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Welcome to Summit Health

New to Medicare?

Are you turning 65 or are under 65 and have been receiving disability for 24 months? You may be eligible for Medicare.


Let us help you understand who qualifies for Medicare and how you can enroll in a plan that meets your lifestyle, priorities and health needs.



Should I enroll?

You can enroll in Medicare during your initial enrollment period, which begins three months before your 65th birthday and ends three months after your birthday month. You may be able to enroll outside of your initial enrollment period if you have a qualifying event.

What if I don't enroll?

It’s important to know that there may be penalties if you do not enroll. If you decide to delay enrollment, you may have to pay a lifetime late enrollment penalty.

How to enroll

If you have not applied for Social Security benefits, you will need to contact Social Security to sign up for Medicare. If you have applied for, or are already receiving, Social Security or Railroad Retirement Board benefits, you will receive a Medicare card and packet in the mail three months before your 65th birthday.

Key dates to enroll

Based on your age and circumstances, there are different time periods that you can enroll in Medicare. Find out when you can enroll during your initial enrollment period and special enrollment periods for other qualifying events. Learn more
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What if I’m covered by my current employer

If you are working now and are covered by your employer or your spouse’s employer, the size of the employer determines whether you can delay enrollment without paying the penalty:
  • If the employer has fewer than 20 employees and you enroll in Part A and Part B during your initial enrollment period, Medicare will pay before your other coverage. It is best to enroll as soon as you are eligible. If you do not, you may have to pay a Part B late enrollment penalty and have a gap in coverage.
  • If the employer has 20 or more employees, talk with your benefits administrator. Ask if they have group health plan coverage as defined by the IRS. If they do, you may be able to delay enrolling in Part A and Part B without paying a lifetime late enrollment penalty.
  • If you are getting retiree coverage from an employer, you should sign up for Part A and Part B as soon as you are eligible.
  • If you have marketplace or other private insurance, you should sign up when you are first eligible and drop your other insurance so that it stops when your Medicare coverage starts.
You have eight months after employer coverage ends to enroll without paying a penalty. This is true whether or not you choose COBRA.

 


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Coordinating benefits with your group plan

Please know that Medicare is the primary coverage in certain situations. If you qualify for Medicare Part B, but do not enroll when Medicare is the primary coverage, an employer health plan may not pay for a covered expense that Medicare Part B covers.

For example, this may affect you if you have one of the following types of coverage: individual, a group plan with fewer than 20 employees, domestic partner, COBRA or retiree. This also applies if you are eligible for Medicare due to a disability, and your employer has fewer than 100 employees.

If one of these situations applies and you do not have Medicare Part B, your plan could reduce the amount paid by the amount Medicare Part B would pay, and you would need to pay the amount due.



Medicare parts: A, B, C, D

Part A and B

Getting Part A and Part B — Original Medicare

Original Medicare is also called Part A and Part B. Part A is hospital insurance. Part B is medical insurance. You can sign up for Part A and Part B during the initial enrollment period. Most people should enroll in Part A at this time. You can delay enrolling in Part A and Part B, but you may have to pay a higher premium.

To sign up for Part A and Part B, you will need to contact the Social Security office. You can apply online at ssa.gov. You can also visit a local office.






Part C

Getting Part C — Medicare Advantage

Medicare Advantage plans offer the same coverage as Original Medicare and more. In addition to what Original Medicare covers, Medicare Advantage plans may offer extra benefits, including pharmacy, vision, dental, hearing, gym memberships, wellness resources and discounts.

To search for and enroll in Part C plans, you can visit medicare.gov. You can also contact private insurers directly.








Part D

Getting Part D — prescription drug coverage

If you have already enrolled in Original Medicare, Part A or Part B, you will need to decide whether or not you would like prescription drug coverage. Prescription drug coverage is also known as Part D.

If you would like Part D, you will need to get it from a private insurer. Each has its own formulary (list of covered drugs) and related costs. Private insurers can provide you with a standalone prescription drug plan. You can also get prescription drug coverage as part of a Medicare Advantage plan.

If you know you will need Part D, it’s best to get it during your initial enrollment period to avoid a late penalty. If you did not enroll in Part D during your initial enrollment period, you can enroll during the annual enrollment period, which is Oct. 15 to Dec. 7.

Last updated Nov. 6, 2020
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Contact us

Have questions? We’re here to help. Call us today at 844-827-2355 (TTY users, please call 711). Our customer service team is available from 7 a.m. to 8 p.m., Pacific Time, seven days a week from Oct. 1 to March 31. After March 31, your call will be handled by our automated phone system on weekends and holidays.

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