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So You’re Turning 65: Your Medicare Guide 101

Category: Health and Wellness Issues

Updated May 17, 2016Note: Although the basics about Medicare are unchanged, the amount you pay in premiums and deductibles changes over time. This article is both Module 9 of our Retirement 101 Online Preparation Course and the first in a series on Medicare.

— Believe it or not, there is some good news about your turning 65 – you are now old enough to be eligible for Medicare! Cheer up, the worst of your medical insurance worries are over, particularly if you retired early and are not covered by an employer plan. Most people in the Medicare system are grateful for the coverage and peace of mind it provides.

This 101 article, part 1 in a series, is meant to address the concerns we know many of you have about how to get started with Medicare. Using information from the very helpful site and in particular its FAQ feature, we’ll explain exactly what the program is and outline the many options it can provide, so you can both rest easy and make more intelligent choices. Our second article in this series. “Topretirements Members to Washington: We Like Medicare, Please Keep it Working!“, reports on the results of our recent member survey on Medicare. Part 3 deals with “What to Do About Health Insurance If You Retire Before Age 65” (see end of article for more).

What is Medicare, and who is eligible?
Medicare is health insurance for people 65 years or older, under age 65 with certain disabilities, and any age with end-stage renal disease (ESRD) or Lou Gehrig’s disease. Medicare has four parts — Part A, which is hospital insurance, Part B, which is medical insurance, Part C, which is Medicare Advantage Plans, and Part D, which is Prescription Drug Coverage.
You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years.

What is the difference between Medicare and Medicaid?
Medicare is a health insurance program that is available to eligible people over 65 and a few other individuals suffering from special illnesses. Most people qualified for the program by paying Social Security and Medicare payroll taxes. Medicaid is a joint Federal and State program that helps pay medical costs for some people, irrespective of age, with limited incomes and resources. Most of your health care costs are covered if you have Medicare and Medicaid. Medicaid programs vary from state to state.

How do i sign up for Medicare?
You can file for Medicare online when you file for retirement or disability. You also can file for just Medicare if you do not wish to start receiving your retirement benefits. If you do not wish to apply online you can make an appointment by calling 1-800-772-1213.

If you are already receiving Social Security benefits, you will automatically be enrolled in Medicare Parts A and B. However, because you must pay a premium for Part B coverage, you have the option of turning it down. You will be contacted by mail a few months before you become eligible and given all the information you need. (Note: Residents of Puerto Rico or foreign countries will not receive Part B automatically. They must elect this benefit.)

What are all the various parts (A,B,C,D) about?
Part A. In general, Part A:
Helps cover inpatient care in hospitals, skilled nursing facilities, hospice, and home health care.

Part B: Part B covers 2 types of services
Helps cover doctors’ and other health care providers’ services, outpatient care, durable medical equipment, and home health care. Also helps cover some
Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Part C. Medicare Advantage Plan.
A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). These rules can change each year.

Part D. Prescription Drugs
Medicare offers prescription drug coverage to everyone eligible for Medicare, but you don’t have to take it. It is offered by Medicare-approved private insurance companies. Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different “tiers” on their formularies. Drugs in each tier have a different cost. Some Part C plans include prescription drug coverage. Warning: There are fairly dramatic penalties if you fail to enroll in Part D when you first become eligible, and then later sign up for it. The longer you go without it the higher the penalties (1% per month, see “Double Ouch: Didn’t Sign up for Part D” article.

What are the costs associated with Medicare?
Part A. Most people get premium-free Part A. But, if you have to buy Part A because you don’t have fewer than 40 quarters of coverage, you’ll pay up to $411 each month. The Medicare Part A annual deductible that beneficiaries pay when admitted to the hospital will be $1,288.00 in 2016.

Medicare Part B (Medical Insurance). You pay a premium each month for this. In 2016 most people will pay the standard premium amount of $104.90/month, plus $166 per year for your Part B deductible. Beneficiaries not subject to the “hold harmless” provision* will pay $121.80. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above certain limits you may pay more:
– Single filers and Joint filers who report income greater than $85,000 and $170,000 respectively will pay $170.50
– Those earning $107,00 (single) or more and $214,000 (joint) or more pay $243.60
– Earning over $160,000 and $320,000 pay $316.70
– And earners over $214,000 and $428,000 pay $389.80, up to $259.70 for joint filers making more than $320,000 (see chart for more details).

Part C. Your out-of-pocket costs in a Medicare Advantage Plan (Part C) depend on several factors including whether it:
… pays any of your monthly Medicare Part B premium
….has a yearly deductible or any additional deductibles
….includes prescription drugs
….co-pays, etc. (see chart)

Part D. The cost will depend on what drugs you use and what type of plan or supplier you sign up with.

Should I sign up for Medicare if I am still working?
Even if you keep working after you turn 65, you should usually sign up for Medicare Part A. If you have health coverage through your employer or union, Part A may still help pay some of the costs not covered by your group health plan. However, you may want to wait to sign up for Medicare Part B if you or your spouse are working and have group health coverage through you or your spouse’s employer or union. (See this link if you work for a small company.)

For more information:
Part 1: So You’re Turning 65: Here Is Your Medicare 101 Course
Part 2: “Topretirements Members to Washington: We Like Medicare, Please Keep It That Way
Part 3: What to Do about Medical Insurance When You Retire Early
Part 4: Medicare Advantage vs. Original Medicare
Part 5: What Is Medigap Insurance and How Can I Find the Right Policy for Me
All Modules in our Retirement 101 Online Preparation Course
Checklist: 6 Things to Do When You Start Medicare
8 Things to Consider When Choosing or Changing Your Coverage
Open Enrollment Season is Here for Medicare and Obamacare
So You Are Turning 65: 9 Things You Need to Know (3 part series)
Medicare FAQs – a great government resource for answering questions and helping you find health insurance
Understanding Medicare

* Hold Harmless Provision:
Beneficiaries not subject to the “hold harmless” provision will pay $121.80 in 2016. Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those:
– not collecting Social Security benefits
– those who will enroll in Part B for the first time in 2016
– dual eligible beneficiaries who have their premiums paid by Medicaid
– and beneficiaries who pay an additional income-related premium.
These groups account for about 30 percent of the 52 million Americans expected to be enrolled in Medicare Part B in 2016.

Comments? What are your questions and concerns about signing up for Medicare and choosing the right plan? If you are currently in a plan, tell us what you like and don’t like about it, and whether you think you made the right choice. Please share your experiences in the Comments section below. You might also want to look at the Comments made to our “Open Enrollment Season” article, which had many interesting comments added in 2016.

Posted by Admin on October 8th, 2012


  1. This is a great topic. Although I am 1 1/2 years away from 65, having information from a source as TopRetirements will provide data to use when exploring the Medicare site. Kudos to you all.

    by Gene — October 9, 2012

  2. You report what the income that will push you into a higher payment is for couples. How difficult would it have been to include the information for singles? Not everyone is part of a couple. Increasingly, more people are single.

    Editor’s note: We were trying to be brief (that’s why we provided the link to more details in that section), sorry if you felt shut out. Have added info now – the max for a single filer is $85,000, after that the monthly rate goes to $139.90 and a max of $239.90, if your income is over $160,000.

    by Linda — October 9, 2012

  3. Two things I found out when I became eligible for medicare. The first was that I had to file my tax returns as MARRIED FILING JOINTLY rather than MARRIED FILING SINGLE – which I had been doing because my pension came from another country. The second was that the tax income that was used to calculate my monthly premium was TWO YEARS BEFORE I turned 65. As a result I was paying 3 times what I should have been paying in monthly Part B premiums. I appealed and won. I am now filing properly and since my current income – for the purpose of paying based on MAGI (adjusted gross income) is half of what I made two years before 65 (because I was working then). I also received a cheque for the “overpayment” before appeal. So its important to know all this before applying for Part B. (I couldn’t find this info. in any of the Medicare material). Just though I’d share my experience …

    (NOTE: This comment was originally made on our “What to about Medical Insurance When You Retire Early” blog post, but it seems especially relevant here too)

    by Sheila — October 10, 2012

  4. Turned 65 in June. I was on TriCare but HAD to go on Medicare for Tricare to be my secondary. I was paying around $65 a month for a TriCare secondary. Now I pay $299 every 3 months. I cannot go on my employers plan because TriCare won’t cover as secondary. Effectively, I am almost paying TWICE as much each month as I was before I went on Medicare. What happened to my “Free” health care I was promised for spending all those years in the military and missing out on my kids birthdays, etc.???? Government screws the military every day….

    by John — October 10, 2012

  5. […] don’t miss Part 1 or our new series: Your Guide to Medicare 101 Posted by Admin on October 10th, 2012 Comments (0) Entries (RSS) and Comments […]

    by » How Would You Fix Medicare? Topretirements — October 10, 2012


    I didn’t feel “shut out” by your neglecting to report the costs for singles. I’m already on Medicare and well aware of the issues.

    I’m just trying to raise your awareness of the fact that a large proportion of the populace is single and for your article to have relevance to all your readers, it would be good to have the facts for both singles and couples.

    by Linda — October 10, 2012

  7. Hey John: We too have Tricare for Life as our secondary (Part B). Its a great plan because it covers drugs – which are $22 at most for any drug. Looks like you are now paying $35 more per month than you were before. I am paying the same and reckon its a great deal because if we didn’t have it we would have to buy Part D medicare coverage for drugs. We have been very happy with Tricare – my husband turns 65 in February 2013 and will also go on it. Its the best deal in town!

    by sheila — October 10, 2012

  8. When I turned 65 in 2011 I was informed I HAD to sign up for Medicare even though I was working and had my own insurance. The rep on the phone couldn’t understand what my issue was – after all Medicare is free, right? What she evidently didn’t know and I had to make her aware of was this: If you are on Medicare you cannot participate in a Health Savings Account. I don’t have any health issues, rarely go to the doctor and take no prescriptions so I had been opting for my employer’s high deductible plan with the HSA option (to which they contribut $1500 a year of truly free money). Both my employer’s contribution and my pre-tax dollars were helping us with tax issues and allowing me to build what was to be a healthy medical account for the future when I finally retired (planned for 2013 or 2014). But once you sign up for Medicare you can no longer participate in this great program. I calculate that I will have missed out on at least $5000 in free money from my employer and tax savings on at least $15k. Why are we forced to take Medicare at 65 or face a penalty later? One way to strengthen the program would be to find ways to encourage people who don’t need it, to not sign up for Medicare until they finally retire and no longer have other options.

    by Genie — October 10, 2012

  9. Perhaps forcing Congress to live by the same rules as the rest of us and making them pay as they go for their free benefits would raise their awareness of our plight. With the firestorm licking their backsides they might keep their paws out of the cookiejar. That should not be the private bank of congress everytime they feel the need to raid it.

    by al — October 10, 2012

  10. Thanks everyone for these helpful comments. Please, please fill out our short survey. You could win a free book, but more importantly, we can’t report on your thoughts on Medicare if we don’t know what they are! Your opinion and experience are valuable – please give back something to this community and make our upcoming report more valuable.

    by John Brady — October 10, 2012

  11. John. As always very useful information Planning to retire at 65 in three years but have learned from your site never to early to plan. I will be eligible at 65 but my wife will only be 58. I assume we will have to purchase private insurance ? You did mention that you can buy part A. For $451 per month. Would she qualify. As you an appreciate we will be on my fixed income so affordable health care for her is also important. Thanks again

    by Michael Imperiale — October 10, 2012

  12. Remember (A)that MAP’s gain their efficiency, (aka “profits”), by limiting you to their (1) health providers and (2)geographical region. If you live in Florida for the winter and Wisconsin for the summer, maybe not for you. And (B), if you have an employer-provided secondary, can you get return if you leave for a MAP?

    by OldNassau'67 — October 10, 2012

  13. We have three children all married american citizens and live in the states and are contemplating moving to the states within three years. Can you possibly give us some advice as to what procedures we need to go through and how we go about getting medical insurance as that seems to be the biggest issue for us at the moment? We are looking at moving to Wilmington North Carolina. We did want to retire completely but looking at things one of us may have two work a couple of days a week to be medically covered.

    by Bob Stone — October 11, 2012

  14. BOB: Where are u coming from? I emigrated from Canada 7 years ago – I am married to an American. He is retired military (U.S.) so we had that coverage that we paid for until I went on medicare. If you come to the U.S. you will have buy medical insurance. The price is dependent on your medical history and age and weight and variables like that. It is quite expensive. After age 65 you can buy Part A (hospital coverage); Part B (doctor coverage); Part D (prescriptions). Again, not cheap. If you work part-time many employers will not offer health insurance. You may have to work full-time to get it. Depends on the employer. The Affordable Care Act – which kicks in in full in January 2014 will help on many of these issues (i.e. pre-existing condition; cost, etc.) but once age 65 medicare kicks in and you can either pay for that or buy your own private insurance. If you want the name of someone who works in this industry who might tell you about options I can give u their contact info. if u send me your e-mail address. Its important to get advice from someone who has no vested interest in one company or another to get the full picture. OR you could call a couple of the big insurers in the U.S. like: Humana; Blue Cross; AETNA and just see what the cost will be if you live in North Carolina – oh, yes, because costs are different in every state too… Its all very complex!

    by sheila — October 12, 2012

  15. BOB: just thought of another source of info. – a few months ago CONSUMER REPORTS did a piece in their magazine – by State – on the best rated medical plans … so you might want to check that out too. Best of luck!

    by sheila — October 12, 2012

  16. BOB-If you are not a natural born American citizen or not worked here, I do not think you will be eligible for Medicare in any form. To be honest with you, I was not aware that anyone could “buy” Medicare Part A because it is a part of Social Security or for that matte Part B. The best thing to do is ccheck with our government, since they are government programs. The Affordable Healthcare Act kicks in in 2014, no one REALLY knows what it entails, but we speculate from what we hear from all over-and what to believe is the tough part. It may all be overturned though-depends on the election. My husband does receive Medicare, but he is American born,so, it is different for him than what Sheila described; he only pays for Parts C and D and it is not expensive…yet. Good Luck

    by DianaF — October 13, 2012

  17. I have a question for Sheila, You were talking about Tricare for Life. My wife is retired military and we use Tricare standard now as our secondary Ins. as we are only 63. Do you have to apply for Tricare for Life at 65 or dose this change automaticaly at age (65)? My next question, at (65) Our Primary coverage will be Medicare and our secondary should be Tricare for Life. Is there any need to apply for part “D” on Medicare? I have been told that Tricare For Life will cover most medications either 100% or with a small co-pay? Do you have any info. on this matter? Thank’s Brad

    by Brad — October 13, 2012

  18. Hi Brad. Tricare for Life should just kick in at 65 at your Part B – IF she’s on Social Security. I would still check with Medicare to ensure that it has done just that. My retired military husband will be 65 in Feb. He currently has Tricare Prime – which I paid for 6 months so he’s covered until Feb. the month he starts Medicare. NO need for Part D because Tricare drug coverage continues as – on Tricare you should have drug coverage now, as in the highest cost for us is $22 for ANY drug – no matter the original cost of the drug. We buy ours through Walmart because they have the lowest dispensing cost. You can also order through the Tricare pharmacy program – which may be even cheaper. Is that the coverage you have now under Tricare? Well, it stays the same on Tricare For Life. (Again, depending on where you buy your drugs and their dispensing cost that’s what you’ll pay). This is a real benefit to retired military. We are very grateful for it.

    by sheila — October 14, 2012

  19. DIANA & BOB: you CAN buy Medicare Part A (hospital coverage). You HAVE to pay for Medicare Part B (doctor coverage). Part D is for drugs (you can pay for that – don’t know the cost but its on top of what you pay for Part A and Part B. Part C is not required – its a choice. Go to Medicare website and read what all the parts offer and determine whether you need them or not. We did not take Part C. Because we don’t need it – with our coverage we can go to any Doctor in the country. Part C is Medicare Advantage and so you choose your “doctor supplier grop”. Some people, for example, choose Kelsey-Seybold. For me, I worried that if we were travelling and that group wasn’t in place in say, Philadelphia, we wouldn’t have coverage. Our coverage is nation-wide and not limited to any group. Its for any Doctor. Be aware as well that some Doctors don’t take Medicare as the rates – according to some Docs – aren’t high enough. Because Fed. Gov. sets the rates. So you have to enquire if they take it when you call. I have NEVER had a Doc not take it. But just thought I’d share the information with you. Again, MEDICARE has a booklet that is pretty thorough in its description of coverage and eligibility/cost. Some of it can be pretty confusing but they are getting better at making is less complex. So if u go to their website its a good place to start. Good luck.

    by sheila — October 14, 2012

  20. […] further reference: Medicare 101 – So You Are Turning 65, Your Guide to Medicare Posted by John Brady on November 4th, 2012 Comments (0) Entries (RSS) and Comments […]

    by » Topretirements Members to Washington: Medicare Is a Great Program – Keep It That Way! Topretirements — November 4, 2012

  21. […] For further reading Results of Topretirements poll about Medicare Prices Set for New Health Care Exchanges (Wall St. Journal online So You Are Turning 65 – Your Medicare Guide 101 […]

    by » With Big Deadline Just Days Away, 7 Things Baby Boomers Need to Know About Obamacare Topretirements — September 25, 2013

  22. Genie, you don’t have to sign up for medicare when you turn 65 if you are still working. A friend of mine was told one thing on the phone and another by a rep he made an appointment with. He was told not to go by what the person on the phone said.

    by terri — September 26, 2013

  23. you need to sign up for part A, but do not need to sign up for part B.

    by Elaine — September 26, 2013

  24. my wife is almost 4 years older than i am so when she is 66 i will be 62 . i heard that in this case the spouse that is 62 can also ged madicare . is it truth? anybody in the same situation knows ? thank you very much.

    by chris dedes — September 27, 2013

  25. I doubt seriously that this is an option unless you qualify under a disability status on your own. My husband and I are in the exact same situation and I went onto Medicare last year and there was no option provided to include him. To be sure, I would contact Medicare because each individual’s situation may be different in many ways.

    by cherie — September 27, 2013

  26. All individuals must be 65 to apply for Medicare.

    by John — September 28, 2013

  27. thank you very much to cherie and john

    by chris dedes — September 30, 2013

  28. […] For further reading: What Will You Spend in Retirement (from Fidelity, includes a nifty calculator) So You’re Turning 65: Your Medicare Guide 101 […]

    by » The Biggest Retirement Expense You Never Thought of Topretirements — November 25, 2013

  29. This question came in from Janet:

    Thank you so much for these emails. My husband and I enjoy them and the information we find in them.

    We are “retirement age” and use Medicare as our primary health care. We are considering moving south – perhaps NC or SC. However, we hear so many doctors no longer accept Medicare patients. We have an excellent primary care physician now, but she is no longer accepting new Medicare patients. We are concerned about moving and not being able to find a good, primary care physician. We are fortunate in that my husband is retired Air Force and we have Tricare for Life for our supplemental coverage.

    What do you hear from your research about medical / health care in NC and SC? We would love to move to a warmer, less expensive area.

    Editor’s note: Despite many people who believe otherwise, about 9 out of 10 doctors in the U.S. still accept new Medicare patients. See Forbes article, so we wouldn’t recommend not moving because of that factor. There will be doctors who will take you.

    by Admin — April 23, 2015

  30. One caveat about Medicare patients. Yes, doctors will take Medicare, but sometimes only if you are a patient first before going on Medicare. For example, when I signed up for the Mayo Clinic in Jacksonville, they would not take me if I was already on Medicare, but since I was on regular insurance, they did accept me, and I will be able to stay on in the system once I’m on Medicare. But, Mayo would not accept a friend who was already on Medicare and wanted to get into the Mayo. My previous doctor (non-Mayo) would only take a Medicare patient if that person had previously been a patient. So, it is worth asking about. From “A 2013 annual report by the Medicare Payment Advisory Commission, an independent congressional agency, shows that 28% of beneficiaries seeking a new primary-care physician last year had trouble finding one who accepted Medicare.”

    So, not recommending you don’t move because of this, but it is worth asking about! You WILL find a doctor who takes Medicare as a new patient. I was calling around to help someone find a new doctor, and I went through three doctors before I found one who would take a new Medicare patient who wasn’t already a patient. It’s just something to keep on your radar.

    Jan Cullinane, author, The Single Woman’s Guide to Retirement (AARP/Wiley)

    by Jan Cullinane — April 24, 2015

  31. Medicare started for me on Feb 1st 2015. I had a heart attack about one month later. Like most people, $104.00 per month comes out of SS for Part B. In addition, I had purchased a Medicare Advantage Plan F from Mutual of Omaha for $158.00 a month. Before the the heart attack I was only on one low cost prescription medication so did not purchase a Plan D. I was recently able to get Plan D SilverScript coverage for an additional $68.00 per month. I am now on five medications. With the insurance, four of them had no cost at all, the 5th med cost is about $120.00 a month. Not sure how long I’ll be on that Med, hopefully not long term. So far have not received any bills from the Hospital or Doctor. Am glad I purchased the higher cost Plan F. It appears to have saved me a lot of $$$.

    by Jim C — April 25, 2015

  32. I am a medical professional here in Washington, DC and it is very difficult to find a primary care physician who will take a Medicare patient. The practice where I am employed has totally opted out of Medicare. I have people call me all the time asking who I would recommend of the doctors that are taking Medicare patients–slim pickings. Many docs who do take Medicare will not take new patients for they fear that if they start then word will get out and they will be inundated with older, high risk, unhealthy patients. It is a terrible situation..everyone even those non par physicians will be on Medicare one day. It is also difficult to find Specialists who will take Medicare patients like GYNs and Urologists. The best rated doctors don’t have to participate with Medicare and many do not here in NW Washington DC.

    by Jennifer — April 25, 2015

  33. We just moved from the Washington DC area in January 2015 and know that it is true that doctors there do not like to take Medicare as Primary Care Physicians. But just ask some of the other specialists, my Dermatologist was more than happy to accept it. When we moved to the Phoenix, Arizona area all of a sudden Medicare is commonplace due to the age of the population, no problem with it here including the medical centers. DC is just an expensive place to work and live and that is why we moved when it was time to be semi-retired, and the no snow and ice is just a bonus! Our Primary Care Doctor of 12 years in DC said that it was a problem to meet his payroll with too many Medicare patients so that seemed to be the reason to us why there is a problem in that area.

    by 703Sue — April 26, 2015

  34. This comment came in from Fiona on another post, in response to others who had discussed the difficulty of finding a doctor who accepts Medicare. We have moved it here because it fits better.

    Elaine, Retired to Greenville SC area last year and had to make half a dozen phone calls before I found a PCP for husband and myself. It’s not impossible, but you may not be able to have your “pick” of docs. If this is of concern, I would make some phone calls to different practices in the area you are considering and ask if they take Medicare patients. My husband found a cardiologist easily, as others have mentioned. Fiona

    by Admin — May 11, 2015

  35. This comment came in from Jim and is being reposted here:

    Comment: Elaine – We live in a suburb of Atlanta. Had to switch primary care Doc as he did not take Anthem Health Ins for my wife or Medicare for me. We were able to find a new Doc after several calls to docs in our immediate area. Not completely happy with this new doc but that’s another story. Had no trouble finding a Cardiologist for myself.

    by Admin — May 12, 2015

  36. RE: finding Medicare docs.

    Thanks for the information Fiona and Jim. Interesting that it is from two areas that I was interested in…although I have decided that it will probably not be Greensville SC.

    Jim, what area in GA are you located? I am considering NE of Atlanta.

    by elaine — May 13, 2015

  37. Anyone have any experience with retiring to the Austin area and the Medicare issues that may be faced?

    by Veloris — May 13, 2015

  38. Elaine,
    We are living in Lilburn Georgia which is part of the Atlanta metro area. Relocated here from Chicago in 1992 for a job. Real estate taxes are less than half of what they were in Illinois. At age 65 the part your taxes that are dedicated to the school district drop off which will probably reduce
    our taxes below $1500.00 a year.

    by Jim C — May 14, 2015

  39. Thanks Jim….I will put it on my list. I recently changed my emphasis to active adult communities as long as they are not in the middle of nowhere. Sounds like you are close enough to Atlanta so that you are not isolated….are there any 45-55+ communities that you can recommend in your area?

    by elaine — May 15, 2015

  40. Elaine,
    Have you looked into Soleil Lauren Canon in Canton or Cresswind at Lake Lanier in Gainesville? May be what you’re looking for, or perhaps too far from Atlanta (About 45 min., i think.)

    by ella — May 16, 2015

  41. Elaine,
    I haven’t investigated those types of communities in the Atlanta area. We will either age in place or live closer to the ocean which would be my preference.

    by Jim C — May 17, 2015

  42. Thanks, Ella…I will explore those communities in northern GA and see if it is easy to get a Medicare doc.. im, sounds like a plan for you!

    by elaine — May 17, 2015

  43. Elaine,
    I am planning to check out the communities i mentioned, but don’t think they’ll work for me. The houses are too close together and there aren’t enough miles of hiking trails. I’m sorry about this as there are many activities, and they do lawn maintenance (about all i’m doing these days!) Also, the prices are a lot lower than in the communities with more land available (sigh!). Perhaps, however, they will work for you. I know you’re not planning to live in the boonies! I did receive a brochure on Carolina Colours today. It seems appealing. I am just so concerned about hurricanes close to the NC coast.

    by ella — May 17, 2015

  44. Interesting article about SSI and Medicare payments. Once again deciding when to take SSI is a challenge. Will this s come to past…but then it may not…elections are coming up.

    Any thought or comments.

    by elaine — July 26, 2015

  45. For further reading FAQ feature at So You’re Turning 65: Your Medicare 101 Guide Topretirements Survey Report: We Like Medicare, Please Keep it Working!“, reports on the […]

    by » Don’t Make These 5 Medicare Mistakes - Topretirements — July 27, 2015

  46. Can some of you that are already on Medicare please help me figure out where to begin with signing up for Medicare.
    My Hub will turn 65 next year (2017) and me in (2018). I have taken notes from the comments in this post and have boiled it down to what sounds good for us. This post has a lot of older information but I took Jim C’s from April 25, 2015 and wrote his costs down:

    Medicare (Part A) covers hospital costs (Jim’s cost in 2015 zero)
    Part B covers doctors and tests (Jim’s cost in 2015 $104.90)
    Part D covers prescriptions-Silver Script-(Jim’s cost in 2015 $68.00)
    Plan F Medigap (Mutual of Omaha) covers costs not covered by Medicare (Jim’s cost in 2015 $158.00)

    Jim C. can you update us on 2016 prices?
    Does Plan F cover the deductible of Plan B per year?
    How did you start the process to apply to Medicare? On line or by phone?
    Who do you contact for Silverscript for plan D?
    As far as Plan F goes, is Mutual of Omaha a preferred insurance carrier?

    Wow, I am asking a lot of questions but I am in uncharted territories here. I don’t even know where to begin this process! Anyone have any words of wisdom? I have plenty of time but I would like to get my ducks in a row!

    Thanks in advance!

    by Louise — May 9, 2016

  47. Louise I will be 65 in July. I started receiving information from Medicare about six weeks ago. The website will let you compare plans. I signed up online. I have Part B @ $104 and Medicare advantage @ $39.

    by Debra — May 10, 2016

  48. Louise,

    1. Still paying $104.90 for part B in 2016. Plan F through Mutual of Omaha for this year is $166.00. Silverscript Part D is still $68.00.
    2. Deductible is covered.
    3. If your already collecting SS then Medicare will automatically kick in when you turn 65. I contacted an insurance broker who was recommended by AARP. He suggested Mutual of Omaha and silverscipt.
    4. As far as Mutual of Omaha being “preferred”. A month after getting on Medicare I had a heart attack. The total hospital cost charged to Medicare was 94K. I did not have to pay any out of pocket expenses for anything including Doctor bills. Really the only out of pocket expenses I have ever had has been an occasional charge for prescription the drugs I am now on. And this of course can vary depending on what drugs are prescribed.

    Hope this helps.

    by Jim C — May 10, 2016

  49. Jim, this helps a lot! I like that the deductible is covered too!

    So I should call AARP to get an insurance broker. Maybe they suggest insurance companies by the State you live in.

    One more question, does all of this come out of your SS check or do you have to mail premiums into the insurance companies?

    That great your insurance covered just about everything when you had the heart attack.

    Debra, thank you for the information too!

    by Louise — May 10, 2016

  50. Louise,

    Part B & D are deducted from SS every month. I setup the Mutual of Omaha to automatically debit our checking acct on the 1st of every month. I Don’t think the Part C (Supplemental) can be deducted from SS but I may be wrong on that point.

    by Jim C — May 10, 2016

  51. Thanks again Jim! I am taking notes on all of this information! You have cleared up so much very quickly for me!

    One thing I would suggest if you have a rewards Visa/MC Amex Blue or another card, make your automatic payments on that card rather than out of checking to get those reward bucks! I have the Costco Amex card which will soon be replaced with a Costco Visa card. Last year I got $330 reward bucks just for spending normally and paying my bill at the end of the month! I would have had more but certain places don’t take Amex. So once I get the Visa I anticipate being able to get more rewards because almost everyone takes Visa! I put everything I can possibly put on it including groceries and prescription drugs.


    by Louise — May 10, 2016

  52. I am a Pa resident and I started Medicare in January of 2016. I am paying 121.60 per month. Why are some of the people only paying 104.00 per month? I was told that any new applicants in 2016 were being charged the new premium. Is this correct?

    by sue — May 11, 2016

  53. Sue: Are you also collecting social security? What I heard is if you collect social security at the same time you start medicare, they deduct the medicare from your monthly check in the amount of $104.00. If you aren’t collecting, then they will charge you the higher amount. Not sure if this is 100% true but it is what I have read.

    by Stacey — May 12, 2016

  54. Stacey & another Sue: Both my husband & I receive social security & our medicare is deducted from it but my premium is $104.90 his is $103.90 & we both have A & B since I cover both on my secondary government insurance. I believe some increases were made in Jan. and it was based on how much money was involved – the more you got the more you paid, it had nothing to do with if it was withheld from the monthly check (which we both also have taxes taken before receiving the payment). It may also vary from State to State but this how it is done in tax heavy Vermont..

    Sue M (Vermont)

    by Sue M — May 13, 2016

  55. Sue,
    This should answer your medicare question on why you are paying $121.60.

    by Louise — May 13, 2016

  56. Sue,
    Click on the link ‘Medicare B’ at the bottom of the page.

    by Louise — May 13, 2016

  57. Jim C,
    Called AARP yesterday in regard to Plan F (Supplemental plan to Medicare). I got an email with the different rates. Plan F will cost my husband $234.50 if he started this year. He will turn 65 next year so price will go up I am sure. Didn’t get information on Part D (Prescription drugs) but the agent I talked to said prices are from $30-$60. The $30+/- plan has a deductible of $360 a year. The $60+/- plan has no deductible. So as far as Plan F, Connecticut’s prices are higher than Georgia’s. Another reason to move to GA!

    by Louise — May 13, 2016

  58. Hi All, I will turn 65 next June, 2017. My wife and I are snowbirds and live in Orlando as our primary home and in NY during the summer. Can anyone comment about using Medicare and Tricare in two states? Thanks!

    by Bob & Barb — May 14, 2016

  59. Louise,
    In my opinion the cost should be the same wherever you live but that would make too much sense, although the overall quality of medical care may be better in Connecticut than in Georgia.

    by Jim C — May 14, 2016

  60. Jim C.

    I mentioned to the Agent that someone I knew in GA was paying $166.00 and why was the quote so much higher. He said that within some states like Texas there could be several different prices and that the prices differ from State to State. Everything costs more in CT so it figures Plan F would cost more too.

    When my Mom was in a nursing home (2013) here in CT it was $12,000 a month. My two aunts are in nursing homes, one in TN and one in KY and both are being charged $6,000 a month. CT is bad news!

    by Louise — May 14, 2016

  61. There seems to be some questions on why some people pay different amounts for their Medicare Part B premium. I am reaching 65 in November 2016 and have been trying to educate myself on Medicare.

    Below, is what I have found out based on my reading. This info is just my interpretation and you should check these statements with the various sources.

    I think the first comment I have is: Whether you pay for your Medicare Part B premium by a deduction from your social security check or by some type of monthly billing has no effect on the premium amount you pay.

    Why individuals pay different premium amounts is based on a few factors. When enrolling for Part B, you can enroll in the ORIGINAL Medicare program (administered by the government) or you can enroll with a non-government company that offers Part B icoverage.

    The ORIGINAL Medicare Part B program charges a standard amount for medical coverage with set deductibles and copayments.

    The standard Part B premium amount for someone turning 65 and enrolling in 2016 is $121.80. It can be higher if you are still working; how much your income is will determine how much higher your initial premium is.

    If you are still working, they look at your modified adjusted gross income as reported on your IRS tax return from 2 years ago. If that income was above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

    Also, if you don’t enroll “on time” you can be assessed a penalty and have an increased premium. Remember take action 3 months before the month (not day) you reach 65.

    What state you live in when you first get Part B or where you live in subsequent years does not have an impact on the standard Part B premium when you enroll through the government’s ORIGINAL Medicare program.

    Because this basic Part B medical coverage has deductibles and co-payments, most people have/purchase supplemental insurance to help with those costs.

    When you use a non-government company, you may be offered a variety of options. Some offer plans that just supplement the Plan B coverage. But some offer plans that take the place of the ORIGINAL Medicare Part B coverage and then combine with supplement coverage. What combination you choose will impact how much your premium is. Also costs can be different company-to-company and state-to-state. Insurance companies have many variables they consider when determining their rates and offer what can be a Medigap Plan or a Medicare Advantage Plan. Many plans combine different kinds of coverages – Part B, Part D and even Part A, and cover amounts for deductibles and co-payments.

    I hope this explains why I think Part B premiums may be different between individuals. Of course there are other variables like if you have both Medicare and Medicaid (a state program for low income people), one of the many state programs offering medical coverage under “Obama Care,” or if you were on SS disability benefits before age 65.

    My advice is read the information on the Social Security website, talk with a SS representative and with reps from companies offering Medigap and Medicare Advantage plans (especially if you are planning to live in a different state from the one you are in when you first get Medicare). It is like any other insurance you purchase – get educated and shop around for the plan that fits your circumstances the best.

    Specifically for those that have Tricare coverage before age 65 (as I do). I have been told by a Tricare rep your present Tricare coverage will need to be converted to Tricare for Life and it will be your Part A and Part B supplemental insurance. It will basically cover same items as Medicare and pay for deductibles and co-payments not covered by Medicare. But Tricare requires you sign up for Part B and you will have to pay that monthly Part B premium. However, you will no longer have to pay a Tricare premium (and the Part B premium will end up being more than your Tricare premium was). However, the added benefit is you will still have the Express Scripts drug coverage just like you had before going on Medicare (so you don’t need Part D).

    I hope my research will help others to understand, but again, check my statements to see if my research is correct. And, please if any readers of this site find my info wrong, please enlighten all of us.

    by BeckyN — May 15, 2016

  62. re: BeckyN comment “I think the first comment I have is: Whether you pay for your Medicare Part B premium by a deduction from your social security check or by some type of monthly billing has no effect on the premium amount you pay.” Not necessarily true for a small percentage of people…I was one of the unlucky ones who was not held harmless.

    Do your research for your individual case and check often for changes.

    by elaine — May 16, 2016

  63. I am in Connecticut. I requested information from AARP for Supplemental insurance. When I looked at the choices, all plans are through United Health Care. Those of you from other States, does AARP offer other insurance companies for you to choose from? Hub and I are currently on Obamacare through Anthem Blue Cross/Blue Shield. We received a Pre-Enrollment Checklist from them and apparently this could be another choice for an insurance provider for a supplement. Should I believe that what AARP offers is the most cost effective? Does AARP change insurance providers often? I tried to get information from Mutual of Omaha but due to my Hub not being close enough to 65 they won’t give us prices until August. I know the prices will go up by the time he signs up but it is good to have ball park prices at this point.

    by Louise — May 17, 2016

  64. Louise. Try Aarp’s competitor, AMAC

    by Liz — May 17, 2016

  65. Louise,
    The AARP recommended Supplemental plans I receive from them here in Georgia have always been United Healthcare. I’m sure AARP has a vested interest with United Healthcare.

    by Jim C — May 18, 2016

  66. You can go through the Medicare website and get all your options. You can compare regular Medicare and the supplemental policies in your state or the Medicare Advantage plans. Everything you need is right there.

    by Debra — May 18, 2016

  67. Very helpful information – thank you, all! I will turn 65 in 2017, but am planning to work until 2018. My employer offers health insurance and HSA – I’ll investigate further, but this information will help me form a final decision.

    by V Nelson — May 18, 2016

  68. By all means educate yourself and be aware of decisions that you are unable to change regarding supplemental plans. When it comes to supplemental plans, pick the best one you can afford while you can get it without underwriting, which is that six-month window surrounding your date of turning 65. AARP might not be the trusted resource you hope given they have a player in the game. I have spent several hundred dollars with a Medicare consultant, who was very hard to find, BTW. You think they would be everywhere. When it comes to supplements (Medigap) Plan F is the most comprehensive, covering everything allowable, including your deductible. Yet, for a much less premium, plan G, covers everything except the Plan B deductible, which is around $147. However, the difference in the premiums between the two more than makes up for having to pay that amount. You can save several hundred in the premiums between the two. Plans F and G are the most popular. Plan F may be on the chopping block as the government changes rules, but G is still a winner.

    If this is all gobbly gook, don’t feel bad. Medicare is a jumble of alphabets and deadlines that can horrify and confuse, but it can be figured out. One book I found Medicare Demystified by Dr. Ronald Kahan was very helpful. An objective look by a physician that I found on Amazon. I am not associated with the book, author, or publisher.

    Just remember you can change your drug coverage every year, but you will definitely face a problem if you try to switch your supplement after the initial enrollment period. Whether to choose an advantage plan or traditional Medicare A and select Part B is a personal/financial decision. Some benefit from having everything covered; some prefer more freedom of choice when it comes to medical decisions. Those who want a say in doctors they can see might not be happy with an Advantage Plan.

    Medicare is better than it seems at first blush, but you still need money because there is some cost sharing, so a good supplement is crucial. All that glitters is not gold to me when it comes to those Advantage Plans. Don’t believe everything the insurers tell you when trying to get you. You have to read the fine print. Access to your doctors could be limited. Be sure the drug coverage you are considering covers YOUR drugs. They change every year. I think that Medicare is a confusing thing to do to people at the age and stage at which they become eligible. As someone who values privacy and security, I was shocked that Medicare puts your SS# right on the front of the card, where it is then shown on every medical document in every doctor’s office you visit. And we wonder why this age group is the victim of so much fraud. Thanks a lot, Medicare. This is supposed to be changing in 2017 or 2018, but not sure the existing cards will be retrofitted.

    This can be figured out, but don’t take any of the decisions lightly. If you miss important deadlines, the penalties can be lifelong. If you pick the wrong supplement, the consequences can be lifelong. Good luck!

    by Ginger — May 19, 2016

  69. Ginger,
    Thank you for your lengthy discussion of what you have learned and passing it on to us. Very good information.

    That is disturbing the Social Security number is on the card!

    If Plan F is on the chopping block, wouldn’t those who are in Plan F be grandfathered in the plan. I talked to an AARP Agent and we only had a quick conversation but I believe he said if plans are eliminated those who are in them can keep them but are no longer available to new people.

    by Louise — May 19, 2016

  70. Ginger,
    We are getting ready for the Hub to go on Medicare next year and I just got a booklet of options/prices that are this years prices and offerings. For 2016 Plan G is not offered in CT. Only Plans: A, B, C, F, K, L, N. Plans: D, G, M not offered. Maybe for 2017 they may be offered.

    by Louise — May 19, 2016

  71. I don’t recall Plan G being offered in Indiana. The best deal I found was Plan N. The premiums are low ($120) and after a $147 deductible, everything is covered with only a copay of up to $20 per visit.

    by LocoBill — May 20, 2016

  72. I will be retiring at the end of the year at 65-1/2 (almost). I have no health issues and not on any meds. I go to 3 docs a year (one twice a year), an internist for yearly check up, dermatologist twice a year for skin checks and an ophthalmologist for yearly eye exam. I am interested in an Advantage plan that my docs are participating in. It seems like a good choice for someone in good health. Also, since you can change your plan every year, I figured as I get older and need more health care, I can change to a different-more expensive-plan. I would appreciate any comments anyone has regarding this plan. Thanks in advance. FYI I’m in NYC and the plans are rather expensive. Eventually I will be moving to Athens, GA or St. Augustine, FL (still undecided) and the plans are cheaper there.

    by Stacey — May 20, 2016

  73. Ginger and all- My husband also researched extensively when he was approaching initial Medicare coverage this year. He also concluded Plan G made the most sense here in SC. We will pay the deductible of $147.00, which covers all of Plan F and save over $370.00 on the annual premium difference. We did hit a wall when the Plan B premium was over $100.00 more a month than we had anticipated, based on our AGI from two years ago, 2014, when he was still working and at the peak of his income. Does not seem logical, since we are paying the higher premium from current, much lower retirement income. We will have to pay the higher “penalty” as the government calls it, for two years, until the AGI reflects our current retirement income. Disappointed that 48 years of hard work, 50-60 hours a week, and consistent excellent performance and raises that finally landed him in management resulted in the government penalizing him in retirement. Wrong message policy makers!!!!

    by SandyZ — May 21, 2016

  74. Stacey, Please look into the Advantage plan carefully. I’ve been informed that many doctors and groups will not accept it, thus you cannot use their services. Also, other negatives. The only good thing about it is the price, and there are reasons for that!

    by ella — May 22, 2016

  75. This Comment and suggestion came in from Larry:

    I am guessing a lot of military retirees look at this information. Folks, like me it just so happens, who are headed for Tricare for Life this year, must sign up for Parts A & B and pay the premium, then Tricare for Life pays what Medicare does not. (there are exceptions to that statement, depending on what Tricare covers versus what Medicare covers and vice versa)…if the first visit of the year is covered by Medicare and Tricare, then Tricare for Life pays the deductible as well…you know you are dealing with the government, so you have exceptions, but generally speaking, that is it in a nutshell. Anyway, thought I would bring that up as a possibility. I would have to say that most military retirees know about Medicare and how it works with Tricare for Life, so maybe this was all for naught…like always, there are exceptions.

    by Admin — May 22, 2016

  76. For SandyZ
    You do not have to wait two years for your AGI to catch up. Get form SSA-44 and file with the necessary documentation. Best to take it into a SSI office if one is near you. First agent told us it was doubtful if this could be done so we asked to speak to another agent. She was much more knowledgable and input the info into the computer in front of us. The adjustment was made the following month.

    by Bill — May 22, 2016

  77. StacyZ
    No need to wait 2 years for your AGI to catch up. File SSA-44 with the necessary documentation and it will be adjusted in just a month or so depending on what time of the month it is submitted. Without that, the government will be glad to collect your overpayment for those two years. Hope that helps.

    by Bill — May 22, 2016

  78. Thanks Ella. According to the website, my doctors are on the plan. I would call them anyway to verify. The plan I was looking at is $69 a month. If I went for a Plan F that everyone is talking about, it’s $270+ plus. Yet that same plan in Hoschton, GA is $170. What I’m thinking of is going with the Advantage plan while I’m still in New York (and pretty healthy) and switching to the F plan when I move to GA. $270 plus the $124 for Medicare B is a big chunk for a retired single person.

    by Stacey — May 22, 2016

  79. Most Medicare Advantge plans, called Medicare C, are usually only good within the plan, which is within the state you reside. If you are a snowbird, be sure and check if your Plan C works when you are in a different state for the winter.

    by LocoBill — May 23, 2016

  80. Glad you’ve thought it thru, Stacey. Wishing you many more healthy (and happy) years!

    by ella — May 23, 2016

  81. My husband has been on Advantage for several years now and is quite happy with it. I just signed up and have many choices of doctors.

    by Debra — May 23, 2016

  82. Thanks, Ella…back atcha.

    Good to hear, Debra, thanks.

    by Stacey — May 23, 2016

  83. I am moving out of the service area for the Medicare supplement plan I currently have. Do I just sign up for a plan at my new location? Thanks.

    by ElaineB — May 24, 2016

  84. Yes, Louise, I read that if you are already in Plan F, you can keep it, but if it is eliminated those who are in can stay. Premiums may go up more significantly because as the population of those covered ages, I was told. I thought they were all offered everywhere, but I see here that’s not the case. 🙁 The rule of thumb is to get the best plan you can while you aren’t subjected to underwriting.

    by Ginger — May 24, 2016

  85. Sandyz, couldn’t agree more. We’re in the same boat, having to pay high premiums for a salary that doesn’t exist. I’ll file that form next year. Thanks Bill for the reminder.

    by Ginger — May 24, 2016

  86. Stacey just be sure you can switch easily without being subjected to underwriting.

    by Ginger — May 24, 2016

  87. Louise, thank you for saying the information was helpful. I meant to say that in the previous post. Yes, the SS# number thing is ridiculous. And the government is so slow to correct mistakes. Arrrgh.

    by Ginger — May 24, 2016

  88. Humana offers many supplemental plans in different states and so does AETNA (and AETNA is in process of buying Humana so together they will have a large network). You might want to check it out in addition to the big insurer on the block, United Healthcare thru AARP.

    Although many discounts are available thru AARP related sources, I recently found AARP promo hotel room rates can actually be higher. Guess some hotels think traveling seniors have more money to spend.

    by BeckyN. — May 24, 2016

  89. This helpful comment came in from Richar:

    I have been reading this newsletter for years. I have yet to have anyone write that every state has a S.H.I.P. (SENIOR HEALTH INSURANCE PROGRAM), goes by a different name in some states. which is free with trained volunteer Counselors who provide current, correct information on Medicare, Medicare Supplements, Medicare Part D Rx Cards & long term care. The counselors can enroll clients when needed.
    Additionally. I am amazed of the questions asked on Medicare, especially in this electronic age. Even if the senior has no computer, his child, friend library have them & they can go to and answer the majority of the questions I read are being posted on Medicare.
    I have been a volunteer S.H.I.P.Counselor now for 23 years. with 20 years in Illinois & 3 in Nevada. In larger cities we do Health Fairs where we have a S.H.I.P. table to give out handout Medicare data & answer questions. Most large cities also have Health Fairs which are another source of information for seniors. This is the web address where you can locate S.H.I.P. programs in every state:

    by Admin — May 24, 2016

  90. Those paying higher premium cost based on past years AMG, stop it. Just file a “Life Changing Event” letter with SS and lower your Medicare premium based on your estimated income for the present year. It worked for me.

    by Vincent — May 25, 2016

  91. The Daily Alert did not go out yesterday so we wanted to alert you that there were a few new comments on this Blog topic.

    by Admin — May 26, 2016

  92. My Hub is going on Medicare next March. I am just trying to play with the numbers available. 2017 rates are not yet ready so I am just using what I can find, 2016 numbers. I went to AARP website and put in my zip code (06776). It is giving me 2016 rates and for Part B it quotes: Plan B Benefits Table Standard Rate $196.00 per month. The article above states that it would cost $121.80 per month. The AARP website did not ask for income and our income is way below $85,000.

    I have also read that 3 months before age 65 a letter will come for those who have SS and will quote Plan B prices. So my question is when my Hub gets that letter should we expect to see $121.80 per month or a bit more due to new 2017 prices? Why are we seeing the $196 price tag on AARP website?

    Can anyone living in CT give me the name of the insurance company’s you are using and if you have Plan D and Plan F what prices are you paying? Plan F through Anthem quoted me $261 per month (2016 prices), Plan F through AARP website quoted me $234.50 per month (2016 prices).

    It is driving me nuts trying to plan for this new expense and I can’t get the real numbers till October for 2017.

    by Louise — August 2, 2016

  93. I know some seniors here in Washington DC who have Kaiser Permanente and they all seem to love it. I have not heard much about if here. I believe they have a national network, correct?

    by Jennifer — August 3, 2016

  94. Editors Note: We are moving a group of Comments to the Blog topic because they concern Medicare (PS – Best advice we have seen on this question is to sign up for Medicare Part A when you are 65, even if you are still covered by your employer plan. Signing up for Part B depends on what kind of employer sponsored coverage you get.

    I am still working and will soon turn 65. I have health insurance through my employer. If I don’t sign up for Medicare at age 65, do I face penalties. I hope to put off taking SS until 66 and I will work until I die or cannot work anymore.
    by MaryNB — October 16, 2016 |

    If you are still working and have insurance from your employer, you don’t have to sign up for Medicare. I am 65 and will retire as of January 1st, 2017. I have applied for Medicare B to begin on January 1st. When I applied, she said she would give me Medicare A starting on 8/2016 (my birth month), since it doesn’t cost anything. Also, if you continue to work after 66 and still have health insurance, you don’t need to take your social security or medicare until our 70-1/2.

    by Stacey — October 16, 2016

    Stacey-“If you are still working and have insurance from your employer, you don’t have to sign up for Medicare.” I think you need to sign up for Medicare A even if you’re still working. If you have less than 20 employees, you need to sign up for Medicare B also. Right?

    by Admin — October 17, 2016

  95. MaryNB/Stacey – I don’t know if medicare varies in different states but being Federal I would think sign up is the same. That said I believe you must ‘sign’ up at 65 but if you have coverage you do not have to take/start paying until you are retired. I was a State employee & had/have coverage but when I retired Medicare became my primary & my State insurance was my secondary. As always homework is very important & varies for each person(s). My local Council on Aging offers a class several times a year for those turning 65 & talks about Medicare/Soc Sec. they also have a person that offers one on one about medical insurance – she looks at your needs & what you should get for a secondary insurance for yourself & your spouse. You might want to check if this type of service is available (mine is a State agency).

    by Sue M — October 18, 2016

  96. A friend of the family’s wife has not worked for 10 years and checking with Social Security she has enough credits for retirement but not Medicare. Apparently the zero’s she obtained over 10 years cut her credits and she needs 4 credits now. Is this something new with Social Security to deduct? Thx — William DeyErmand

    by Admin — October 5, 2017

  97. PLAN F GOING AWAY IN 2020*
    Plan F offers the basic benefits, plus coverage for both the Part A and Part B deductibles, skilled nursing care, emergency care abroad, and 100% of Part B excess charges (the difference between what a doctor or provider charges and the amount Medicare will pay up to Medicare’s limiting amount). Plan F also has a high-deductible option that can lower your premiums.
    With Medicare Supplement Plan F, you get the most complete coverage available. Because the plan covers costs in excess of Medicare-approved amounts, you may have no out-of-pocket costs for hospital and doctor’s office care with this plan.

    by jack — October 6, 2017

  98. Plan F is going away for new users in 2020 but those who have it can be grandfathered and can keep it.

    Hub has Plan F and just finished with $156,000 worth of treatments and he only got one bill two days ago. It was for a special blood test. It should have been covered. I called the doctor’s office that ordered the blood test and they called Quest Labs to ask them to resubmit the bill with the correct medical code. Apparently, they did not code it right. They told us not to pay the bill till it goes thru Medicare again. It should be covered by Medicare and what isn’t will be covered by Plan F. Plan F has been a great plan and is a great relief we are not bombarded with bills.

    by louise — October 6, 2017

  99. Louise, I will be able to get plan F just in time. How much does it cost per month?


    by Jennifer — October 7, 2017

  100. Jennifer, I live in CT and the costs are higher than in other states. My hub pays $241.50 a month. His is from AARP United Health Care. Different insurance companies charge different prices.

    Here is an example of different Medigap rates in CT:

    by louise — October 7, 2017

  101. Plan F here in Georgia costs $170.00 for myself and $160.00 for my wife. Within the last year we both had Hospital costs totaling 200K each and paid nothing out of pocket.

    by Jim C — October 7, 2017

  102. Jim C about a year ago you helped me sort out some of this Medicare, Medigap stuff. Hub turned 65 in March and needed treatments in July. $156,000 later he is doing good and no bills due to Plan F! Hope you and the wife are doing well. Medical bills add up fast, that is for sure! Thank you for sharing information with us!

    I wish CT had your States prices!

    by louise — October 7, 2017

  103. How do you get plan F

    by Cliff — October 8, 2017

  104. These comments moved here for a better fit:
    From Louise
    Staci, yes I know Part B is based on income. Hub and I are nowhere close to the $170,000 income so we each fall into the $134.00 per month category.
    Plus, we are adding Part F to our Medicare so we will have pretty much no copays, no bills. Hub had 39 radiation treatments last year, doctor visits, etc and we received not one bill. I know it was a lot of money because we did see the bills. Probably close to $200k.

    From Louise
    Maimi, I too would like to see some comparisons of someone who moved from CT to Georgia and how they reaped the rewards of lower cost of living. For one thing, yesterday I checked Medicare Plan F costs from different states. I put in some random zip codes and found the costs vary a lot! I live in CT and Plan F costs $241.50 per month. If my husband and I moved to MI between the two of us we could save $2,501.28 a year. I don’t want to move to MI but this is just an example of how just one item could save money and then add other things like lower taxes could really stretch your retirement money. I know not everyone wants Part F but if they want the other plans, the prices are probably lower than CT too. I didn’t check every state because not interested in them at this point. However, be aware, there are many zipcodes per state so each zipcode needs to be checked for price. These prices are just a ball park and you would have to check the exact zipcode you might move to for accurate numbers.
    Here is what I found:?AK 99501 $133.28?MI 48197 $137.28?HI 96813 $138.72?TN 37660 $143.20?AZ 85701 $145.12?SC 29572 $145.92?VI 00801 $154.50?MA 01103 $191.00?FL 32162 $194.50?GA 30269 $194.50?AR 71601 $206.75?ME 03904 $224.75?NY 12202 $236.75?CT 06810 $241.50?NY 10001 $294.50

    From Staci
    Just a note that your Medicare payment IS based upon your current income. Check out their website!!!

    by Admin — April 8, 2018

  105. If Medicare premium is based on your current income, what happens when you retire two years later and your current income is cut in half? Does your premium go down? Do I need to notify the SS office? Any answers? Please help!

    by Skip — April 9, 2018

  106. Skip, looks like you contact SS and tell them you have a life changing event.

    by Louise — April 9, 2018

  107. Skip

    Medicare determines your premium based on your tax returns. So if your income goes up or down vs. the threshold your premiums will be automatically adjusted in future years. You don’t have to do anything – other than pay the premiums!

    by Admin — April 9, 2018

  108. I believe that your Medicare premiums for the current year are determined by your income on your tax return for the prior 2 years. So if you go on Medicare in 2018, your premium is determined by your income in 2016. I believe this information is available in the Medicare guide on their website.

    by Nancy — April 10, 2018

  109. An important form for new retirees is Form SSA-44. This is a form for change in status due to a life-changing event. Instead of having your Medicare Pt. B premium adjusted based on your prior two years’ of earnings, this form allows you to notify the government that you are retired and your future income will be lower than your prior two years of earnings would indicate! You need proof of retirement (I used my employer’s Change of Status form) and will need to provide an estimate your income after retirement. Within 3 weeks of dropping my SSA-44 form off at the local Social Security office, I received confirmation that the high income Premium for my Part B insurance was dropped. Since I was starting Social Security widow’s benefits and retiring at age 65, I then received a refund from my first check for the Medicare Part B premium that had already been deducted. When I went to our local office to sign up for Social Security, this Form SSA-44 was mentioned. I had to ask for it.

    by Kate — April 10, 2018

  110. Typo – sorry – the form was NOT mentioned when I went to the office, so I had to ask for a Form SSA-44. The form was updated for 2018, so you would want to get it from the SSA site directly if looking for it online.

    by Kate — April 10, 2018

  111. Skip
    I just went thru this last week. I wanted the Medicare cost based on my pension. You need to set up an appointment with SS and explain. Each year, your Medicare cost is recalculated

    by Sue — April 10, 2018

  112. Thank you everyone for your valuable information regarding my SS question.

    by Skip — April 10, 2018

  113. I used the form and documentation Kate mentioned and just dropped it off at the SS office. No appointment or meeting was necessary.

    by Staci — April 10, 2018

  114. Can this form be filed online?

    by Jennifer — April 11, 2018

  115. I thought the premiums did not go up on part B if income was below 170,000.?

    by Sandyg — April 11, 2018

  116. Sue thank you for sharing your information regarding SS form.

    by Skip — April 11, 2018

  117. Jennifer: & Sandyg: (1) I didn’t spot a way of filing the form online. You can mail it, but I wanted to be sure they got it! As Staci mentioned, I called the SS office to find out if I needed an appointment to deliver the form. They said no. There was a drop-box in the lobby for stuff, where I left it. (2) The premiums go up on a sliding scale. From the Form SSA-44, it looks like the premium starts to increase for a single after $85K.

    Hope all of this info about SSA-44 helps some people! It was definitely good news for me when I found out about it.

    by Kate — April 12, 2018

  118. While I would love a retirement income of 85,000 as a single. I can safely say I do not have to worry about Medicare increases if the rules are the same when I apply in Spring 2019.

    by Jennifer — April 12, 2018

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