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Consumer Alert: Medicare Enrollment

Insurance Commissioner Teresa Miller is advising consumers of factors that must be considered before they make a decision on which part they will enroll in when they become eligible for Medicare. If consumers are still working past 65 or go onto a retiree health plan through their employer after retirement, they need to see how their coverage is affected by Medicare-eligibility.

Medicare, which is administered by the federal Department of Health and Human Services, provides coverage. either directly or through private health insurance companies, at four different levels:

  • Medicare Part A (Hospital coverage)
  • Medicare Part B (Medical coverage)
  • Medicare Part C, or Medicare Advantage (Parts A and B together)
  • Medicare Part D (Prescription Drug coverage)

In order to offset some costs on to Medicare Parts A or B plans, some employer-sponsored health insurance policies may be secondary to Medicare when an individual becomes Medicare-eligible regardless of whether they have actually enrolled. Consumers should check with their human resources office or plan administrator and read their policy to see if this applies to their plan. Commissioner Miller also encouraged consumers to check this every year, as policy/plan terms may change, or the employer may change the plans offered to employees/retirees..

If a consumer decides that enrolling in Medicare is the best choice to ensure proper coverage, it may be better to enroll when they first become eligible. Electing to enroll in Medicare after their initial eligibility may result in a higher premium for late enrollment. The Medicare Initial Enrollment Period begins three months before a person turns 65 and ends three months after, and the General Enrollment Period for Medicare takes place from January 1-March 31 each year. Coverage selected during open enrollment begins July 1. There are also select situations which may qualify for a Special Enrollment Period.

Commissioner Miller also advised consumers who are disabled and Medicare-eligible to check how the eligibility will affect their  coverage.

For more information on Medicare enrollment and eligibility, visit www.medicare.gov. For more information on insurance in Pennsylvania, visit www.insurance.pa.gov or call 1-877-881-6388.