Search
Close this search box.

Medicare Eligibility at 65: What You Need to Know

Print Article

NOVEMBER 10, 2014 VOLUME 21 NUMBER 41

Almost ten thousand Americans turned 65 today. Almost all of them will be eligible for Medicare coverage. Those who are new to Medicare will need to make some decisions about whether to sign up for Part B, what to do about Part D, whether to choose Medicare Advantage or “traditional” Medicare, and whether to purchase a “Medigap” policy. Generally speaking, today’s new 65-year-olds have a seven-month period to make their decisions — starting three months ago and running through this month and the next three months.

If you are in that group, you might wonder where you can go to find information about your options. There are a few reliable, unbiased options out there, but our favorite by far is your local Area Agency on Aging. If you live in Tucson, that would be the Pima Council on Aging. If you’re planning on turning 65 in the next few months, or if you just did and you haven’t done anything about it yet, get on the phone and call the PCOA right now. They’ll probably suggest that you sign up for their monthly New to Medicare Workshop, held once a month at the PCOA offices. Go.

There are a number of common Medicare mistakes new 65-year-olds make. You can learn about your options, and how to avoid those mistakes. Some of the things to watch out for:

  • When you sign up for Medicare, you have the option of skipping Part B coverage. Very, very few new Medicare beneficiaries should skip that coverage — even if you feel that you just don’t need it (or can’t afford it) now. Generally, the only people who should skip Part B are those who have current employer-provided health coverage (including active-duty members of the military). Covered by COBRA, Tricare or other private insurance? Get Part B coverage. What happens if you don’t? Later, when you do sign up for Part B (and you almost certainly will), the premiums will be high enough to essentially recapture your “missed” contributions. And don’t assume that your existing coverage qualifies to avoid the increased premiums in the future — check with your Area Agency on Aging, Medicare and/or your employer.
  • You get coverage for medications one of two ways: either you sign up for a “Part D” plan or drug coverage is part of your Medicare Advantage plan. Make sure you sign up for Part D one way or the other. As with Part B, failure to sign up now just means your premiums will be higher later. Don’t think you need (or can afford) Part D coverage? Consider AARP’s suggestion: sign up for the cheapest plan available in your community, primarily so that you don’t pay a penalty later when you do need medication coverage.
  • Don’t think you qualify for Medicare because you haven’t worked for 40 quarters? Get more information. You might want to sign up for Part B and Part D coverage now. You might be better off getting Medicare coverage even if you have to pay a premium (it might, for example, be cheaper and better than your current coverage). You might qualify under a spouse’s work history. Check it out.
  • Still working at 65? You still qualify for Medicare. It’s not tied to your work status, and the eligibility age hasn’t increased to 66, as Social Security already has — and Social Security’s retirement age is headed to 67. But not Medicare.
  • Are you already receiving Social Security benefits? If you are on Social Security Disability, your Medicare card will automatically arrive in the mail after you’ve had two years of SSDI benefits. If you’re receiving Social Security retirement benefits (because you signed up for Social Security between ages 62 and 65), your card will arrive automatically three months before your 65th birthday. When you get that card, you have seven months to sign up for Part A and Part B, choose your plan and select drug coverage.

Those are some of the basic rules (and things to watch out for). The program is complicated, though, and there is much uncovered here. There are special rules for people who are volunteering out of the country on their 65th birthday. There are new rules for same-sex spouses (expanding their coverage to match prior rules covering opposite-sex couples). There are issues of overlap between Affordable Care Act policies and Medicare. There are other benefits that help poor Medicare beneficiaries pay for their premiums, deductibles and co-payments. There is a high likelihood that one of the special rules has some effect on you, so get in touch with your Area Agency on Aging to find out more about your Medicare coverage.

Stay up to date

Subscribe to our Newsletter to get our takes on some of the situations families, seniors, and individuals with disabilities find themselves in. These posts help guide you in the decision making process and point out helpful tips and nuances to take advantage of. Enter your email below to have our entries sent directly to your inbox!

Robert B. Fleming

Attorney

Robert Fleming is a Fellow of both the American College of Trust and Estate Counsel and the National Academy of Elder Law Attorneys. He has been certified as a Specialist in Estate and Trust Law by the State Bar of Arizona‘s Board of Legal Specialization, and he is also a Certified Elder Law Attorney by the National Elder Law Foundation. Robert has a long history of involvement in local, state and national organizations. He is most proud of his instrumental involvement in the Special Needs Alliance, the premier national organization for lawyers dealing with special needs trusts and planning.

Robert has two adult children, two young grandchildren and a wife of over fifty years. He is devoted to all of them. He is also very fond of Rosalind Franklin (his office companion corgi), and his homebound cat Muninn. He just likes people, their pets and their stories.

Elizabeth N.R. Friman

Attorney

Elizabeth Noble Rollings Friman is a principal and licensed fiduciary at Fleming & Curti, PLC. Elizabeth enjoys estate planning and helping families navigate trust and probate administrations. She is passionate about the fiduciary work that she performs as a trustee, personal representative, guardian, and conservator. Elizabeth works with CPAs, financial professionals, case managers, and medical providers to tailor solutions to complex family challenges. Elizabeth is often called upon to serve as a neutral party so that families can avoid protracted legal conflict. Elizabeth relies on the expertise of her team at Fleming & Curti, and as the Firm approaches its third decade, she is proud of the culture of care and consideration that the Firm embodies. Finding workable solutions to sensitive and complex family challenges is something that Elizabeth and the Fleming & Curti team do well.

Amy F. Matheson

Attorney

Amy Farrell Matheson has worked as an attorney at Fleming & Curti since 2006. A member of the Southern Arizona Estate Planning Council, she is primarily responsible for estate planning and probate matters.

Amy graduated from Wellesley College with a double major in political science and English. She is an honors graduate of Suffolk University Law School and has been admitted to practice in Arizona, Massachusetts, New York, and the District of Columbia.

Prior to joining Fleming & Curti, Amy worked for American Public Television in Boston, and with the international trade group at White & Case, LLP, in Washington, D.C.

Amy’s husband, Tom, is an astronomer at NOIRLab and the Head of Time Domain Services, whose main project is ANTARES. Sadly, this does not involve actual time travel. Amy’s twin daughters are high school students; Finn, her Irish Red and White Setter, remains a puppy at heart.

Famous people's wills

Matthew M. Mansour

Attorney

Matthew is a law clerk who recently earned his law degree from the University of Arizona James E. Rogers College of Law. His undergraduate degree is in psychology from the University of California, Santa Barbara. Matthew has had a passion for advocacy in the Tucson community since his time as a law student representative in the Workers’ Rights Clinic. He also has worked in both the Pima County Attorney’s Office and the Pima County Public Defender’s Office. He enjoys playing basketball, caring for his cat, and listening to audiobooks narrated by the authors.