Trying to figure out the steps you need to take when you are newly eligible for Medicare can be a little overwhelming. But it doesn’t have to be. We put together this Medicare checklist of the items you need to do to get your coverage started.
There are a lot of things you can do on your own. There are also some things you should enlist some help for. The great news is that getting help from an insurance agency or independent agent costs you absolutely nothing. Yes, you heard that right! We will get more into how you can get an agent who works for you (and not the insurance company) can be of great benefit, but first, here is a Medicare checklist of the steps you can take to get the ball rolling on the best medical insurance you have ever had
Table of Contents
Step 1 – Confirm You Are Eligible For Medicare
Most people choose to enroll in Medicare Part A and Part B when they first turn 65. But there may be situations where you choose to continue working and have coverage through your employer or may choose to take benefits from a retiree plan. You can check with Medicare directly for eligibility at 1-800-MEDICARE or at medicare.gov. We also have a page on our website with more helpful information at https://integritysenior.com/medicare-eligibility/
Step 2 – Learn About Medicare Costs
You can enroll in Medicare Part A when you turn 65. Most people don’t pay anything for Medicare Part A. If you worked at least 40 quarters (or 10 years) in your life in the United States, you can receive Part A at no cost. Part B and Part D premiums are based upon your modified adjusted gross income. We have some helpful income charts and information on our website to help you know what you can expect to pay for your actual Medicare coverage. These costs are in place regardless of what type of insurance coverage you choose to cover the gaps in Medicare (with a Medigap plan) or to replace Medicare Parts A and B with Medicare Part C, also known as a Medicare Advantage plan. That website is at https://integritysenior.com/medicare-costs/
Step 3 – Apply for Medicare Coverage Through Social Security
You apply for Medicare Part A and Part B coverage through Social Security. Be sure that you don’t miss your opportunity to enroll when you are first eligible. Not doing so could lead to late enrollment penalties and delays in getting coverage.
If you are already receiving Social Security benefits at least 4 months before turning 65, you will automatically be enrolled in Part A and Part B effective on the first day of your birth month. If your birthday falls on the first day of the month your coverage is effective on the first day of the previous month. So if you were born on September 1, 1960, your effective date will be on August 1, 2025.
If you are not already receiving SSA benefits when you turn 65, you will need to enroll with Social Security in one of three ways:
- Call them at 1-800-772-1213 (TTY 1-800-325-0778)
- Enroll through the website at https://ssa.gov
- Enroll through your local Social Security office
When you receive your red, white, and blue Medicare card in the mail, confirm that you are enrolled in both Part A and Part B.
Step 4 – Learn About the Different Medicare Coverage Options
The biggest decision you will have to make concerning your coverage to fill the gaps of Medicare is whether to go with a Medicare Supplement plan or a Medicare replacement plan. A Medicare Supplement, or Medigap, plan works alongside original Medicare. It fills the gaps and covers some or even all of the co-pays and deductibles, depending on which Medigap plan you choose. There are no networks to worry about with a Medigap plan along with original Medicare. If your doctor or hospital accepts Medicare, they will accept your Medicare Supplement plan 100% of the time.
With a Medicare replacement plan, or Medicare Advantage plan, you are pulled from Medicare Part A and Part B and covered under Part C. Part C coverage is provided completely by an insurance company that determines which doctors and facilities you can use to get the best coverage. There are many different types of Medicare Advantage plans.
There are pros and cons for each program. We go in-depth into those pros and cons of both programs on our website at https://integritysenior.com/medicare-advantage-medicare-supplement-pros-cons/
Step 5 – Find the Best Part D Drug Plan
If you are choosing a Medicare Advantage plan, it will most likely include prescription drug coverage in the plan. If you are choosing original Medicare with a Medigap plan, you will want to find a suitable drug plan. You can contact Medicare directly to find the best drug plan at 1-800-MEDICARE or online at Medicare.GOV.
Step 6 – Why You Should Use an Independent Agent
There is a lot of information concerning your coverage under Medicare. An independent agent can help you wade through all of the information and make sense of it all. Best of all, there is no charge to you for this service. You pay the same exact premium for coverage whether you allow an independent agent to help you before and after your enrollment in a plan or you go directly to the insurance company to get you coverage. But there are far more benefits to using an independent agent. They can shop the entire market and show all available plans to you. If you call the insurance company directly, they will only tell you about their plans. They will not share about upcoming rate increases or how they have handled rate increases in the past. They will never tell you their competitors’ prices or where they fit compared to all the other available plans. There are many more benefits, all of which are free to you! Check out more information on how an independent agent can benefit you at https://integritysenior.com/use-independent-agent/
Click here to download and print this Medicare checklist as a PDF so you can mark the items off as you complete them – Medicare Checklist (CLICK)