Most people are eligible for Medicare when they turn 65.  Medicare has specific enrollment periods.  When you turn 65, you are eligible for your Initial Enrollment period, which is a 7 month period.  This begins three months before the month of your 65th birthday, includes the month of your 65th birthday, and then also extends for the three months after the month of your 65th birthday.   Some people may be eligible for Medicare earlier based on special circumstances. 

If you are on enrolled in social security disability for 24 months you also be eligible for Medicare.

Medicare comes in different parts.  Medicare Part A has no premium for most people.  Medicare Part B has a monthly premium.  The premium for Part B is based on your income from two years ago.  As an individual, if your tax returns with modified adjusted gross income for 2021 was Less than or equal to $97,000, or as couple if you file a joint tax returns with modified adjusted gross income less than or equal t0 $194,000 , you will be charged $164.90 for the Medicare Part B premium in 2023.  If you are taking social security when you start Medicare, the Medicare Part B premium will be automatically deducted from your social security check.  If you are not taking social security, Medicare will bill you quarterly for this premium.  

Medicare has specific enrollment periods. If you are losing employer coverage, you will get a special election period to enroll in Medicare part B and in a Medicare advantage or prescription drug plan.  This enrollment period will vary depending on your specific circumstances so please call us for specific details. However, a good general rule is that you have up to two months after the employer coverage end to enroll.  

The late enrollment penalty (also called the “LEP” or “penalty”) is set by Medicare.  It is an amount that may be permanently added to your monthly premium for Medicare drug  coverage (Part D).  If you have not had any credible drug coverage since you turned 65, Medicare can assess a late enrollment penalty if you have gone without Part D or other creditable prescription drug  coverage for any period of 63 days or more in a row.  Usually, the late enrollment penalty is added to your monthly Part D premium for as long as you have Medicare drug coverage, even if you change your Medicare plan.

Extra help is a program administered by social security that can assist people with lower incomes who need help paying for the Part D premium, decuctible, and copays. You can apply for Extra Help any time before or after you enroll in Part D or in an Advantage plan with Part D coverage.   It is based on income and asset limits.   Depending on your income and assets, you may receive Full or Partial Extra Help benefits. Additionally, there are four levels of Partial Extra Help that will impact how much you save on your plan’s monthly premium. When you qualify for Extra Help, you will receive a letter detailing the level of help you’ll receive.  An individual’s Medicare Part D Extra Help income limit in 2023 is $21,780. For a married couple, the 2023 income limit is $29,580. Income limits for Extra Help are based on your adjusted gross income as reported on your tax return.   In addition, your resources such as your saving, stocks, bonds, and other assets are considered when you are applying for Extra Help.  

 You can call us to discuss this program, or you can call social security directly to apply.  1-800-772-1213. TTY users can call 1-800-325-0778.