Fewer than 20
In most cases, switching to Medicare will be your best option. Medicare is designed to help you save money on all your healthcare needs, so there are lots of good options when you switch. First, you'll want to sign up for Original Medicare during your Initial Enrollment Period, which is the the three months before your 65th birthday month, the month you turn 65, and the three months thereafter. Then talk to us about Empire Medicare plans with benefits that include prescription drug coverage, dental, vision, and hearing.
If you're self-employed or on an individual plan, chances are you'll want Medicare when you turn 65, even if you're still working. The good news is, it should save you money on your health insurance. Medicare is designed to help. Sign up for Original Medicare during your Initial Enrollment Period, which is the three months before your 65th birthday month, the month you turn 65, and the three months thereafter to avoid late fees and gaps in your coverage. Then you can find the right health plans here with us to add more coverage for things like prescription drugs, dental, vision, and hearing. Our plans can save you money on the copays, coinsurance, and deductibles of Original Medicare.
Original Medicare Costs
For most people the monthly premium for Part A is $0 and the monthly premium for Part B is $164.90.
For Part A you may pay more if you or your spouse did not contribute to social security via payroll taxes for at least 10 years. For Part B you may pay more based on your current income.
Copays, Coinsurance, and Deductibles:
There are also co-pays, coinsurance, and deductibles with Original Medicare Parts A and B.
For Part A, there is a $1,600 deductible per benefit period. This is not an annual deductible. A benefit period starts when you’re admitted to a hospital or inpatient facility and ends 60 days after your release. There are also copays with Part A. Your copay for the first 60 days in a hospital is $0. For days 61-90, your copay is $400 per day. For days 91 and beyond, the copay is $800 per day.
For Part B, the annual deductible is $226. You will also pay 20% coinsurance for doctor visits or other outpatient care.
Original Medicare Parts A and B do not cover prescription drugs and there is no annual maximum for your out-of-pocket costs.
We offer plans with $0 or low monthly premiums, no medical deductibles, prescription drug coverage, and annual maximum out-of-pocket protection. They also cover services and expenses Original Medicare doesn’t. There are programs available if you need more help affording the costs of Medicare. Learn more about Medicare costs.
What Disabilities Qualify For Medicare Under 65?
If you’re permanently disabled and you’ve been receiving Social Security Disability Insurance (SSDI) benefits for at least two years, you’re eligible for Medicare and you’ll be automatically enrolled in Medicare Parts A and B.
If you have End-Stage Renal Disease (ESRD), you’ll qualify for Original Medicare (Parts A and B) no matter how old you are. You’ll need to sign up for Medicare when you first become eligible, as enrollment is not automatic. Contact Social Security or visit your local Social Security office for more information on signing up for Medicare if you have ESRD.
If you have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease, you’ll be automatically enrolled in Medicare Parts A and B the month your disability benefits begin — whatever your age is.
Is Medicare Mandatory At Age 65?
Enrolling in Medicare is not mandatory, but you might have gaps in coverage or will have to pay late enrollment penalties if you don’t enroll when your first eligible. If you’re already receiving Social Security or Railroad Retirement Board benefits, you’ll be automatically enrolled in Medicare Parts A and B when you turn 65. If you’re not enrolled in Social Security and you decide not to sign up for Medicare Part B when you’re first eligible, you may have to pay some late-enrollment fees.
Is There A Penalty For Not Signing Up For Medicare At Age 65?
Yes. If you don’t enroll in Medicare Part A, Part B, and Part D when you're first eligible, your monthly premium may go up by as much as 10% for each year you were eligible but didn't sign up. In most cases, you'll have to pay this penalty each time on your monthly premiums, for as long as you have Medicare.
Making Sure Your Loved Ones Are Covered
It’s important to think about any dependents you have on your current health insurance plan. When you sign up for Medicare, your dependents will no longer be covered under that plan or under your new Medicare plan if you’re the primary insurance holder on your plan. Your dependents can purchase a separate individual or family health plan from a private insurer, like us.