Whether you are retired or still working, Medicare will likely become a part of your life when you turn 65 (or in some cases, before the age of 65). In the United States today, most health plans pay secondary to Medicare.

If you are currently covered by a retiree health plan, an individual policy, or a small employer group plan, you must enroll in Medicare when you turn 65. However, if you are covered by a large group health plan through your employer or your spouse’s employer, you may be able to delay enrolling in Medicare. Not enrolling in Medicare on time may result in Late Enrollment Penalties (LEP).

During the three months before you turn 65, you should contact the Social Security Office (the gatekeeper to Medicare) to sign-up for Medicare. After receiving your Medicare card, the next step is to contact an insurance agent if you wish to obtain a Medicare supplement or Medicare Advantage Plan. Typically, Medicare pays about 80 percent of approved medical charges (after deductibles are met), the supplement would help you pay for the remaining 20 percent.

The final step is to obtain a Medicare D plan for your prescription medications – this is something I can help you with, your pharmacy may be able to assist you, or you can call Medicare directly. Even if you do not take any prescription medications right now, it’s still important to sign-up for a Medicare D plan to avoid penalties.

There are four different parts to Medicare. Part A - inpatient coverage (usually no premium if you have worked at least 10 years), Part B - outpatient coverage (monthly premium of $148.50 in 2021), Part C - Medicare Advantage (a private health insurance – premiums vary), and Medicare D (premiums vary) - prescription medication coverage.

Fall Medicare Open Enrollment is right around the corner, October 15 – December 7. If you have never signed up for a Medicare D plan, you can do it during this time. If you are already enrolled in a Medicare D plan, Open Enrollment is the time to review it and make sure it is still the right fit for you.

If you are in a Medicare Advantage plan and want to switch back to original Medicare or vice-versa, now is the time for that too. On the flip side of that, if you are happy with your current coverage, you do not need to do anything. It will stay the same for 2022.

If you would like assistance reviewing your Medicare D (prescription) plan or have Medicare related questions, please contact Angie at Richland Health Department to set up an appointment 701.642.7735.

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Angie Conzemius is a Health Program Professional with Richland County Health Dept.

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