Turning 65 and Medicare

Turning 65 is widely considered a significant milestone in life. It could mean retirement and the beginning of an exciting new chapter that often includes more time for family and friends, travel plans, hobbies and other activities that you may not have had time to enjoy before. It also means changes to the medical landscape. Turning 65 brings with it eligibility for Medicare coverage which changes how you pay for your healthcare.

Medicare is the federal health insurance program for people who are 65 and over. If you are under 65, you may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s Disease).

The process of becoming eligible for Medicare benefits is known as the Initial Enrollment Period (IEP). The IEP begins three months before your 65th birthday month and lasts for three months after your 65th birthday month. So, for example, if you turn 65 on June 12, your IEP starts March 1 and ends September 31.

• Before Your Birthday Month

  There are advantages to enrolling early. If you apply for Medicare in the three months prior to your birthday month, your coverage will begin on the first day of your birthday month. So, following the above example, if you apply in April, your coverage will begin June 1.

• During Your Birthday Month

  If you decide to apply during your birthday month, your coverage will not start until the following month. So, in our example, your coverage would begin on July 1.

• After Your Birthday Month

  If you apply for Medicare in the three months after your birthday month, your coverage will begin the first of the month following your application. In the same example, if you apply in July your coverage start date would be the first day of August. Be aware that you may pay a penalty or have a gap in coverage if you do not enroll when you first become eligible.

Original Medicare has no limit on out-of-pocket costs, so if you have a lot of medical costs in a year, expenses can add up very quickly. But you have options. A Medicare Advantage plan can limit out-of-pocket costs and also provide benefits you do not get from Original Medicare, including dental, vision and hearing coverage. Understanding Medicare’s Parts is the first step toward deciding which is best for you.

• Part A – Hospital Insurance

  This covers hospital stays, skilled nursing and home healthcare.

• Part B – Medical Insurance

  This covers doctors’ costs and home healthcare.

• Part D – Prescription Drug Coverage

  Can be added to Original Medicare at an additional cost or may be included with a Medicare Advantage Plan.

• Part C – Medicare Advantage

  This is an all-in-one plan that combines Parts A, B and D, plus extras like dental, vision and hearing. Medicare Advantage Plans like KelseyCare Advantage provide all-in-one coverage, including prescription drugs, dental, vision and hearing at no extra cost.

Are you turning 65 or did you recently celebrate your 65th birthday? Please give us a call at (713) 442-5646. A KelseyCare Advantage representative will be happy to answer your questions and help guide you through the enrollment process.