Council on Aging Answers 2015 - 99

COUNCIL ON AGING - ORANGE COUNTY

When to sign-up for Medicare:
n You are entitled to an initial enrollment period
to sign up for Medicare Parts A and B when you
are 65 years of age. The initial enrollment period
begins three months before your birthday month
(not your actual birthday), your birthday month
and three months after your birthday month.
n Do not wait until you are full Social Security
retirement age to sign up for Medicare as you will
be charged a financial penalty for late enrollment.
n If you continue to work after turning 65 years of
age and have employer group health coverage,
you may be able to delay enrolling in Medicare
until you no longer have active employment
group health insurance. You will be entitled to
a special enrollment period when you no longer
Council On Aging-Orange County | 714-479-0107 | www.coaoc.org

have employer group coverage. Check with your
employee health benefits coordinator to see if you
need to enroll in Medicare.
n If you become disabled receiving Social Security
Disability Benefits, you may be able to enroll in
Medicare with the 25th month of SSDI benefits.
n If you are diagnosed with End-Stage Renal Disease
(ESRD) or Lou Gehrig's Disease (ALS) you will
have a special enrollment period.
n If you fail to enroll in Medicare during your initial
enrollment period, you may enroll during the
General Enrollment Period of January 1st thru
March 31st. Medicare will not start until July 1st.

Where do I sign-up for Medicare?
Go to the Social Security Administration to sign up
for Medicare parts A and B. If you take early Social
Security retirement you will receive your Medicare
card automatically at age 65 and will have the option to
decline part B if you continue to have employer group
health insurance coverage.
How do I pay for Medicare?
If you are receiving Social Security benefits at the
time you enroll in Medicare, your Part B premium will
be deducted automatically from your monthly check. If
you have not begun to receive Social Security yet, you
will receive a quarterly bill for your premium, which
you can pay by check, credit card or a pre-scheduled
monthly deduction from your bank account.
If you enroll in a Medicare Advantage or Part D
prescription drug plan, typically you will pay the plan
directly for your premium.
For more information regarding Medicare, coverage
options or appeals, contact the Council on Aging -
Orange County HICAP at 1-800-434-0222 or visit us on
the web: www.coaoc.org.
HICAP is a no-cost service to help you understand
and maximize your Medicare benefits. Funded in part
by the California Department of Aging, HICAP is the
most dependable source of unbiased, accurate, and
up-to-date Medicare-related information for Orange
County residents.
Answers Guide 2015

99

INSURANCE

Examples of items Medicare does not cover:
n Hearing aids
n Eyeglasses
n Dental care
n Acupuncture
n Long-term care at home or in a nursing home,
when the care you need is primarily personal care
services/custodial care
n Health care outside the United States
Medicare safeguards to ensure coverage of medically
needed services:
n All Part C -Medicare Advantage Plans (ex. HMOs,
PPOs and SNPs) are required to cover the same
services as Original Medicare.
n If you have a Medicare Advantage plan and you
are referred to a specialist, verify that the specialist
is part of your assigned medical network.
n If you are signed up for a plan without your
consent, you may be able to get a retroactive
disenrollment.
n When enrolling in a new Part D plan you are
entitled to a transition prescription fill if your
medication is not on your new plan's formulary.
n If you disagree with coverage or payment decision
by Medicare or your health plan or Part D plan,
you can take action by filing an appeal which
allows you to have a review of the decision which
possibly could reverse the decision.
n HICAP provides free legal help with the appeals
process.
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Council on Aging Answers 2015

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