact Social Security, they will review your situation and help you determine whether or not you need Medicare Parts A and B. You may choose to enroll in Part A and not Part B. They also will explain the billing procedure for paying for Medicare Part B. Since you are not collecting Social Security, you can't have it deducted from that check. They will send you an invoice every three months to pay your Part B premium amount (usually $99.90 x 3).
As individuals retire or age into Medicare, their insurance situation can change dramatically. There are a multitude of options open to those with Medicare. The terms are different, the prices are different, the products offered are dramatically different each year.
The purpose of this column is to give those who are eligible for Medicare, or soon to be eligible for Medicare, some understanding of their insurance options and how it could impact their health and finances.
These questions and answers are meant as a guide to help you understand the complex questions you are now thinking about. Each individual's specific situation may create a different solution. You shouldn't necessarily do what your friends, family and neighbors do.
Another fact to consider is that if you have insurance from another source you may not have to enroll in Medicare at age 65. The other source must be an employer plan of either yourself or your spouse's full time active employment. Most retiree plans require you to join Medicare at age 65 if you want to continue to receive coverage from their plans.
I cannot stress enough how important this decision is with regard to refusing Medicare or not signing at the correct time. If you have any doubts or are not sure what to do, contact the Social Security Administration prior to your 65th birthday and find out what you should do. If you receive the packet automatically, you will probably receive it three months prior to your 65th birthday. If you don't receive it, go to the local Social Security Administration office at 321 Hazeltine Ave. in Jamestown, call the local SSA office at 877-319-9182 or call 800-772-1213 to clarify your particular situation.
In some situations, if you wait until after your 65th birthday to contact Social Security and you don't start Medicare at the appropriate time, you may have time without coverage, or penalties to pay.
It is your 65th birthday - celebrate it early by getting your Medicare situation straightened out ahead of time. Welcome to Medicare!
Janell Sluga is a geriatric care manager certified and works for Senior Life Matters, a program of Lutheran Senior Housing, and has worked in Chautauqua County with seniors for more than 18 years. She is HIICAP (Health Insurance Information, Counseling & Assistance Program) counselor-trained by Office for the Aging. She does not sell insurance or represent any insurance company. She is an unbiased source of insurance and education to help seniors choose the best option for them.
You may submit questions to be answered in later columns to Janell Sluga at Senior Life Matters, 737 Falconer St., Jamestown, NY 14701, or call 716-720-9797, or by email at firstname.lastname@example.org. Please remember that not all questions can be answered in this format, but as many as can be, will be.