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Today we are launching a new series of guest columns. From time to time, we will bring you articles from expert practitioners in the field. This we hope will bring you more relevant, practical information on topics that might interest you. Today, in our guest column, we are introducing to you, Jim Merriman of the MedicareMan fame. Jim Merriman is a health insurance, medicare, long-term care insurance advisor. In consideration of the currently open annual medicare enrollment, Jim would like to bring you the following information pertaining to medicare and is commonly asked of him. In this post Jim wants to share with you some of the basic information on medicare enrollment.

How does one enroll in Medicare?
One is enrolled in medicare through one of the following options:
• automatically
• or by submitting an application

What do we mean?
If you are receiving Social Security benefits (or Railroad Retirement benefits), but not yet 65 years old, then you will be automatically enrolled in Medicare and so do not have to apply. You are automatically enrolled in both Part A and Part B and the Medicare card is mailed about 3 months before you turn 65. If you do not want Part B, you must follow the instructions that come with the card.

A disabled person will also be enrolled automatically in both Part A and Part B of Medicare beginning on the 25th month of disability. His/her card will be mailed about 3 months before the commencement of Medicare coverage.

One must manually apply for Medicare if, not already receiving Social Security or Railroad Retirement benefits, three months before the person turns 65, or if the person requires regular dialysis or a kidney transplant. From that day that person has up to 6 months for completing their initial enrollment. By applying early, one can avoid a possible delay in the start of his/her Part B coverage. Application can be made by contacting any Social Security Administration office. If an individual or his or her spouse worked for the railroad, they should contact the Railroad Retirement Board.

What happens if I don’t enroll during the initial enrollment window?
If you do not enroll during this 6-month period, you will have to wait until the next general (annual) enrollment period to enroll and receive Medicare benefits. General enrollment periods are from January 1 to March 31 of each year, and Part B coverage starts the following July. If you wait 12 or more months to sign up, the premiums will generally be higher. Part B premiums go up 10 percent for each 12 months that one could have enrolled but did not. The increase in the Part A premium (if one has to pay a premium) is 10 percent more regardless of the actual amount of delay in enrolling, as long as the enrollment was delayed.

Hint: This year’s general enrollment period will be ending soon on March 31st. So if you are eligible to enroll this year, but haven’t enrolled yet, now is probably the best time to enroll and thus ensure your coverage begins on time.

Can I delay enrollment if I have a special situation?
Under certain circumstances, however, one can delay his/her Part B enrollment without having to pay higher premiums. If the person is age 65 or over and has group health insurance based on self or spouse’s current employment, or if he/she is disabled and has group health insurance based on his/her current employment or the current employment of any family member, he/she has a choice:
• he/she may enroll in Part B at any time while covered by the group health plan
• he/she can enroll in Part B during the 8-month enrollment period that begins the month the employment ends or the month he/she is no longer covered under the employer plan, whichever comes first

When does my coverage begin?
If you enroll in Part B while still covered by an employer plan or during the first full month of terminating that plan, your coverage begins the first day of the month enrolled. You may also have the option of delaying coverage until the first day of the following 3 months. If the enrollment happens during any of the 7 remaining months of the special enrollment period, the coverage begins the month after enrollment. If you do not enroll by the end of the 8-month period, you will have to wait until the next general enrollment period that begins January 1 of the next year.

Even if you continue to work after turning 65, you should sign up for Part A of Medicare. Part A may help pay some of the costs not covered by the employer plan. It may not, however, be advisable to sign up for Part B if you have health insurance through an employer. You would have to pay the monthly Part B premium, and the Part B benefits may be of limited value as long as the employer plan was the primary payor of medical bills. By signing up you would also trigger the 6-month Medicare Supplement open enrollment period.

Applicants have three important decisions to make:
• Do I want to keep Medicare Part B?
• If I keep Medicare Part B, how do I want to receive the Medicare-covered services?
• Do I need supplemental insurance to pay for services and products that Medicare does not cover?

You must keep Part B to be able to join any of the Medicare managed care plans, Medicare medical savings accounts, Medicare Supplemental Plans, or other Medicare health insurance options. If you do not keep Part B, you will only be eligible to receive Medicare hospital coverage.

If you are turning 65 or are older, you can delay taking Part B medical insurance if:
• you or your spouse (of any age) continue to work
• you are covered under a group health plan from that employer

If someone is under the age of 65 and disabled, he/she can also delay Part B if
• he/she or any family member is currently working
• he/she has group health plan coverage from that current employment.

If one does not have group health plan coverage based on current employment, and still delays taking Part B, then the monthly premium may be higher. The premium will increase by 10 percent for every 12 months that someone does not take Part B in spite of being eligible.

If you do not keep Part B during your initial enrollment, you will only have a chance to sign up again for it only once a year – between January 1 and March 31. Your Part B insurance will start the following July. If you choose to delay taking Part B because of current coverage through a group health plan, you may be able to avoid paying this higher premium by signing up for Part B while you continue to have this group coverage. You can also sign up within eight months after the employment ends or the group health coverage ends, whichever comes first.

Things to remember while the medicare coverage is in force:
Once enrolled, the insured will receive a Medicare card imprinted with his/her name and Medicare claim number. It shows what coverage you have (Part A, Part B, or both), and the effective date your coverage started. You should show this card while obtaining medical care. This will assure that a claim for payment is sent to Medicare. Each person should make sure to use their exact name and claim number. If you are married, your spouse will have his or her own card and claim number. Under no circumstances should one ever let anyone else use their Medicare card. You should safeguard your medicare number just as you would safeguard your credit card number. You should also take your card with you during your travels, and have it handy while making calls about a Medicare claim. If you lose your card, you should contact the Social Security Administration right away.

Coming Soon: All your basic questions on medicare answered. So stay tuned…