Going on Medicare for the First Time? (Part 1)

When Medicare season rolls around, we like to bring in a pro to offer up some insight. We bring to the platform Max Bernadsky, one of our resources in the insurance industry, who provides invaluable information for first-time Medicare enrollees. Here’s Part 1.

For many people, the thought of trying to figure out the Medicare system is overwhelming. When you turn 65 you start receiving a LOT of phone calls, sometimes in the double digits per day.  Perhaps what is most annoying about these calls is that the person on the other end of the line does not really understand your situation or your needs.  They just want to sell you something. That leaves you at a loss for what you need in order to get Medicare coverage and to have the coverage be what you need. Below are the basics of what you need to know about your first foray into Medicare.

Election Periods

The first thing that will be very helpful in your Medicare journey is understanding the different election periods.  The four main election periods are IEP (Initial Election Period), AEP (Annual Election Period), OEP (Open Enrollment Period), and SEP (Special Election Period).

IEP (Initial Election Period)

IEP is the 7-month window in which you can enroll in Medicare when you first turn 65.  You have three months before you turn 65, the month you turn 65, and three months after you turn 65 to get the entire process of joining Medicare done.  If you do not do it during this window you may suffer penalties which we will talk about later.

AEP (Annual Election Period)

AEP happens every year from October 15th to December 7th.  This is the time of year when you get to review your Medicare plan for the following year and switch to a new plan if beneficial.

OEP (Open Enrolment Period)

OEP happens from January 1st to March 31st every year.  This is a time when people with a Medicare Advantage plan can switch to a new plan or go back to original Medicare.  It should be noted that if you have a Medicare Advantage plan you still need to review it and make any changes you want during AEP from October 15th to December 7th.  OEP is primarily used when people switch their plan during AEP and then change their mind.

SEP (Special Election Period)

This is an election period that is triggered by a life change.  Some examples include moving to a new county or state, retiring after turning 65, or losing creditable health coverage, covered below.

Medicare Part A & B

Signing up for Medicare part A and Part B is the most important step in the entire process.  But there are a few things to know about it.  The first is that everyone needs to get Medicare Part A when they turn 65 even if they have creditable coverage. There is usually no cost for having Part A, so it is usually advisable to sign up when available.

Part B is a little different.  Unlike part A, you do not need to get Medicare part B when you turn 65 as long as you have creditable coverage. If you do not have creditable coverage when you turn 65 then you will need to enroll in Part B in addition to Part A.

There are two separate ways that you can enroll in Medicare Part A and B. If you are already taking Social Security benefits at the time you turn 65 you will be automatically enrolled in both Medicare Part A and B. If you are covered under “creditable coverage”, you would need to call Social Security Administration and dis-enroll from Medicare part B to avoid paying the monthly premium.

If you are not taking Social Security benefits, you will need to call the Social Security Administration and enroll in Medicare Part A and Part B.

Disclaimer: Max Bernadsky is responsible for this content. Nothing in this blog is intended to be legal advice, nor is this blog intended to solicit any business for Houck Menninger Law, LLC.  This blog is for informational purposes only.

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