2004-01-23 / Community

Seniors Encouraged To Enroll In Medicare

Social Security District Manager
Far Rockaway Office
By James M. Glasser
Seniors Encouraged To Enroll In Medicare By James M. Glasser Social Security District Manager Far Rockaway Office

Social Security District Manager
Far Rockaway Office

If you did not take Medicare’s Supplemental Medical insurance (Part B) when you first had the chance, another opportunity is here. January begins the annual three-month "general enrollment period" for Medicare.

As most people know, Medicare coverage generally begins at age 65. There are two parts to Medicare. Hospital insurance, or Part A, covers inpatient hospital care, provides some limited skilled nursing care following a hospital stay and also helps out with some home health care and hospice services.

The other part of Medicare is called Supplemental Medical insurance, or Part B. It helps pay for doctors’ services, outpatient hospital care, ambulance charges and many other medical services and supplies not covered by Part A. Part B is funded by a monthly premium ($66.60 in 2004) that is usually deducted from the Social Security benefit payments of Medicare beneficiaries.

Most people apply for Medicare around the time they turn 65. The Part A coverage becomes effective with the first day of the month you turn 65, or with the month you apply for it if you choose to file later.

However, people can only apply for Part B coverage during certain enrollment periods. The first time you are eligible, called the "initial enrollment period," begins three months before your 65th birthday (including the month you turn 65) and ends three months after that birthday. We strongly encourage you to apply for Part B coverage in the first three months of the enrollment period because your coverage will begin at the same time as your Part A coverage, beginning with the month you turn 65. However, if you wait until the first, second or third month after your 65th birthday, your Part B coverage will not start until one to three months after you apply.

Most people start both parts of their Medicare coverage when they turn 65. The largest percentage of people who do not are those who are still working at age 65 and are covered under an employer’s group health plan, or who are covered under a working spouse’s health plan. In those situations, the employer’s insurance is their primary coverage, and they usually don’t need to pay for Medicare Part B coverage. (They generally take the Part A coverage at 65 because it is free.) But at some point, they or their spouse will stop working and they will lose the employer’s coverage. That is when a "special enrollment period" for Medicare Part B kicks in. It starts with the month that group health care or their employment ends, whichever comes first, and runs for eight more months.

If you did not apply for Part B Medicare during your initial enrollment period or during a special enrollment period, then you can sign up for Part B only during a "general enrollment period." This runs from January 1 through March 31 of each year. But there are disadvantages to waiting for a general enrollment period to apply for Part B. One is that you pay a premium penalty. An extra 10 percent is added onto your Part B premium for each year you delay enrolling in the program. Also, your coverage will not start until July of the year you apply.

For more information about Medicare and enrollment periods, read the booklet, Medicare, published by the Social Security Administration. You can get a copy online at www.socialsecurity.gov/pubs/10043.html. Or by calling 1-800-772-1213.


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