Medicare Enrollment: How to Enroll and the Different Enrollment Periods
From the Show: Stoughton Hospital Health Talk
Summary:
Air Date: 12/21/21
Duration: 10 Minutes
In this episode, Ben Rothering talks about the basics of Medicare. We can learn who Medicare is for, how to enroll, and what is the enrollment period.
Transcription:
Scott Webb: Welcome to Stoughton Health Talk. I'm Scott Webb. And this is part one of a five-part series on Medicare. For anybody who is eligible for Medicare or perhaps already on it, you probably know that it can be a bit confusing. And joining me for this series to help answer the most common questions folks have about Medicare enrollment and the various parts A through D is Ben Rothering. He's a licensed insurance salesman who specializes in helping guide people through the Medicare process.
So Ben, welcome to the podcast. This is the first in a five-part series that we're doing on Medicare and the respective parts A through D. In this first episode, we're going to just kind of do a little Medicare 101 for listeners. Just kind of explain what it is, who it's for, and then we're going to get into enrollment and all those, you know, particulars. So as we get rolling here, what is Medicare exactly? And who generally is it for?
Ben Rothering: Medicare is a federally-funded program. It's health insurance for seniors, typically for people that are getting ready to turn 65. It can be available for people who are under the age of 65, if they qualify due to some sort of medical requirements. If they have a disability that qualifies them or permanent kidney failure, that can also get them into Medicare earlier.
Scott Webb: And you mentioned that it's generally for folks who are turning 65. So let's talk about that and let's get into enrollment because I know that it's particular, it's specific, there's things that folks need to know, and that's why we have you on and your expertise today. So tell us about Medicare enrollment.
Ben Rothering: First, what I would say to help people with enrollment is to go to the Social Security website, ssa.gov and create a my Social Security account. That can certainly help streamline the process and make it a lot easier versus setting up phone calls or going and standing in line at the Social Security Office.
There are three different timelines that most people are going to fall into or enrollment periods as we call them. The first enrollment period is called the initial enrollment period. This is when someone is getting ready to turn 65 and it's a seven-month long window. It starts three months prior to your birth month, your birth month and then three months after your birth month. So a lot of people will fall into that, especially if you want to go on Medicare right away.
The next enrollment period that most people will fall into would be called a special enrollment period. So this would be if someone decides that they're going to keep working beyond the age of 65 and they still maybe have group coverage through an employer or maybe their spouse has coverage through an employer. And down the road, years later, they decide that they're going to retire and now that group coverage is going to end, they are going to fall into this special enrollment period where they have a qualifying event, losing that group coverage, that allows them to pick up Medicare Part B and a supplement or anything else that they need at that time, without having to incur a penalty for taking it out later.
The third and maybe less common enrollment period is called the general enrollment period. So this is when someone does not take Medicare out at 65 and they have no other health insurance to speak of like through a group, you know, group insurance or through an employer, and they get outside of their initial enrollment period and now they think, "I should probably pick up Medicare." So what happens here, this is between January 1st and the end of March every year, this is the general enrollment period, when those people can apply for Medicare. And then it won't begin until the following July, and that is when a penalty will take effect.
Scott Webb: Is there ever a time when someone would be denied Medicare? Like, is that a thing? Is that possible? You talked about, you know, there's times to enroll when there is no penalty. But also, as you say, this last option, there could be a penalty. Is there ever a time when someone would be denied Medicare coverage?
Ben Rothering: I don't believe anybody would be denied Medicare parts A and B. Again, just during that general enrollment period, if you didn't take advantage of the initial enrollment period or the special enrollment period if you had one, you know, you would just end up having to pay a higher amount, right? There's a 10% penalty per year for every year that is delayed in picking up Medicare, you know, if you didn't have other health insurance to speak of that would be considered as credible coverage.
Scott Webb: Got it. So you can't really be denied Medicare, but of course there can be penalties for missing enrollment windows or enrolling late, or, you know, whatever it might be. So it's really great to have your expertise because my head was kind of spinning a little bit there. I was like, "Oh my, how would the average person, the average citizen be able to manage all of this?"
And Ben, I'll give you an opportunity here. Tell folks how they can reach you, what you do specifically. I mean, today your role as in this series is to help educate obviously on behalf of Stoughton, and for the listeners, this is a great education, a great free education, but you also get paid to do what you do. So tell folks a little bit about yourself, what you do and how they can reach you.
Ben Rothering: So I am actually a former school teacher and I got into this because I still want to be able to help and educate people. I know that Medicare can be very confusing for a lot of people. And so if I can help try to smooth out the process, that's my goal. And I don't charge consulting fees or anything like that. If somebody likes me enough and they want to work with me and I'm more than happy to help then, you know, that's how I ended up making my living. But you can reach me. My cell phone number is (608) 354-3869 or you can reach me by email and that's my last name, is Rothering, R-O-T-H-E-R-I-N-G, the number 2-7 at gmail.com, so This email address is being protected from spambots. You need JavaScript enabled to view it. .
Scott Webb: Got it. Well, this has been educational and we've got plenty more education to come as we go through the respective parts, A through D. But we got our sort of Medicare 101 out of the way in the enrollment stuff. And obviously, if folks have more questions and, as you say, they like you, they can certainly reach out to you. And in our next episode, we're going to talk about Medicare Part A and we'll do that soon. So thanks, Ben, and you stay well.
Ben Rothering: You as well. Thank you so much.
Scott Webb: For more information, head to stoughtonhealth.com And that concludes this episode of Stoughton Health Talk. Please remember to subscribe, rate and review this podcast and all the other Stoughton Hospital podcasts. I'm Scott Webb. Stay safe and be well.
Scott Webb: Welcome to Stoughton Health Talk. I'm Scott Webb. And this is part one of a five-part series on Medicare. For anybody who is eligible for Medicare or perhaps already on it, you probably know that it can be a bit confusing. And joining me for this series to help answer the most common questions folks have about Medicare enrollment and the various parts A through D is Ben Rothering. He's a licensed insurance salesman who specializes in helping guide people through the Medicare process.
So Ben, welcome to the podcast. This is the first in a five-part series that we're doing on Medicare and the respective parts A through D. In this first episode, we're going to just kind of do a little Medicare 101 for listeners. Just kind of explain what it is, who it's for, and then we're going to get into enrollment and all those, you know, particulars. So as we get rolling here, what is Medicare exactly? And who generally is it for?
Ben Rothering: Medicare is a federally-funded program. It's health insurance for seniors, typically for people that are getting ready to turn 65. It can be available for people who are under the age of 65, if they qualify due to some sort of medical requirements. If they have a disability that qualifies them or permanent kidney failure, that can also get them into Medicare earlier.
Scott Webb: And you mentioned that it's generally for folks who are turning 65. So let's talk about that and let's get into enrollment because I know that it's particular, it's specific, there's things that folks need to know, and that's why we have you on and your expertise today. So tell us about Medicare enrollment.
Ben Rothering: First, what I would say to help people with enrollment is to go to the Social Security website, ssa.gov and create a my Social Security account. That can certainly help streamline the process and make it a lot easier versus setting up phone calls or going and standing in line at the Social Security Office.
There are three different timelines that most people are going to fall into or enrollment periods as we call them. The first enrollment period is called the initial enrollment period. This is when someone is getting ready to turn 65 and it's a seven-month long window. It starts three months prior to your birth month, your birth month and then three months after your birth month. So a lot of people will fall into that, especially if you want to go on Medicare right away.
The next enrollment period that most people will fall into would be called a special enrollment period. So this would be if someone decides that they're going to keep working beyond the age of 65 and they still maybe have group coverage through an employer or maybe their spouse has coverage through an employer. And down the road, years later, they decide that they're going to retire and now that group coverage is going to end, they are going to fall into this special enrollment period where they have a qualifying event, losing that group coverage, that allows them to pick up Medicare Part B and a supplement or anything else that they need at that time, without having to incur a penalty for taking it out later.
The third and maybe less common enrollment period is called the general enrollment period. So this is when someone does not take Medicare out at 65 and they have no other health insurance to speak of like through a group, you know, group insurance or through an employer, and they get outside of their initial enrollment period and now they think, "I should probably pick up Medicare." So what happens here, this is between January 1st and the end of March every year, this is the general enrollment period, when those people can apply for Medicare. And then it won't begin until the following July, and that is when a penalty will take effect.
Scott Webb: Is there ever a time when someone would be denied Medicare? Like, is that a thing? Is that possible? You talked about, you know, there's times to enroll when there is no penalty. But also, as you say, this last option, there could be a penalty. Is there ever a time when someone would be denied Medicare coverage?
Ben Rothering: I don't believe anybody would be denied Medicare parts A and B. Again, just during that general enrollment period, if you didn't take advantage of the initial enrollment period or the special enrollment period if you had one, you know, you would just end up having to pay a higher amount, right? There's a 10% penalty per year for every year that is delayed in picking up Medicare, you know, if you didn't have other health insurance to speak of that would be considered as credible coverage.
Scott Webb: Got it. So you can't really be denied Medicare, but of course there can be penalties for missing enrollment windows or enrolling late, or, you know, whatever it might be. So it's really great to have your expertise because my head was kind of spinning a little bit there. I was like, "Oh my, how would the average person, the average citizen be able to manage all of this?"
And Ben, I'll give you an opportunity here. Tell folks how they can reach you, what you do specifically. I mean, today your role as in this series is to help educate obviously on behalf of Stoughton, and for the listeners, this is a great education, a great free education, but you also get paid to do what you do. So tell folks a little bit about yourself, what you do and how they can reach you.
Ben Rothering: So I am actually a former school teacher and I got into this because I still want to be able to help and educate people. I know that Medicare can be very confusing for a lot of people. And so if I can help try to smooth out the process, that's my goal. And I don't charge consulting fees or anything like that. If somebody likes me enough and they want to work with me and I'm more than happy to help then, you know, that's how I ended up making my living. But you can reach me. My cell phone number is (608) 354-3869 or you can reach me by email and that's my last name, is Rothering, R-O-T-H-E-R-I-N-G, the number 2-7 at gmail.com, so This email address is being protected from spambots. You need JavaScript enabled to view it. .
Scott Webb: Got it. Well, this has been educational and we've got plenty more education to come as we go through the respective parts, A through D. But we got our sort of Medicare 101 out of the way in the enrollment stuff. And obviously, if folks have more questions and, as you say, they like you, they can certainly reach out to you. And in our next episode, we're going to talk about Medicare Part A and we'll do that soon. So thanks, Ben, and you stay well.
Ben Rothering: You as well. Thank you so much.
Scott Webb: For more information, head to stoughtonhealth.com And that concludes this episode of Stoughton Health Talk. Please remember to subscribe, rate and review this podcast and all the other Stoughton Hospital podcasts. I'm Scott Webb. Stay safe and be well.
