If you already have a Medicare Part B, your next step is identifying when your employer coverage is going to end. Then you’ll need to enroll in prescription coverage (Part D) or a Medicare Advantage Plan (MAPD) before your employer coverage ends. This will avoid any potential gaps in your health care coverage.
Medicare beneficiaries can enroll in a Medicare Part D or Medicare Advantage plan to help fill gaps in Original Medicare. You have 63 days after your employer coverage ends to enroll in replacement coverage.
Medicare Advantage & Prescription Drug coverage starts at the beginning of the next month or the 1st month you are eligible for medicare.
If you don’t have a Medicare Part B, you have 8-months to apply to enroll. We would highly encourage you to submit your Part B application before your employer coverage ends. Don’t risk going without coverage; plan a 6 week+ window for your Part B to be approved by Social Security.
Original Medicare is managed by the Federal Government and provides Medicare eligible individuals with coverage for and access to doctors, hospitals, or other health care providers who accept Medicare. It does not cover 100% of your medical cost or prescription drugs. Additional coverage will be needed.
If you choose not to enroll or deny Part B coverage when you were first eligible, you would need to have a valid election period to enroll. Loss of employer coverage is a valid reason to apply. Your employer will have to sign off on the forms below. After completion, you can apply at your local Social Security office or online below.
Part C or Medicare Advantage (MA), is additional coverage that is administered by private health insurance companies. Most MA plans include Part D Prescription drug coverage at no extra cost, they are referred to as MAPD plans.
Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. They also may offer extra benefits Original Medicare doesn’t cover.
Don’t forget, Part B Cost $174.90/month at minimum (2024). If you make more than $103,000 as an individual or $206,000 as a joint filer you will pay an IRMAA for your Part B & Part D Benefit.
The government uses your income from 2 years ago. But you can appeal if you’ve had a major change in income Prescription Drug Coverage.
To request a new initial determination, submit a Medicare IRMAA Life-Changing Event form or schedule an appointment with Social Security.
You will need to provide documentation of either your correct income or of the life-changing event that caused your income to decrease.
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