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Medicare Pre Enrollment Checklist

Summary: If you’re about to turn 65, it’s a good idea to begin planning for enrolling in Medicare coverage. To help you prepare for enrollment in the months before your 65th birthday, we’ve made this Medicare turning 65 checklist. Learn more about what you need to do before enrolling for Medicare. Estimated Read Time: 11 mins

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Table of Contents:

    1. Medicare Enrollment Checklist
    2. Medicare Pre-Enrollment Checklist: Twelve Months Before You Turn 65
    3. Medicare Pre-Enrollment Checklist: Four to Six Months Before You Turn 65
    4. Medicare Checklist One to Three Months Before Turning 65
    5. What Should You Do the Month You Turn 65?
    6. How Do I Prepare for Medicare?

If you are turning 65 soon, Medicare enrollment is approaching. While applying for Medicare may seem like a daunting task to many, with the right resources, it does not have to be complicated. Thus, we have compiled everything you need to know about Medicare enrollment into our Medicare pre-enrollment checklist below.

Medicare Enrollment Checklist

Signing up for Medicare looks different for everyone. However, we have compiled an itemized Medicare pre-enrollment checklist to help ease you into your Medicare enrollment journey.

The Medicare Checklist will break down when you should be completing essential tasks:

  • Twelve months before you turn 65
  • Four to Six months before you turn 65
  • One to three months before you turn 65

Medicare Pre-Enrollment Checklist: Twelve Months Before You Turn 65

6 Months Before Turing 65 Medicare Checklist
During this time, thinking about the most important benefits and how you wish to be covered is essential. Below are the five steps you should check off your Medicare Checklist 12 months before your Medicare eligibility start date.

Understand the Four Parts of Medicare

Understanding the different Medicare parts is vital because each part covers different services and has different costs.

Medicare Part A and Part B make up Original Medicare. Original Medicare covers hospital inpatient and outpatient doctors’ services, respectively. These two parts of Medicare work hand-in-hand to cover your typical medical expenses.

Medicare Part C, or Medicare Advantage, includes the benefits of Original Medicare and may also include prescription drug coverage, depending on the plan. When you have Medicare Advantage, it stands in for Original Medicare.

Medicare Part D prescription drug coverage helps cover your prescription medications when you have Original Medicare.

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You would enroll in Medicare Advantage and Medicare Part D through private insurance companies, unlike Original Medicare, which you get from the federal government.

Educate Yourself on Medicare Supplement Plans

In addition to the four parts of Medicare, you should also educate yourself about Medicare Supplement plans.

Medicare Supplement (Medigap) plans are good to know about because they can help you cover the out-of-pocket cost gaps in Original Medicare, such as co-pays, deductibles, and extra days in the hospital. However, you must decide between enrolling in Medicare Advantage or a Medicare Supplement plan, as you cannot have both at the same time.

Review Additional Vision and Hearing Plans

One of the most significant holes in Original Medicare coverage is the lack of vision and hearing coverage. Those on Medicare often enroll in stand-alone dental, vision, and hearing plans to cover this hole in benefits.

Learning how these ancillary plans work alongside your chosen Medicare coverage ensures you receive the best benefits possible.

Learn how Medicare Works with Other Insurance

If you receive health insurance from an employer or union, the VA, or another entity outside of Medicare, you will need to understand how that coverage works with Medicare.

Whether you are actively working or retired will play a massive role in whether your insurance coverage is creditable for Medicare or not. In some cases, if your coverage is considered creditable, you may delay Medicare Part B benefits without penalty. On the other hand, if your coverage is not creditable, you will need to enroll in Medicare Part B.

This includes if you are eligible for Medicaid. In this case, Medicare would be your primary coverage, and Medicaid would pay secondary.

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Understand Medicare Enrollment Periods

The next item to note is understanding the different Medicare enrollment periods. Understanding the enrollment periods can help you avoid a delay in coverage and any potential monetary penalties you could get for missing your enrollment period.

The three main Medicare enrollment periods are:

  • Initial Enrollment Period
  • General Enrollment Period
  • Annual Enrollment Period

Your Initial Enrollment Period is the one you want to prepare for as it’s your first chance to sign up for Medicare once you turn 65.

Medicare Pre-Enrollment Checklist: Four to Six Months Before You Turn 65

4 Months Before Turning 65 Medicare Checklist
Four to six months before you turn 65, it is crucial to begin pinpointing which Medicare plans you wish to enroll in so you are prepared to become eligible for coverage. Comparing benefits, costs, and availability is essential during this time to ensure you receive the best coverage possible.

Check With Your Doctors and Hospitals to Ensure They Accept Medicare

While approximately 93% of doctors nationwide accept Original Medicare, it’s essential to check with your doctors beforehand to see if they accept it.

When you enroll in a Medicare Supplement plan, you will not need to double-check with your doctors. If your doctor accepts Original Medicare, they will take your Medicare Supplement plan regardless of the carrier.

However, if you enroll in a Medicare Advantage plan, you must ensure that the doctor you see accepts your coverage. Just because a physician accepts Original Medicare does not mean they will take your Medicare Advantage plan, as Medicare Advantage involves networks.

Enrolling in coverage accepted by the doctors you are comfortable working with and who understand your health history is essential to many of those on Medicare.

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Understand Your Out-of-Pocket Responsibilities with Medicare

Unfortunately, Original Medicare does not cover 100% of your healthcare costs once you enroll in the federal healthcare program. This means you are responsible for out-of-pocket expenses when you use the coverage. Understanding your out-of-pocket expenses with each form of health insurance can help you decide what kind of coverage is right for you and your budget.

Medicare Part A has a per-occurrence deductible that you will be responsible for each time you are admitted to the hospital. Additionally, you are responsible for per-day copayments when admitted to the hospital.

Medicare Part B requires you to cover an annual deductible before coverage begins. Once you meet the annual deductible, Medicare Part B will cover 80% of your Medicare-approved costs, leaving you responsible for 20% of the total cost of your medical bills.

Medicare Part C plans can create cost-sharing regulations and set maximum out-of-pocket limits. Because of this, it is crucial to fully understand your coverage before enrolling if you choose to enroll in Medicare Advantage.

Medicare Part D plans require copayments and deductibles that vary by policy. Each Medicare Part D plan offers different benefits, so, like Medicare Part C, it is vital to fully understand your Medicare Part D plan before enrolling in coverage.

Decide on Which Extra Coverage to Get After Signing Up for Original Medicare

Four months before enrolling in Original Medicare, it is crucial to know whether you will be enrolling in a Medicare Supplement or Medicare Advantage plan.

If you decide only to have Original Medicare coverage and not enroll in additional coverage, you will not need to do anything during this time. However, it is essential to note that you will not have a maximum out-of-pocket limit. This means there is no cap on your out-of-pocket costs.

Often, Medicare Supplement carriers will allow you to choose your plan up to six months before your Medicare Part B start date. This allows you ample time to budget and understand your plan’s benefits.

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Additionally, if you choose to enroll in a Medicare Advantage plan, you can begin enrolling in your plan three months before you turn 65.

Compare Top Plans in Your Area

Once you decide whether to enroll in a Medicare Supplement or a Medicare Advantage plan, it is essential to compare the available plans in your area.

When it comes to Medicare Advantage, you will find several different Medicare plans available through different carriers that offer other price points, out-of-pocket costs, and benefits.

When it comes to Medicare Supplement plans, since benefits are standardized, it is essential to use this time to decide which plan letter you wish to enroll in and which carrier offers coverage for the lowest cost in your area. Each Medicare Supplement plan offers different benefits and levels of coverage. Medicare Supplement Plan F, Plan G, and Plan N are the most popular Medicare Supplement plans.

Knowing which Medicare Part D Plan you want is essential if you plan on enrolling in a Medicare Supplement plan. Remember, if you enroll in a Medicare Advantage plan, you are not eligible for Medicare Part D.

Medicare Checklist One to Three Months Before Turning 65

1 to 3 Months Before Turning 65 Medicare Checklist
Three months before you turn 65, you can finally enroll in Original Medicare. For some, this process is automatic. Others will need to sign up through Social Security.

Apply for Original Medicare through Social Security

As you are closing in on your 65th birthday, starting your application for Original Medicare is essential. You can apply for Medicare through Social Security up to three months before you turn 65.

If you are receiving Social Security benefits, you can skip this step. You will automatically be enrolled in Medicare and receive your Red, White, and Blue card.

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If you are not enrolled in Social Security benefits, you must contact Social Security to enroll in Original Medicare. This process can take up to a month before you receive your cards. It is recommended to begin this step as soon as possible, three months before your 65th birthday.

When you are enrolling in Original Medicare, it is essential to provide the following documents:

  • Birth certificate
  • Proof of citizenship or legal residency if you were not born in the United States
  • Income statements
  • W-2 and other tax forms
  • Discharge papers or other records of military service before 1968

Additionally, to qualify for zero-premium Medicare Part A, you must have worked at least 40 quarters (ten years) in the U.S., paying Medicare taxes. You will not need to pay a monthly Medicare Part A premium if you qualify.

Your Medicare Part B premium will be determined based on your income two years before the current year.

Enroll in Medicare Advantage or Medicare Supplement

After applying for Original Medicare, you can choose to enroll in Medicare Advantage or a Medicare Supplement plan.

If you decide to enroll in a Medicare Advantage plan, you can do so once you receive your Medicare Identification Number. This number allows you to enroll in a Medicare Advantage plan through an agent.

On the other hand, you do not need a Medicare Identification Number yet to enroll in a Medicare Supplement plan with most carriers. However, they ask you to provide the number once you receive your Medicare Red, White, and Blue Card.

Once you know which Medicare Supplement plan you are enrolling in, contact your licensed agent. The agent can walk you through the application process. Enrolling with an agent can help to ensure you don’t miss any steps in the application process.

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Enroll in Medicare Part D

The last step of the Medicare checklist at this time is to look into Medicare Part D enrollment. If you enroll in a Medicare Supplement plan or have Original Medicare coverage only, you will need to enroll in Medicare Part D unless you have other creditable prescription drug coverage.

You may be responsible for paying a monthly penalty if you do not enroll in Medicare Part D when you first become eligible. The Medicare Part D penalty adds 1% of the average premium cost for each month you go without creditable drug coverage. Once you are assessed the premium, it never goes away.

Once you receive your Medicare Identification Number (located on your Red, White, and Blue Card), you can enroll in Medicare Part D. You will complete this step through a licensed agent or with a Medicare representative over the phone. Your Medicare Part D benefits will begin on the first day of your 65th birth month. If any questions come up along the way, the Medicare benefits hotline is always available to you.

What Should You Do the Month You Turn 65?

Following the Medicare Checklist above, you could begin enjoying your Medicare benefits on the first day of your 65th birth month.

However, Medicare enrollment does not end here. Each year, you will be given opportunities to change your plans or enroll in new coverage if you wish.

Every Medicare beneficiary can utilize the Annual Enrollment Period. Each year, you can make changes to your coverage for the upcoming year. This enrollment period runs from October 15 to December 7. The Annual Enrollment Period is your best chance to select new coverage if you are unhappy with your current plan.

How Do I Prepare for Medicare?

This may seem like a lot of information to take in, but it’s important for you to be as informed as possible before enrolling in Medicare. Here are the basics of preparing to sign up for Medicare in three steps.

Step 1: Research the federal Medicare program and additional forms of Medicare coverage. Check out the benefits Original Medicare offers and the out-of-pocket costs you would be responsible for. Then, find information about Medicare Part D, Medicare Supplement, Medicare Advantage, and other add-on plans for vision, dental, and/or hearing to see if you could benefit from the extra coverage.

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Step 2: Learn when and how to sign up for Medicare. Research the different enrollment periods to see when you should sign up for Medicare. Typically, your first and best chance is your Initial Enrollment Period window.

Step 3: Apply for Medicare online through the federal Social Security website. If you don’t already have a Social Security account, you must create one before signing up for Medicare. You would also need to contact the Social Security office by phone or in-person to enroll in Medicare if you don’t receive Social Security benefits at enrollment.

Get Help Preparing for Medicare Enrollment

There’s a lot to know about Medicare, and it can get overwhelming. Our licensed agents are here to help you navigate the Medicare enrollment process and are happy to answer any questions. We want you to get the best Medicare coverage possible.

We can help to walk you through the Medicare enrollment process step-by-step, and we’ll still be here to help once you’re a Medicare beneficiary and beyond. For more information, call the number above or complete our online form today!

Sources

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. Medicare, KFF. Accessed June 2022.
    https://www.kff.org/medicare/
  2. Medicare, CMS. Accessed June 2022.
    https://www.cms.gov/
  3. Checklist, SSA. Accessed June 2022.
    https://www.ssa.gov/hlp/isba/10/isba-checklist.pdf
Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare educator serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

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