Dear 65: Why Should I Enroll in Medicare?

Dear 65,
I have many concerns about Medicare. But today I am interested in understanding the “WHY” behind this: why I should go on Medicare or the why I shouldn’t go on Medicare.

Concerns such as:

• Is the employer plan credible?

• Which one is better?

• Do I have to make a decision now?

• Will I have a Medicare penalty if I don’t get on Medicare when I first become eligible?

These questions can lead to uncertainty and confusion. “Why am I being rushed?!” I don’t know what to do!” Many Americans face these dilemmas, weighing the benefits of Medicare against alternative options provided by their employer. It’s crucial to address these valid concerns, especially for those newly eligible for Medicare. In this post, I will delve into these common concerns and provide clarity on the matter.

Should I enroll in Medicare or should I delay Medicare?

Let’s clarify this. Even though Medicare is not mandatory, delaying enrollment can add extra costs or penalties at a later point. You may choose to refuse Medicare coverage if you have creditable coverage as an alternative option through your employer. It’s ultimately up to you. If you don’t have alternative creditable coverage through your employer, it is advisable to enroll in Medicare to avoid potential penalties in the future.

Medicare Part A
The month of your 65th birthday, you should automatically get Medicare Part A which is your hospital coverage. Part A of Medicare is typically free for those that have paid into Medicare more than 10 years (40 quarters). There are many individuals that are not eligible to receive part A free of charge and may have the option to buy into Part A of Medicare.

Medicare Part B
You would enroll in Medicare Part B if you choose to. Part B is medical coverage. Medicare Part B focuses on outpatient care, which includes services such as doctor visits, preventive care, and certain home health care. Beneficiaries typically pay a monthly premium for Part B coverage. Enrollment is automatic for those already receiving Social Security benefits, and others can sign up during specific enrollment periods.

Medicare Part C
Once you have Medicare Part A and Part B, commonly referred to as traditional or original Medicare, it’s important to note that this coverage is not 100% coverage. There are deductibles, coinsurance, and co-payments that are not fully covered under traditional Medicare, which you may need to pay out of pocket.

You have two main options for obtaining additional coverage:

• The first option is to enhance original Medicare by adding one or both of the following:

  • Purchase a Medicare Supplement plan offered by private insurance companies to help cover some or all of the out-of-pocket expenses.

  • Add Medicare Part D, also available through private insurance companies, to assist with prescription drug costs.

• The second option is to choose a Medicare Advantage plan, known as Part C of Medicare. This plan combines Part A (hospital insurance) and Part B (medical insurance) into one, often including prescription drug coverage and typically offering extra benefits such as dental, vision, and hearing care.

If you’re looking to fill the gaps in original Medicare with a Supplement plan or  the alternative option a Medicare Advantage plan, weigh your options thoughtfully.

Which one is better?

Concerns about switching to Medicare from an employer’s plan often revolve around whether Medicare options will be a better option. Many newly eligible Medicare receipts want what’s best for their well-being not only health wise but financially, too. Numerous Americans continue working beyond the age of 65 and are being provided health insurance by their employer. One of the first things to do if you have access to credible coverage through your employer is to compare it to the options offered by Medicare and see which one is the best choice for you. In most cases Medicare beats regular health insurance offered through the employers but in some cases your current credible plan might be a good choice for you based on your needs – that’s why it’s so important to compare your options.

Is my employer plan credible?

Creditable coverage is coverage equal to or better than Medicare. It’s important to note that not all employer-based health plans qualify as creditable coverage. Specifically, companies with less than 20 employees may not meet the criteria for creditable coverage. It’s essential for individuals to verify with their health insurance provider to confirm they have creditable coverage through their employer.

Understanding the advantages of selecting Medicare as your healthcare option is essential. It is imperative to compare and comprehend your options. Below you will find resources on the discussed topic above.

ABOUT MYRIAM LEIVA:

Myriam Leiva, a native Floridian, is a fluent Spanish speaker with over 15 years of experience in the financial services sector. She hosts a show on Legends Radio in her hometown of Palm Beach County, FL, aiming to offer education, clarity, guidance, and resources to her audience. As an experienced Medicare Advisor, Myriam provides valuable insight and assistance on Medicare Supplements, Medicare Advantage Plans, and prescription drug plans. She also aids in Part A&B filing with Social Security, representing some of the nation’s most reputable carriers. Myriam takes pleasure in connecting with her clients and fostering strong relationships with them.