Medicare Initial Enrollment Checklist: 6 Things You Need to Know

Your Step-by-Step Guide to Medicare Enrollment

1. Sign Up for Original Medicare (Basic Medicare)

The first step is to confirm whether you’re signed up for Original Medicare, also known as Basic Medicare. Original Medicare consists of Part A, which is hospital insurance, and Part B, medical insurance. As a minimum, it’s a good idea to ensure you’re signed up for Part A, hospital insurance.

Pay Attention to Your Medicare Initial Enrollment Period (IEP)

Your Medicare Initial Enrollment Period usually occurs around your 65th birthday. It’s essential to understand when your enrollment period begins and ends to ensure you’re fully covered. Missing the period can also mean you’re subject to late fees.

The enrollment period starts three months before the month you turn 65 and continues the month of your birthday and three months after your birthday. Also, note that if your birthday is on the 1st of the month, your initial enrollment period begins four months before your birthday month. It’s also possible to qualify for Medicare before reaching your 65th birthday month if you have a disability or illness.

Automatic Enrollment for Original Medicare Part A and Part B

You may be automatically enrolled in Medicare Part A and Part B in some instances. For example, if you’re already receiving Social Security benefits, you will be automatically enrolled by your 65th birthday. If you have been automatically enrolled, you’ll receive a red, white and blue Medicare card approximately three months before your 65th birthday.

Option to Delay Medicare Part B

Depending on your circumstances, you may want to delay enrolling in Medicare Part B. The most common reason for postponing Part B is if you are currently covered by your employer’s health plan. If you discover that staying with your employer-based health plan will save you money, you can delay enrollment in Part B by consulting the information included in your Welcome to Medicare Packet.

If you’re considering delaying enrollment in Part B, be mindful that several Original Medicare coverage options require enrollment in Part A and Part B. If you’re in North Carolina, one of our specialized Medicare agents can help you assess what’s best for you.

Although there’s typically no monthly premium with Medicare Part A, there usually is for Medicare Part B, which is based on your income. If you have similar coverage through your employer, check with your employer’s group health insurance plan administrator to determine how Medicare Part B coverage works. If you’ve got questions, you can contact one of our local NC Medicare agents.

 2. How to Enroll in Original Medicare (Basic Medicare)

The best time to enroll is during your Initial Enrollment Period (IEP), around your 65th birthday. You can enroll in several ways: 

• Visit SSA.gov and enroll online.

• Visit your local Social Security office in person.

• Call the Social Security office at 1-800-772-1213 (TTY users call 1-800-325-0778). You can call from 8 AM to 7 PM on Monday through Friday in all US time zones.

If you don’t enroll during your IEP period, you need to wait until the Medicare General Enrollment period. This enrollment period runs from January 1 to March 31 each year. Your coverage will begin on July 1 of the same year. It’s essential to be aware that you may have to pay late enrollment penalties and that these penalties increase as time goes by.

3. Selecting Your Medicare Coverage

There are two ways to get your Medicare Part A and Part B benefits:

Medicare Advantage (Also known as Part C)

The Medicare Advantage program allows you to get Medicare coverage through a private insurance company approved by Medicare. The Medicare Advantage plan covers some benefits that Original Medicare doesn’t. For example, routine vision, hearing, and dental coverage are not included in Original Medicare but may be covered with a Medicare Advantage plan. Additional benefits may consist of fitness plans or allowances for eyeglasses.

Directly through the Government

When you receive Original Medicare coverage by default, it’s directly through the government.

To stay with the Original Medicare (Basic Medicare) plan but add expanded features, you can enroll in a stand-alone Medicare Part D Prescription plan. You can also purchase a Medicare Supplement (Medigap) insurance plan to help pay the out-of-pocket costs of Original Medicare. 

Medicare Supplement plans are guaranteed issue during your 6 month Medigap Open Enrollment Period, which starts the first month you have Medicare Part B. There are no health questions to answer during that period. Be aware that you may be turned down outside the enrollment period or have to pay higher premiums if you have health problems.

Remember, Original Medicare and Medicare Supplement plans do NOT cover:

• Prescription drugs

• Routine Vision, Dental, or Hearing visits

Carefully consider your health needs and options when choosing your Medicare coverage. Also, consider your budget and other factors, such as your family health history.

4. Compare Medicare Plans in NC

Before you make any decisions, it’s a good idea to compare Medicare plans in North Carolina. Comparing Medicare Advantage versus Original Medicare (with optional Medicare Part D and Medicare Supplement insurance) can help you understand the best option for you. If you need any assistance on Medicare plans in North Carolina, contact our agents directly.

5. Select the Medicare Coverage You Need

Once you’ve compared the options available to you, it’s time to choose your Medicare coverage.

Most plans require you to enroll in both Medicare Parts A and B. Although different coverage plans may have different enrollment dates, you can usually enroll during your IEP. 

Plans often have monthly premiums, though some Medicare Advantage plans don’t have any premiums. When considering monthly costs, make sure you assess your health needs. Paying a monthly premium may mean more money out of your pocket now but can save you money in the long run when you require care. There is also a monthly premium for Medicare Part B, based on your income.

6. Changes to Coverage

It is possible to make changes to your Medicare plan if your needs change. For example, suppose you signed up for Original Medicare during your IEP but now want expanded coverage. In that case, you can update your plan during the annual enrollment period. This is from October 15 to December 7. 

Changes are also possible during the Medicare Advantage Open Enrollment Period from January 1 to March 31. However, during the Medicare Advantage Open Enrollment Period, you cannot change from Original Medicare to a Medicare Advantage plan. You also can’t join, switch, or drop a Medicare prescription drug plan. 

Need help?

 You can easily compare plans online or if you’re interested in discussing Medicare plans in NC, then chat with one of our specialist agents. We can provide open enrollment tips, let you know about Medicare Advantage open enrollment period 2022 and answer any specific NC open enrollment questions. We’re passionate about helping people in North Carolina find the right coverage for them. Contact us today.