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"easyMedicare made getting the coverage
I deserved easy and saved me a great deal of money."

- Joe Theismann

Joe Theismann - NFL MVP and Super Bowl Champion

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"easyMedicare made getting the coverage I deserved easy and saved me a great deal of money."

- Joe Theismann

Joe Theismann - NFL MVP and Super Bowl Champion

Medicare and Turning 65 — It’s Time to Plan

As long as you’ve got a good plan, most problems in life don’t feel impossible. Planning for Medicare and turning 65 is no exception. If you’re less than a year away from turning 65, or you’re older and about to leave a group health plan for retirement, the prospect of navigating Medicare might feel overly complex or even impossible — that’s until you put together a good plan.

Feeling anxious about securing healthcare coverage in retirement? Exhale. You’re at the right place and on the right track to demystifying Medicare and enrolling in coverage that can provide you peace of mind.

As you keep reading, we’ll walk you through an overview of what it takes to qualify for Medicare. We’ll help you stop puzzling over the parts of Medicare and begin to understand how they fit together. We’ll share answers to some of the commonly asked questions about Medicare and turning 65. And we’ll lay out some options for how you can start the enrollment process.

Medicare and Turning 65

Requirements for Joining Medicare

Understanding your eligibility for Medicare is the first step to finding coverage. Since you already know turning 65 has something to do with it, you already understand a huge factor!

To qualify for Medicare, you’ll need to be a U.S. citizen or a permanent resident. Beyond residency, there are several factors that will help determine how much coverage you can get and how much of it you’ll have to pay for out-of-pocket:

Turning 65 - You’ll need to be at least 65 years old to get Medicare coverage in most cases, though there are exceptions based on health and income. You’ll get your first opportunity to enroll in Medicare about three months before you turn 65. Your enrollment window will include your birth month, and then last for three more months after that.

Medicare tax credits -The more you contributed to Medicare through payroll deductions during your career, the less you’ll have to pay for coverage when you’re enrolled. Contributions are counted quarterly and are capped at 40 quarters (ten years combined), at which point Part A premiums fall to $0.

Entitlements - Social Security, Railroad Retirement Benefits and other entitlements can qualify you for Medicare and help bring down your healthcare costs.

Severe health issues - People living with ALS (amyotrophic lateral sclerosis) or permanent kidney failure may qualify for Medicare at any age, along with assistance to help pay for it.

FAQ: If I qualify for Medicare, will I be enrolled automatically?
In some cases, Medicare will automatically enroll qualified people in the program. However, it’s important to make sure you’re enrolled when you first become eligible to join Medicare.

Be prudent. Make sure you’re enrolled on time. If you miss your initial enrollment, you could be penalized with higher premiums the entire time you’re a member of Medicare.

Turning 65 and Enrolling for the First Time

When you first become eligible for Medicare, you’ll have a wide window of time to join. This seven-month-long window is known as the Initial Enrollment Period (IEP). As you approach 65 years of age, your IEP will start three full months before your birth month, cover your birth month, and last for three more months after that. So you’ll have plenty of time to enroll and make adjustments to your coverage before your Initial Enrollment Period closes.

Every year, you’ll have the opportunity to adjust your Medicare coverage to account for changes in your life. Your coverage choices during your Initial Enrollment Period are not permanent. If you find that they don’t best fit your needs, compare plans again during the next Annual Election Period (Oct. 15 - Dec. 7).

Medicare and Turning 65

FAQ: Can I stay on my union or employer-sponsored plan or must I sign up for Medicare as soon as I’m eligible?

If you are still working past age 65, you are able to stay on your employer’s health plan without penalty until you retire. However, if you are not receiving benefits from Social Security within four months of turning 65, you may have to sign up with Social Security to receive Medicare Parts A and B.

Parts and Parcels: Understanding the Parts of Medicare

Each part of Medicare is essential to helping the Centers for Medicare and Medicaid Services carry out its objective of providing affordable healthcare to Americans 65 and older, and those with unique needs. Yet, not every eligible individual needs every part of it.

Review each of the major components of Medicare below to get a better idea about which combination of parts works best for your lifestyle.

Medicare Part A

The simplest way to think of Part A coverage is “inpatient care.” Part A covers inpatient care at hospitals, hospice centers, skilled nursing facilities, home health services and nursing homes.

Note that Part A doesn’t cover nursing home care if it is only custodial care, meaning no medical services are regularly rendered. Home health care includes services such as physical therapy, speech pathology, occupational therapy and more. It excludes around-the-clock care, meal delivery and housekeeping services.

Most people don’t have to pay a premium for Medicare Part A, due to one of the following reasons:

  • You or your spouse have paid enough Medicare taxes through payroll deductions
  • You or your spouse worked a government job that included Medicare coverage as a benefit
  • You qualify for Social Security or Railroad Retirement Board benefits
  • You have permanent kidney failure
Medicare and Turning 65

While Part A may be obtained premium-free, there is still a deductible and coinsurance tied to coverage.

Medicare Part B

While Part A covers inpatient care, Medicare Part B delivers coverage for outpatient services. It covers doctor visits, medical equipment, lab tests, ambulance services, mental health care and preventative services.

Part B includes a premium, deductible and coinsurance. Unlike Part A, you can’t use tax credits to cover the premium for Part B insurance.

Keep reading to learn more about the additional parts of Medicare, how to save money, and how to get help with your Medicare coverage.