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Initial Enrollment

When you turn 65 years old, you will automatically be enrolled in Medicare Part A and Medicare Part B if you are receiving benefits from Social Security or from the Railroad Retirement Board (RRB).

If you are age 65 and you are not yet receiving Social Security or RRB benefits (because you’re still working), you won’t get Part A and Part B automatically. Instead you will need to sign up for them.

If you need to sign up for Part A, you can sign up during the following times:

• Initial Enrollment Period  - When you are first eligible for Medicare. This is the 7 month period that begins 3 months before your 65 birthday, including the month you turn 65, and ends 3 months after you turn 65.
• General Enrollment Period - Between January 1 through March 31 each year. Your coverage will begin July 1. You may have to pay a higher premium for late enrollment.
• Special Enrollment Period - If you or your spouse (or family member if you are disabled) is currently working, and you are covered by a group health plan through an employer or union.
• Special Enrollment Period for International Volunteers - If you are serving as a volunteer in a foreign country.

Medicare is effective the month you turn 65. As an example, if your 65th birthday were June 20, 2011, your Medicare effective date would be June 1, 2011. If your birthday is on the 1st day of the month, Medicare Part A and Part B will be effective on the 1st day of the prior month. For example, if your 65th birthday were June 1, 2011, your Medicare effective date would be May 1, 2011.

If you are under age 65 and disabled, you automatically get Part A after you get disability benefits from Social Security or certain benefits from the RRB for more than 24 months. You will get your Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.

If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease), you automatically get Part A the month your disability benefits begin.

If you have End Stage Renal Disease (ESRD) different rules apply.

Coverage Choices

Decide How To Get Your Medicare:

You can choose Original Medicare (Part A and B) and if you want prescription drug coverage, you must also join a Medicare Prescription Drug Plan (Part D).

You can choose to join a Medicare Advantage Plan (like an HMO or PPO, also referred to as Part C), and the plan may include Medicare prescription drug coverage. In most cases, you must take the drug coverage that comes with the Medicare Advantage Plan.

You might be able to join other types of Medicare health plans.

Compare both options by following the steps outlined below.

ORIGINAL MEDICARE STEPS TO FOLLOW:

1. Part A (Hospital Insurance) and Part B (Medical Insurance): Medicare provides this coverage. You have your choice of doctors, hospitals, and other providers. Generally, you or your supplemental coverage pay deductibles and coinsurance. You usually pay a monthly premium for Part B.
2. Decide if you want Prescription Drug Coverage (Part D): If you want this coverage, you must choose and join a Medicare Prescription Drug Plan.
3. Decide if you want supplemental coverage: You may want to get coverage that fills gaps in your Original Medicare coverage. You can choose to buy a Medicare Supplement Insurance policy (also known as Medigap or Medsup) from a private company. Costs vary by policy and company. Employers/unions may offer similar coverage.

MEDICARE ADVANTAGE PLANS STEPS TO FOLLOW:

1. Part C - Includes BOTH Part A (Hospital Insurance) and Part B (Medical Insurance): Private insurance companies approved by Medicare provide this coverage.This option is most similiar to an HMO or PPO plan. In most plans, you need to use plan doctors, hospitals and other providers or you will have to pay more or all of your costs. You usually pay a monthly premium (in addition to your Part B premium) and a copayment or coinsurance for covered services. Costs, extra coverage, and rules vary by plan.
2. Decide if you want Prescription Drug Coverage (Part D): If you want Prescription Drug Coverage and it's offered by your plan, you must get it through your plan in most cases. If your plan doesn't offer drug coverage, you can choose to join a Medicare Prescription Drug Plan.

NOTE: If you join a Medicare Advantage Plan, you don't need a Medigap policy. If you already have a Medigap policy, you can't use it to pay for out-of-pocket costs you have under the Medicare Advantage Plan. If you already have a Medicare Advantage Plan, you can't be sold a Medigap policy.

ANNUAL ELECTION PERIOD (OPEN ENROLLMENT)

The 2012 Annual Election Period (AEP) and subsequent years, the period in which you can change you Medicare health or prescription drug coverage, is October 15 through December 7. (NOTE: This is a change from 2011) You coverage will begin January 1, 2012, as long as the plan gets your enrollment request by December 7, 2011.

NEW - Making changes to your coverage after December 31, 2012: Between January 1- February 14, 2012, if you're in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare. If you switch to Original Medicare during this period you will have until February 14 to join a Medicare Prescription Drug Plan to add to your coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

During this period (January 1, 2012 and February 14, 2012) you CAN NOT do the following:

• Switch from Original Medicare to a Medicare Advantage Plan
• Switch from one Medicare Advantage Plan to another
• Switch from one Medicare Prescription Drug Plan to another
• Join, switch, or drop a Medicare Medical Savings Account Plan

In most cases, you must stay enrolled for that calendar year starting on the date your coverage begins. However, in certain situations, you may be able to join, switch, or drop a Medicare Advantage Plan at other times. Some of these situations include the following:

• If you move out of your plan's service area
• If you qualify for Extra Help
• If you live in an institution (like a nursing home)