Your Medicare enrollment checklist

For those turning 65, receiving Social Security Disability Insurance (SSDI) checks, or diagnosed with a qualifying disability or illness, Medicare might be on your mind.  

That’s because any of those reasons means you can officially enroll in Medicare, the federal health insurance program for people 65 and older to help with hospital, medical, and other health costs. It’s a little different than the health insurance you might have had in the past, so there’s a bit of a learning curve here. With four parts to choose from, it can get tricky. 

That’s why we’ve created this easy-to-follow enrollment checklist for you to keep on hand as you make your enrollment decision. So toss the confusing mailers, sales letters, and packets of fine print — and make your choice with confidence.  

Learning your Medicare options

Step 1: Start with some research.  

Do you know your A, B, Cs (and D) of Medicare? Before you officially enroll in coverage, it’s important to understand what you’re signing up for.  

Medicare is divided into parts. Part A and Part B make up Original Medicare (what you get through the government), Part C is also known as Medicare Advantage, and Part D is prescription drug coverage. Here’s what each part includes:  

• Medicare Part A is hospital insurance, which covers inpatient hospital stays, care in a nursing facility, hospice care, and some home health care.  

• Medicare Part B is medical insurance, which covers certain doctors’ services, outpatient care, labs, medical supplies, and preventive services.  

• Medicare Part C, or Medicare Advantage, is privatized, all-in-one health insurance that covers dental care, vision care, over-the-counter items, and other specialized health needs.  

• Medicare Part D is prescription drug coverage, which covers your prescription medications.  

You may be automatically enrolled in Medicare Part A on your 65th birthday — this is because most people don’t usually pay a monthly premium for this type of coverage. If you’d like Part B (which has a monthly premium of around $148, depending on your income), you must elect for it.  

Step 2: Enroll in Original Medicare.  

You can enroll in Original Medicare through Social Security. If you’re not automatically enrolled in Original Medicare, you can sign up during your Initial Enrollment Period, also called IEP. You’ll need Parts A and B to get additional coverage like Medicare Advantage or Medigap. 

Your IEP is a seven-month period of time when you can enroll in Original Medicare for the first time. It begins three months before your birthday, lasts throughout your birth month, and ends three months after your 65th birthday. 

Once you’ve enrolled in Original Medicare, you can begin to think about your supplemental coverage options, if you’d like them. 

Getting enrolled in additional Medicare coverage 

Step 3: Set your budget. 

Would you rather have a maximum out-of-pocket, or pay 20% of the total cost of all your care? Do you need prescription drug coverage? This will help you determine the additional options you need. 

Medicare Advantage (or Medicare Part C) offers plans with low-cost premiums (that you pay in addition to your Part B premium). These dollar amounts will vary based on your geographic location. Plus, most Medicare Advantage plans will have a set dollar co-pay and maximum out-of-pocket (MOOP), so once you’ve reached this amount for the year, your insurance company covers your services 100%.  

Another option is Medigap, or extra health coverage you can buy from a private company. This coverage can help pay for health costs that are not covered by Original Medicare. You won’t have a MOOP or set dollar co-pay, but your overall out-of-pocket expenses will be kept low. For example, Original Medicare members can typically expect to pay 20% of the total cost of covered services, but if you have Medigap, your portion of the bill will be lower — in some cases, even $0. 

Step 4: Think about your current care team.  

If you’ve already been going to your physicians for years and don’t want that to change, it’s important to take a look at your plan’s doctor networks before signing on the dotted line.  

If you are looking into Medicare Advantage, members must visit doctors that are in the plan’s network to get the full benefit. As far as Original Medicare, members can go to any doctor that accepts Medicare. (This doesn’t change if you have Original Medicare with Medigap, either.)  

Step 5: Choose additional coverage, if you’d like.  

Enrolling in additional Medicare coverage must be done over the phone. 

To enroll in Medicare Advantage (Part C), Medigap, or Medicare Part D, you’ll need to do so with a private insurance company.

Still not sure which coverage option to choose? We’ve broken down the differences between Medicare Advantage and Medigap here.