Basic terms identify Medicare time periods
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Medicare is very confusing to me. I am 64 years old and was recently talking to my friend who delayed taking her Medicare, so she told me she’s going to enroll during the “Special” enrollment period and not the “Initial” enrollment period. She also said that if I don’t apply during the “Initial” period I would have to wait until the “General” period since the “Special” period is not available to me, which could in turn cost me a 10 percent monthly fee increase. This is very confusing to me. Can you explain it?
Medicare Illiterate
Dear Medicare,
Try to keep in mind that the words – Initial, General and Special – are basic terms that Medicare uses to identify periods of time for which you can apply for Medicare. Also, all of the Medicare terms that you are asking about are related to Medicare Part B enrollment. So, let’s take a look at each of these individual terms and what they might mean to you.
Initial Enrollment Period – This is your first opportunity to apply for Medicare Part A and B. If you are not receiving your Social Security retirement benefits at age 65 you will need to apply, which you should do during your initial enrollment period which begins three months before the month you turn 65 and ends three months after the end of that month. So, for example, if you turn 65 in September, your initial enrollment period started June 1, and ends Dec. 31.
Savvy Note: You can apply for the Medicare Part A anytime during or after the initial enrollment period. But Medicare Part B enrollment (if you’re not employed and covered by your employer’s health plan) must be within the initial enrollment period or you will have to wait until the general enrollment period which could cost you an increase on your monthly premium.
General Enrollment Period – If you miss applying for Medicare Part B during your initial enrollment period, you’ll have to wait until the next general enrollment period, which is Jan. 1 through March 31 of each year. By doing that, the cost of your Part B may go up 10 percent for each 12-month period that you could have had Part B but didn’t, and you’ll have to pay this extra amount as long as you have Part B, except in special cases, which we’ll cover next.
Special Enrollment Period – The special enrollment period is for special circumstances.
It occurs when you want to delay applying for Medicare Part B because you or your spouse are working and have group health plan coverage through your or your spouse’s employer, providing you work for an employer with 20 or more employees. The special enrollment period is:
Anytime you are still covered by the employer or union group health plan through your or your spouse’s current or active employment.During the 8 months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first).
Avoid the Confusion – The best thing you can do for yourself is to call Social Security at 1-800-772-1213 three months before you turn 65 and enroll in Medicare. This will ensure that your coverage begins as soon as you are eligible, on your 65th birthday and will help you avoid the confusing Medicare terms we just covered.
Savvy Resource – State Health Insurance Counseling Program (SHIP): Offers free one-on-one counseling to Medicare beneficiaries and their families. To locate your local SHIP call Medicare at 1-800-633-4227 or visit www.medicare.gov/Contacts/Related/Ships.asp
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a regular contributor to the NBC Today Show and author of “The Savvy Senior” book.