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Medicare Part A, B, C and D

MEDICARE PART A

Medicare Part A helps cover inpatient hospitalization, hospice, and home health care costs. To avoid late enrollment penalties, enroll in Medicare Part A (and Part B) during your Initial Enrollment Period when you first become eligible at 65 or, if you are still working after age 65 and have employer-provided coverage, during your Special Enrollment Period.

If you fail to enroll in Medicare Part A within three months of your 65th birthday (unless you qualify for a Special Enrollment Period), you will be liable for uncovered medical costs, and you will also pay a 10% penalty in additional premium payments for every 12-month period that you fail to enroll. You’ll have to pay the higher premium for twice the number of years you could have had Part A, but weren’t enrolled in the program.

If you’re already getting benefits from Social Security, you’ll automatically get Medicare Part A (and Part B) starting the first day of the month you turn 65. (If your birthday is on the first day of the month, Part A (and Part B) will start the first day of the prior month.) You can also request that the Part B premium be paid automatically from your Social Security check.

If you are not receiving Social Security benefits when you turn 65, to avoid late enrollment penalties, you must enroll in Medicare Part A during the 7-month initial enrollment period, which begins three months preceding the month in which your 65th birthday falls, includes the month in which you turn 65, and ends the three months after, unless a Special Enrollment Period applies.

You can apply online if you meet certain requirements.

You can find answers to questions about the online application here.

MEDICARE PART B

This helps cover doctors’ services – and many other medical services and supplies that are not covered by Medicare Part A such as lab tests, ambulance transportation, second opinions, durable medical equipment like CPAPs, and some preventive services.

If you enroll in Part B late, you will also be liable for uncovered medical costs, and may have to pay a late enrollment penalty for as long as you have Part B coverage. For each 12-month period you delay enrollment in Part B, you will have to pay an extra 10% of the Part B premium, unless you qualify for a Special Enrollment Period.

Make sure you pay your Medicare Part B premium. Simply signing up does not grant coverage.

IF YOU ARE WORKING AT A JOB THAT PROVIDES HEALTH COVERAGE then you do not need to enroll in Part B during your Initial Enrollment Period to avoid late penalties and can wait, if you wish, until your employer-supplied health coverage runs out. You have eight months that begin the month after your employment ends or your employer-supplied health coverage ends (whichever happens first) to enroll in Medicare Part B. (See this chart for more details)

IF YOU ARE NOT WORKING AT A JOB THAT PROVIDES HEALTH INSURANCE COVERAGE then to avoid late penalties you need to enroll in Medicare Part B (as well as Medicare Part A) in the 7-month Initial Enrollment Period, which begins three months preceding the month in which your 65th birthday falls, includes the month in which you turn 65, and ends in the three months after.

If you are not receiving health coverage from employment, then to avoid late penalties you will want to enroll in a timely manner for Medicare Part B.

If you fail to enroll in Medicare Part A in the initial enrollment period (unless you qualify for a Special Enrollment Period), you will be liable for uncovered medical costs, and you will also pay a 10% penalty in additional premium payments for every 12-month period that you fail to enroll. You’ll have to pay the higher premium for twice the number of years you could have had Part A, but didn’t enroll. If you enroll in Part B late, you will also be liable for uncovered medical costs, and may have to pay a late enrollment penalty for as long as you have Part B coverage. For each 12-month period you delay enrollment in Part B, you will have to pay an extra 10% of the Part B premium, unless you qualify for a Special Enrollment Period. (Please note: Make sure you pay your Part B premium. Merely signing up does not activate coverage.)

Appendix D lays out the monthly premium cost for Part B as of November 2015.

MEDICARE PART C

Most writers elect Medicare Part C only if they are not covered as a Certified Retiree. You may want to consider whether Part C is right for you based on your needs.

Technically, this is called Medicare Advantage, but it is almost universally referred to as Medicare Part C. It works like this: Private companies offer healthcare plans that Medicare approves. If you join a Medicare Advantage Plan, you still have Medicare, but you’ll get your Medicare Part A and Medicare Part B coverage through the Medicare Advantage Plan, not Original Medicare.

Medicare Advantage might place you in an HMO like Kaiser, or in an open-access or gatekeeper plan such as are typically offered by large health carriers like Blue Cross. If the cost-certainty of such a situation appeals to you despite the other restrictions you are likely to encounter, then this might be an option you would select.

MEDICARE PART D

This is Medicare’s drug coverage program. The Health Fund has what Medicare refers to as “creditable” drug coverage. What this means is that the Health Fund has determined that its prescription drug coverage is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay. If you decide to keep Fund coverage and not opt for Medicare Part D when you are first eligible, you will not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

If you decide to opt for Medicare Part D, your Fund drug coverage is suspended until such time as you no longer have Medicare Part D coverage.

If you are a Certified Retiree, one reason it might make sense for you to purchase Medicare Part D is if Medicare’s formulary carries a drug you need that the Health Fund does not and the cost of that drug is prohibitive.

If you are not a Certified Retiree and are not on Earned Coverage, you may want to consider signing up for Medicare Part D to cover your prescription needs.