What You Must Know Before You Apply for Medicare

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Everyone needs healthcare coverage. And almost everyone will someday start using Medicare as a primary component of their comprehensive plan. While that is very comforting, it can also lead to complacency.

Because while we all know Medicare will be there for us when we need it, fewer of us actually dig into the details to understand how it all works — until it’s time to sign up. This is natural. We all procrastinate. But with something this important, it pays off to dive in with a lot of knowledge.

But whether you are desperately in need of Medicare coverage today, planning on retiring in a few years, or have aging parents who need some support, it’s time to get with the program. 

There’s no need to worry, however. You’re in luck. Because Medicare actually isn’t as confusing as it might initially seem.

So before you get lost in the weeds, be sure to nail down the basics. In particular, the following are a few of the biggest factors to keep in mind as you or your loved ones get prepared to apply for Medicare.

When to Apply for Medicare

A lot of people nearing retirement age aren’t sure about when to apply for Medicare. Especially in today’s economy, when so many people keep working beyond their 65th birthday, they don’t know whether they should enroll now or wait until they actually stop working.

The answer? Do it right now if you can. Because even if you are planning to stay in your current job and opt to remain with your employer-provided plan, it still makes sense to apply as soon as possible when you are nearing 65. This way, you will be prepared for the day when you need to start taking advantage of Medicare benefits and you won’t be hit with any of the penalties or restrictions that can apply if you miss your Initial Enrollment Period.

Medicare Initial Enrollment Period (IEP)

Everyone who is a U.S. citizen on the verge of turning 65 years old will first become eligible for Medicare during what is called the Initial Enrollment Period (IEP). This begins three months before you hit the magic age and then continues for another three months after your big day. In all, this is a seven-month window. (Technically, you have the three months preceding your 65th birthday, the month of your 65th birthday, and then the three following months.)

If you miss this window, you will still be able to enroll later. But there will be a late-enrollment penalty and the window gets smaller and will only open up at certain times of the year. And that last part can prove especially problematic if you decide to retire suddenly or otherwise come off of your employer-provided healthcare coverage unexpectedly.

Getting the Broadest Coverage

Once you enroll, you will then have access to the basic healthcare coverage offered through Medicare. Known as Part A and Part B, these two components are the core (or “Original Medicare”) aspects of your plan and will provide for hospitalization and typical doctor visits. This is the basic coverage.

But broader, optional coverage is also available through what is known as Medicare Part C and Part D. Typically called Medicare Advantage plans, signing up for this coverage will give you more access to a wider network of medical professionals, including specialist visits without a referral, and cover many common drug prescription costs. 

Most people who have the means these days opt for a Medicare Advantage plan. They add a lot — without costing a lot — so it makes a lot of sense from both a medical and financial perspective.

Making Medicare Work for You

With all of its technical terms, medical language, and confusing segmentation, Medicare can certainly seem very confusing. But it really isn’t quite that complex once you understand the key provisions and realize that applying is not actually that difficult. No bureaucratic process will ever be “simple.” But now you know that it doesn’t have to be so hard.

The keys to making it work for you are knowing when to apply for Medicare, recognizing when the Initial Enrollment Period (IEP) begins for you, and working to make sure you get the broadest possible plan to cover all your medical needs during the later stages of life.

There are definitely a few other details and nuances that you will want to learn as you continue down the path to enrollment. And it’s definitely worth doing even more homework. 

But, for now, as you start to prepare for this new healthcare journey, focus on the big-picture aspects of Medicare. That way, you will be able to rest easier without becoming overwhelmed. Because, as we all know, cutting out stress is a great way to stay healthy — and enjoy your twilight years.


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