This article was last updated on Aug. 26, 2021.
A milestone birthday is approaching, which means Medicare is in your not-so-distant future. But if you're like a lot of people who are turning 65 in the next year or two, you haven't quite got around to figuring it all out yet.
Well, you're in the right place.
We’ve compiled a list of the most-asked questions from people just like you, who are approaching age 65. Use this to help guide your decision-making. This is by no means a comprehensive list of things you need to know about Medicare, but it's a good start.
Q: When do I need to sign up for Medicare?
A: You have a 7-month enrollment window (also known as the Initial Enrollment Period), to sign up for Original Medicare, which includes Medicare Part A (hospital costs) and Medicare Part B (medical care). The seven-month enrollment window includes the three months before your 65th birthday, your birthday month, and three months after.
Q: How do I sign up for Medicare?
A: If you've been collecting Social Security benefits at least four months before your 65th birthday, you’re automatically enrolled in Medicare Parts A and B. You’ll receive your Medicare card in the mail from the Social Security Administration. You may want to consider a Medicare supplement plan for the additional costs Medicare doesn’t cover.
If you have not been collecting Social Security benefits, you will need to do a little legwork to sign up for Medicare. You can enroll online at the Social Security Administration website External Site.
Q: What happens if I don’t sign up for Medicare?
A: If you miss your initial enrollment period, you will have a chance to enroll in Medicare again during the general enrollment period. The general enrollment period takes place every year between Jan. 1 and March 31, and if you enroll during this time, coverage begins the month after enrollment. If you wait to enroll in Medicare, you may have to pay more.
Q: Should I enroll in Medicare if I have insurance through an employer?
A: If you have insurance through your employer or your spouse’s employer, you will need to consider what is best for your situation. Generally, because Part A is available at no cost to you, it is still recommended to enroll during your Initial Enrollment Period. However, since Part B comes with a monthly premium, you may be able be to delay enrollment without a penalty if you have other health care coverage. When coverage through your employer or your spouse’s employer ends, you have eight months to sign up for Medicare without penalty.
Q: What if I’m enrolled in a Health Savings Account (HSA)?
A: If you have employer-sponsored coverage with an HSA, you may want to delay signing up for Medicare External Site. Once you are signed up for Medicare, you can continue to use the dollars you have saved up in your HSA, but you can no longer contribute to it.
Q: What is Medicare supplement insurance and do I really need it?
A: Medicare supplement insurance helps pay for health care costs and some services not covered by Medicare, such as deductibles, copays and coinsurance. To be eligible, you must be enrolled in Medicare Part A and Medicare Part B. For the things Medicare doesn't cover, you could still be left with a very large bill, which is why you might want to consider purchasing Medicare supplement coverage.
Q: Can I go to any doctor?
A: With a Medicare supplement plan, you can see any Medicare-participating doctor or hospital with no referrals. But, some plan networks from other carriers are more limited. Use this tool on Medicare.gov External Site to check if your doctor accepts Medicare.
Q: How do I get coverage for prescription drugs (Medicare Part D)?
A: If you are enrolled in Medicare Part A, Part B, or both, you can sign up for a Part D prescription drug plan External Site. It will help protect you from unexpected drugs costs, which can quickly add up. If you enroll, you will pay a monthly premium plus a share of the cost of your prescriptions. Drug plans vary by types of drugs covered, how much you pay and the pharmacy you use.
Q: What happens if I don't sign up for prescription drug coverage (Medicare Part D)?
A: If you don’t enroll in Medicare Part D plan during the Initial Enrollment Period, the Centers for Medicare and Medicaid Services may charge you a penalty — in the form of a higher monthly Part D premium — when you enroll later. You’ll have to pay this penalty for as long as you have prescription drug coverage. The longer you wait to enroll, the higher the penalty. The easiest way to avoid this penalty is to join a Medicare Part D plan when you are first eligible for Medicare, during your Initial Enrollment Period.
Learn more about your Medicare options
No matter when or how you decide to enroll in Medicare, it's important to understand all the options available to you. If you live in Iowa or South Dakota, you can request your free Medicare Get-Ready Guide Opens New Window to learn more about the different parts of Medicare, your coverage options, and when you're eligible to enroll. You can also call us directly at 800-336-0505.
If you live outside Iowa or South Dakota, visit the Blue Cross Blue Shield Association website External Site or call 888-630-2583 to find a Blue plan near you.
This is a solicitation of insurance. Wellmark MedicareBlue Supplement plans are specific to Wellmark Blue Cross and Blue Shield of Iowa and Wellmark Blue Cross and Blue Shield of South Dakota and can only be purchased by Iowa and South Dakota residents, respectively. MedicareBlue Supplement plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Wellmark Blue Cross and Blue Shield of Iowa and Wellmark Blue Cross and Blue Shield of South Dakota are independent licensees of the Blue Cross and Blue Shield Association.