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Horizon Elder Law & Estate Planning Blog

Thursday, August 20, 2020

Do I Automatically Get Medicare When I Turn 65?

No, you do not automatically get Medicare when you turn 65. You have to apply for Medicare and meet the eligibility requirements. You can face financial penalties if you do not sign up for Medicare by the deadline. There are multiple parts to Medicare and many options available for coverage. A California elder law attorney can help you navigate through the application process and appeal denials of eligibility or coverage.

Unfortunately, too many people assume that they automatically get Medicare when they turn 65. They run into problems when they realize that they do not have health insurance for their golden years and see firsthand the high cost of aging in America.

When to Apply for Medicare

You should apply for Medicare by your 65th birthday. You can apply anytime during the three months before and the three months after you turn 65. It is best to apply as soon as you can to avoid a lapse in coverage. In other words, you have a seven-month enrollment window.

Your Medicare Part B coverage, for outpatient care, is not effective immediately. If you need to see the doctor within the first three months after you turned 65, Medicare might not pay for it unless you signed up well in advance.

Medicare will charge you a late enrollment penalty for Part B coverage if you delay your enrollment. This penalty is not a one-time charge. Medicare will tack on this penalty every single month as long as you have Part B coverage.

If you did not sign up for Medicare Part A (hospitalization or in-patient coverage) and or Part B when you were first eligible, you can enroll during the General Enrollment Period, which happens every year from January 1 to March 31. Your coverage will begin on July 1 of that year. You might have to pay a higher premium for part A and or Part B because of late enrollment.

How Much Medicare Costs

For most people, Medicare Part A is free If they qualify for Medicare and enroll when first eligible. If you are 65 years old, and you or your spouse paid Medicare taxes out of your paychecks for enough time (usually 10 years), you can generally get “premium-free Part A.” In these situations, you might get premium-free Part A at age 65:

  • You already receive Social Security retirement benefits or railroad retirement board benefits.
  • Although eligible for those benefits, you have not yet filed for them.
  • You or your spouse worked for a long enough time in a government job that had Medicare coverage.

If you are not eligible for part A coverage at no cost because you did not pay into the Social Security/Medicare system, you can purchase part A by paying monthly premiums. You might have to pay as much as $458 every month (as of 2020). People who have to pay for Medicare Part A usually have to buy Part B coverage as well and pay monthly premiums for both.

Your Medicare Plan Options

Private insurance companies negotiate with Medicare to provide coverage similar to Medicare Parts A&B. Many of these private plans offer coverage for items that Medicare does not pay. Some private plans also help with copays and deductibles.

Contact us today to speak with a member of our team. Our California elder law attorney can answer your questions about eligibility, coverage, and claims.


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