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

So 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. If you don’t, your insurance claims may not be paid. If you do not enroll in Medicare on time, you will be subject to 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, your 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 with the remaining 20 percent. The next 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 is inpatient coverage (usually no premium if you have worked at least 10 years). Part B is outpatient coverage (monthly premium of $144.60 in 2020), Part C is Medicare Advantage (a private health insurance – premiums vary) and Medicare D (premiums vary) is prescription medication coverage.  

You can postpone enrolling in Medicare if you (or your spouse) continue to work and are covered by a group health plan that has at least 20 employees. Otherwise, there may be a penalty for not signing up for Medicare right away.  

Fall Medicare Open Enrollment is right around the corner, from October 15–December 7 every year. This is when you can make changes to your current Medicare coverage. 

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 2021.  

If you would like assistance reviewing your Medicare D (prescription) plan or have Medicare related questions, please contact me at Richland Health Department to set up an appointment Call 701-642-7735 for more information.  

Angie Conzemius is Community Resource Coordinator for Richland County Public Health.

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