Dear Dr. Don,
At what age can I file for Medicare, and how will it impact my Social Security benefits? Can I file for Medicare and Medicaid even if I delay filing for Social Security?
— David Denouement
First, let me put part of your apparent concern to rest. Application for Medicare shouldn’t affect Social Security benefit eligibility. This is the proverbial apples and oranges comparison.
You should file for Medicare before you turn 65 unless you plan to use a private health insurance plan and want to continue using it. The initial enrollment period for Medicare begins three months before the month you turn 65 to three months after the month you turn 65. There can be a late enrollment penalty for certain types of Medicare coverage.
If you have a disability or permanent kidney failure, you may be able to apply for Medicare even earlier.
Avoid gaps in coverage
While you’re making this transition, make sure there aren’t any gaps in your health care coverage. Don’t cancel any health insurance until your Medicare coverage actually begins. Also, make sure to discuss any continuing coverage options with your employer or health care provider. You can download the publication “Medicare and Other Health Benefits: Your Guide to Who Pays First” for additional information on this topic.
Medicare coverage comes in four distinct parts:
- Part A (hospital insurance).
- Part B (medical insurance).
- Part C (Medicare Advantage plan). Like an HMO or PPO, this part replaces Part A and Part B.
- Part D (drug coverage).
One solution for the ‘gap’
You can buy a Medicare supplemental insurance policy, or Medigap, from a private insurer to cover gaps in original Medicare coverage, parts A and B. A Medigap policy can’t be used with the Medicare Advantage plan.
Medicare.gov has a publication, “Decide how to get your Medicare,” that walks you through the decision process as to which choice may be right for you. Contact Medicare if you don’t understand your choices.
Medicaid is a separate, state-run program. It provides hospital and medical coverage for people with low income and limited resources. Some people qualify for both programs. If you think that you qualify for both, then contact your local medical assistance agency, social services or welfare office.
Thanks to Edward Lafferty, a public affairs specialist at the Social Security Administration, for helping me with this reply.
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