When can I get Medicare benefits?

Unless you’re disabled, the answer is 65 years old. A common misconception among  Americans is that you can get Medicare as soon as you claim Social Security benefits, which can be as early as age 62. Unfortunately, even if you retire early and claim your Social Security Benefit early, you’ll have to wait until 65 before you’ll be covered for Medicare.

How do I apply for Medicare?

You may not have to. If you’re already receiving Social Security retirement benefits when you turn 65, you’ll be enrolled in Medicare automatically. If this is the case, you’ll be automatically enrolled in Parts A and B of Medicare (more on the parts in a bit), and you can expect to receive your Medicare benefits card about three months before you turn 65.

If you aren’t receiving your Social Security retirement benefit when you turn 65, you’ll have to apply for Medicare, which you can do quite easily on the Social Security Administration’s website. It’s advisable that you contact Social Security 2 to 3 months prior to your birth month to enroll in Medicare to ensure your Medicare will start when eligible.

What are the "parts" of Medicare?

There are four “parts” of Medicare. Here’s a quick rundown of each part:

*  Part A is Hospital Insurance or HI.  This primarily covers hospital stays and some stays in skilled nursing facilities

*  Part B is Medical Insurance. This covers doctor’s visits, lab tests, and outpatient procedures, just to name a few.

*  Part C is Medicare Advantage. These are plans offered by private insurance companies to provide Medicare benefits.

*  Part D is Prescription Drug Coverage. 

Parts A and B are collectively referred to as “Original Medicare” and are generally what’s being referred to when I use the term Medicare.

What does Medicare not cover?

One of the most important things for seniors to know is what Medicare doesn’t cover. While this isn’t an exhaustive list, Medicare usually doesn’t cover services such as long-term care, routine dental or vision exams, prescription glasses, dentures, acupuncture, hearing aids, or routine foot care.

This list is what Original Medicare (Parts A and B) doesn’t cover. Certain Medicare health plans may cover some of these services.

What is Medigap?

Since there are many co-pays and deductibles with Medicare, private insurers sell Medicare Supplemental Insurance Plans, or Medigap plans. There are currently 10 different varieties of Medigap plans. While Medigap plans are standardized in terms of the coverage they provide, costs can vary significantly.

I have health insurance already through an employer. Do I have to enroll in (and pay for) Medicare at age 65?

It depends what kind of health insurance you have. If you have insurance through your employer or your spouse’s employer and the primary insured is still working, you may not be required to enroll in Medicare as long as the company sponsoring your coverage has at least 20 employees. In this case, you’ll  have a special enrollment period after you (or your spouse) retire or leave that employer.

On the other hand, if your insurance is through an employer you’ve already retired from, you still have to sign up at 65. If you are required to sign up for Medicare Part B, and don’t, you’ll face a permanent penalty of 10% of the Medicare Part B premium for every year you were supposed to enroll but didn’t.

It’s also worth noting that since for most people Medicare Part A is premium free, it generally doesn’t make sense to delay signing up for it, even if you’re not required to. If your employer’s group plan has over 20 employees then usually it will be your primary coverage, and Medicare will be secondary. However, since Part B comes with a premium, it may make sense to wait if you’re still covered by your employer’s plan.