Medicare Enrollment Checklist: An Easy Guide to Get Prepared

Even for a seemingly straightforward trip around town, a checklist can come in handy.

If you wouldn’t go grocery shopping without a checklist, you certainly shouldn’t shop for health insurance without one.

If you soon will be eligible for Medicare for the first time, here’s a checklist worth — well — checking out.

For most people new to Medicare, their journey begins around the time they turn 65, but a little planning before your birthday can assure that you’re not late to the party.

The Initial Enrollment Period (IEP) for Original Medicare is a total of seven months surrounding your 65th birthday. Enroll in Medicare during this period, and you won’t face the prospect of Medicare’s late enrollment penalties. If your IEP has come and gone, you can still join Medicare during other Medicare enrollment periods on the calendar.

All U.S. citizens or Resident Aliens ages 65 and older are eligible for Medicare. You might be eligible before age 65 if you have certain disabilities or illnesses. You will need documentation to prove any and all statements in your application before you can receive your Medicare coverage.

Yes, I currently receive benefits from Social Security Administration

First and foremost, do you receive Social Security benefits? If you do, the Social Security Administration already has your information on file. In most cases, you won’t need to provide Social Security with new documentation to enroll in Medicare.

No, I have not started to draw my benefits from Social Security Administration

If you don’t receive Social Security benefits, typically you should plan to have documentation ready for when you enroll in Medicare. Whether you enroll online, in-person at your local Social Security office, or over the phone, you will need to show some basic documents to confirm your eligibility.

It’s a good idea to gather official documents like:

• Social Security number

• Citizenship status

• Any documentation associated with Social Security benefits and/or applying for Social Security benefits.

• Birth Certificate (or any two: immunization records, school records, state census records, insurance records, or medical records).
• Any documentation related to a federal pension or retirement

When it’s time to apply, the Social Security Administration will inform you which documents are needed.

Some folks think that becoming a Medicare beneficiary takes care of itself, but often — as is common in life — you have to deal with a few of the details.

If you receive Social Security benefits or Railroad Retirement Board benefits at least four months before turning 65, then your Medicare should arrive in your mailbox without you taking any action. Otherwise, it’s up to you to apply during your IEP by connecting with the Social Security Administration online, on the phone or in person.

Being eligible for Medicare is one thing. Knowing whether you should take advantage of your eligibility is another.

That question isn’t going to be answered in a few paragraphs, but GoHealth has resources to help make Medicare simple, not to mention no-obligation access to a licensed insurance agent ready to go through all the options.

In a nutshell, if you are covered by employer-sponsored health insurance, you may not want to switch to Medicare right away — or at least not both Parts A and B.

Keep reading.

Original Medicare — also known as Part A and Part B — is the starting point for Medicare. Only in rare cases would anyone initially pass on Part A because it’s hospital insurance that doesn’t have a monthly premium (as long as you or your spouse paid Medicare taxes through an employer for 10 years).

Part B, or medical insurance, isn’t quite as clear-cut because it does require a monthly premium:

• If you’re on an employer-sponsored health insurance plan (for a company with 20 or more employees), you can pass on Part B and not be charged a penalty, opting instead to sign up later during a Special Enrollment Period when your circumstances change.
• With few other exceptions, not enrolling in Original Medicare during your IEP will result in a 10% lifetime penalty on your Part B premium for every 12-month period you don’t enroll after your 65th birthday.

If you decide that it’s time to enroll in Parts A and B upon turning 65, then it’s time to look more closely at what Medicare benefits are right for you.

You’ve decided to sign up for Parts A and B. But that’s only part of the story.

Part A can be a lifesaver when it comes to hospital expenses, but the coverage only goes so far. It’s the same story with Part B, which covers lots of expenses related to doctors’ visits — but not everything. There are gaps in coverage when it comes to capping out-of-pocket costs because of expenses that might fall on you, such as coinsurance and copays.

To fill the gap and place a cap on your costs, you might consider Medigap — the term given to Medicare supplemental coverage administered by private insurance companies that can be added to Parts A and B.

That’s one approach. Another one? Medicare Advantage (Part C) replaces Original Medicare (Part A & B), but offers the same Part A & B benefits or coverages as Original Medicare. Along with receiving Part A & B benefits, Medicare Part C often bundles your benefits with additional ones like dental, hearing, vision and prescription drug coverage.

Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:

• Copayments
• Coinsurance
• Deductibles

Original Medicare doesn’t include drug coverage, but Part D does. A Part D plan — a stand-alone plan administered by private insurance companies — can be paired with Original Medicare to help ease your burden at the pharmacy. Medicare Advantage plans also offer drug coverage.

While there are ways to add supplemental and drug coverage to both Original Medicare and Medicare Advantage, a few offerings are exclusive to Medicare Advantage. Most Medicare Advantage plans offer options for dental, vision and hearing insurance — none of which are an option for Original Medicare beneficiaries. If those options are important to you, then…

In addition to offering some extra benefits and the ability to bundle, some Medicare Advantage plans also offer medical insurance without the monthly premiums charged to Part B enrollees. A GoHealth licensed insurance agent can walk you through the entire process of determining whether a Medicare Advantage plan is right for you — without cost or obligation.

Once you enroll in Original Medicare or a Medicare Advantage plan, you can take a deep breath. But that doesn’t mean you shouldn’t take stock of your situation in the future.

Each year from October 15 through December 7 — known as the Annual Enrollment Period (AEP) — brings you choices anew. During this period, you can switch from Original Medicare to Medicare Advantage or you can switch from one Medicare Advantage plan to another one. You also can add or switch Part D plans.