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Medicare Enrollment—Clearing the Air

Written by NAIFA | 5/1/17 3:33 PM

If you are an agent selling Medicare plans, one of the best things you can do for your clients is to clarify the sometimes confusing eligibility and sign-up rules and procedures they have to follow if they do not want to be penalized.

As you know, Medicare enrollment begins three months before your client’s 65th birthday and continues for seven months. If your clients are currently receiving Social Security benefits, they do not need to do anything--they will be automatically enrolled in Medicare Parts A and B effective the month in which they turn 65.

If they do not receive Social Security benefits, then they will need to sign up for Medicare three months before their 65th birthday by calling the Social Security Administration at 800-772-1213 or online at http://www.socialsecurity.gov/medicareonly/. It is best for them to do so as early as possible so that their coverage will begin as soon as they turn 65. In most cases, if your client doesn’t sign up when first eligible, he may have to pay a late enrollment penalty for as long as he has the coverage.  Your client may have a chance to sign up for Medicare during a Special Enrollment Period if your client (or his spouse) is still working. However, if your client is self-employed or works for a company that employs fewer than 20 people, he has to apply three months before his 65th birthday. If he does not, his benefits will be delayed. The 132-page official U.S. government Medicare & You 2017 handbook offers a great deal of data about Medicare including initial enrollment information on pages 21-30.

Help is on the way

The U.S. Congress has recognized that information about Medicare eligibility and sign-up rules can be confusing and needs to be made clearer. That is why in December of 2016, it passed the 21st Century Cures Act, which directs the Secretary of the Health and Human Services to clarify Medicare-eligibility and sign-up rules and procedures.

Ayo Mseka
Editor-in-Chief