FAQs About Medicare

It’s common to have numerous questions about Medicare and the various options for Medicare Supplements and Medicare Advantage Plans. I am here to answer your questions. Please feel free to email me at: norma@yourmedicarepharmacist.com You can text or call me at: 931-777-9801 as well. I will pick up or respond as long as I am available. I don’t restrict questions to limited office hours.

I’m turning 65, when can I enroll into Medicare? 

The window to enroll into Medicare is 3 months before your birth month, the month of your birth month, and the 3 months after your birth month. For example, if your birthday is June 15th, your enrollment period opens March 1st and continues through September 30. Following the above example, if you enroll between March 1st and May 31st, your effective date will be June 1st. If you enroll between June 1st and June 30th, your effective date will be July 1st. If you enroll July 1st through July 31st, your effective date will be September 1st. If you enroll August 1st through August 31st, your effective date will be November 1st. If you enroll September 1st through September 30th, your coverage won’t be effective until December 1st. For this reason, it’s important to enroll during the first 3 months before your birth month.

How do I enroll into Medicare? 

The easiest way to enroll into Medicare is to go to www.socialsecurity.gov If you have never created a Social Security account, they will have you create one now. Be sure to record username, password, and any security question answers. Once that’s completed you are ready to sign up for Medicare. Select Medicare Enrollment. Scroll down the page until you find the light blue button labeled Apply for Medicare Only. Fill out the application as instructed. If you want to sign up for Part A now and delay Part B because you have creditable coverage through an employer, you will select delay Part B when you get to that point. If you plan to take Part A and B now just don’t select delay Part B. Once the application is completed hit Submit. Write down the confirmation number and keep it to reference later if needed. The enrollment process time varies but it can take 2-4 weeks or longer. You can sign into your account and check the status from time to time to see if you Medicare number is posted. You will receive a letter and your Medicare card so watch your mail.

I am turning 65 but have coverage through my (or my spouses) employer. Do I still need to enroll in Medicare? 

If you have credible coverage from your or your spouses’ employer and that will continue past 65 then you will want to sign up for Part A but delay Part B. You will sign up just like the above scenario but when it asks you if you want to delay Part B you will say yes. Part A is premium free for most people, therefore, it’s a good idea to go ahead and sign up of Part A. However, if you or your/spouses employer contribute to an HSA account, you will NOT want to sign up for Part A at this time either. In that case you will do NOTHING. But if you or your/spouses’ employer does not contribute to an HSA, then sign up for Part A and delay Part B for now. You will sign up for Part B about 2 months before you lose that coverage when you or your spouse decides to retire.

 I delayed Part B because I had credible coverage, but I am now ready to retire, what do I do? 

About 2 months before retiring, you will want to sign up for Part B. To do that you will need to print off CMS form L564 Request for Employment Information and CMS form 40B Application for Enrollment in Medicare Part B. You will have your employer fill out form L564 and you will fill out form 40B. When you go to enroll in Part B you will be required to upload both of these forms. You can request a particular start date for Part B by writing that in the remarks section of the form. The requested date will be the first of whichever month you want it to start. Be sure to print this legibly. If you need these forms you can email me and I’ll be happy to email them to you.

How will Medicare bill my premiums?

If you are NOT drawing Social Security: Once you apply for Medicare and are approved you will be sent a bill for 3 months advanced premium ($445.50) due before your Medicare even starts. You can create an account at mymedicare.gov where you can pay that initial bill and you may want to sign up for Medicare Easy Pay. If you sign up for Easy Pay, Medicare will bill all future premiums monthly around the 20th of each month. If you do NOT sign up for Easy Pay, Medicare will bill you quarterly (every 3 months) via paper bill. To prevent falling behind in payments, which will result in your losing Medicare and any other plan you signed up for (MAPD or Supplement), its best to sign up for Easy Pay after you pay the initial 3 months advance. If you ARE drawing Social Security and elected to have your premium withdrawn from your Social Security check, they will bill your premium monthly ($148.50). There will be no 3 month advance pay. Keep in mind that if you owe IRMAA due to having a higher income or have any late enrollment penalties, you will also be billed that adjusted rate as well.

How does my income affect Medicare?

Higher income earners will be assessed an Income Related Monthly Adjustment Amount (IRMAA) on both Parts B and D. Please see below for more on this topic.

2021 Medicare Costs & Premiums

PART A (Hospital)

Inpatient Hospital Stay You Pay...(benefit period ends 60 days after release from care)

  • Deductible: $1,484 per benefit period
  • Coinsurance (days 1-60): $0 per day of each benefit period
  • Coinsurance (days 61-90): $371 per day of each benefit period
  • Coinsurance (60 lifetime reserve days): $742 per day after day 90 of each benefit period

Skilled Nursing Facility Stay You Pay...(3-day inpatient hospital stay required first)

  • Coinsurance (days 1-20): $0 per day of each benefit period
  • Coinsurance (days 21-100): $185.50 per day of each benefit period
PART B (Medical)

Part B Deductible You Pay... $203 per calendar year

Part B Coverage You Pay... Generally 20%, after $203 deductible is met


Part B Premiums & Part D High Income Premiums (paid to Medicare)

Those enrolled in Medicare Part B will pay the premiums listed in the table below (based on income). Higher income earners will pay a Part B IRMAA (Income Related Monthly Adjustment Amount) in addition to the $148.50 base premium.


Those with higher income who are enrolled in Part D Prescription Drug coverage also pay a Part D IRMAA in addition to the monthly premium for a Part D prescription drug plan with an insurance carrier (see table below).


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