This post gives you the link to sign up for Medicare because they make it so darned hard to find. Talk about burying the lede! It also explains Medicare in plain English, so that Medicare is demystified for you before you have to sign up for it.
So you’re turning 65 and it’s time to start the Medicare application. You do a web search (as one does) for “where to sign up for Medicare” or “how to sign up for Medicare”, and what you get are a bunch of ads followed by some nearly useless links to information about Medicare, and links to where to find out if you are eligible for Medicare, but no direct link to sign up for Medicare! Frustrated? I was too, and that’s why I am posting this, to save others the frustration.
“But Anne,” you say, “Surely you aren’t old enough to sign up for Medicare! You’re so youthful and energetic!” Well, thank you for the compliment, but in fact I will be 65 on April 3, 2023 (feel free to send birthday gifts and cards :~) ).
Medicare Explained in Plain English
First, it helps to understand that anything the government touches is never explained in a straight-forward, plain English manner.
Second, it helps to understand that anything that any insurance industry touches is never explained in a straight-forward, plain English manner.
When you combine the two? It’s enough to make you tear your hair out trying to understand something that is actually pretty straight-forward!
Obligatory disclaimer: This is neither medical nor legal advice. I am not an insurance expert nor a broker. This is my own explanation based on my own experiences. This is greatly simplified, but it is accurate.
Now for something we need to get out of the way:
Medicare is not free!
Regardless of which Medicare plan you select, you pay a premium for Medicare, just like any other health insurance.
Ok, now that that’s out of the way, here we go.
Medicare “Parts” and Their Alternate Names
Part of the reason that it’s all so damned confusing is that there are alternate names for each of the options (just to add extra confusion). Not only that but there are “Parts” and then there are “Plans” and they are not the same thing!
There are four “parts” to Medicare: A, B, C, and D
Part A is what covers things like hospital stays.
Part B is what covers things like visits to your doctor.
It helps to think of Part A as analogous to the Blue Cross part of Blue Cross/Blue Shield (which covers hospital stays and things associated with them), and Part B as analogous to the routine stuff and doctor visits covered by the Blue Shield part of Blue Cross/Blue Shield.
Parts A+B taken together is also called “Original Medicare”. If someone talks to you about “Original Medicare” they are talking about Part A + Part B.
Got that? (Note: Technically with Original Medicare you only pay a premium for Part B; Part A comes along for free. There are exceptions, but that’s the general rule. According to the Federal government’s Centers for Medicare & Medicaid Services the standard monthly premium will be $164.90 for 2023, with an annual deductible of $226.)
Part C is an alternative to the Blue Cross/Blue Shield-like coverage of Part A + Part B. It is separate, you opt in to either ‘Original Medicare’ (Parts A+B) or Part C, not both.
Part C is also called ‘Medicare Advantage’ (or more often just ‘Advantage’), and it is an alternative provided by private insurance carriers such as United Health Care, Anthem, and Aetna, not the Federal government. Basically it is the government outsourcing your Medicare coverage to the private insurance companies. This way the government doesn’t have to worry about it, and instead you are the private insurance carrier’s headache.
The insurance carriers offer all sorts of additional benefits to entice you to sign up with them, such as free gym memberships, or a couple of massage therapy sessions a year. Having done a lot of research, and heard the horror stories from both adult children who couldn’t get loved ones (elderly parents) the care they needed under their Part C ‘Advantage’ policy, or directly from people who were kicked out of the hospital because their Part C ‘Advantage’ policy only covered a very few number of days, and even from medical providers who weren’t able to get their patients the care they needed under the Part C ‘Advantage’ policy (and you can’t just switch back out of Part C ‘Advantage’ back to Original Medicare), I find it helpful to think of the ‘Advantage’ in Part C as standing for “we insurance companies take advantage of your gullibility in thinking this is a great deal” and “the Federal government takes advantage of tricking you out of signing up for Original Medicare (a/k/a Parts A+B).”
But hey, that’s just me.
Part D (D is for Drugs) is the prescription drug coverage. You have to sign up for it separately if you are going with Part A + Part B (again, collectively also known as ‘Original Medicare’). If you instead sign up for Part C (again, also known as “Advantage”) even though now you have my opinion on it, the Advantage companies will sometimes try to further entice you by saying that Part D (D for Drugs) is included in your Advantage premium. Don’t fall for it, whether rolled into your Advantage premium or having to pay for your Part D prescription coverage separately, you are paying for it.
Once you sign up for Medicare and are approved, you can add your Part D. You do that through the Medicare site. Basically you will be able to compare Part D plans for your state, plugging in the medication you currently take, and figuring out which one has the best coverage for you (both for your medication and also for which pharmacies are in-network for a given plan), along with the best premium and deductible price. One thing to note is that you can change Part D plans every year between October 15th and December 7th regardless of the medications you take, so it can make sense to look at the Part D plans each October and, if appropriate for you, switch to the Part D plan that has the lowest total cost (including premium, co-pays, and deductible) for your given medications and your choice of pharmacies at that time.
Medicare “Plans” (Different from Medicare Parts!)
A Medicare “Plan” (also known as a “Medicare Supplemental Plan” or a “Medigap plan” or just “Medigap” – they all mean the same thing) is an optional extra insurance that you can purchase to help cover the things that your Parts A+B don’t cover. It’s kind of like the extended warranty for your body and health. You don’t have to purchase it, but you may end up wishing that you had.
Medicare Supplemental Plans (again, also known as ‘Medigap’) are provided by private insurance companies such as Aetna, United Health Care, Anthem, etc.. You can sign up for a supplemental plan (Medigap) if you have signed up for Original Medicare (Part A + Part B). If instead you sign up for Part C (Advantage) then you cannot sign up for Medigap, because you are already opting out of Parts A + B (Original Medicare).
The Medicare “Plans” have letter designations (A, B, C, D, F, G, K, L, M and N). Isn’t that so nice of them to have both a Part A and Plan A, a Part B and a Plan B, a Part C and a Plan C, and a Part D and a Plan D, and have the “parts” and “plans” have nothing to do at all with each other? They are arbitrary, almost random, designations, and I’m pretty sure that they do this intentionally to make it as confusing as possible, so that when you get advice from your insurance broker (more on brokers below) you really don’t know what the hell they are talking about. (Hence this post!)
Not to put too fine a point on it, but the “parts” and the “plans” are two completely different things despite their very confusingly similar names.
(Does your head hurt yet?)
Also note that if you are newly signing up for Medicare, you can’t sign up for either Plan C or Plan F, they have been essentially replaced by Plan D and Plan G, but are still listed on all of the sites along with the other plans, just to confuse you further.
Each plan has its own advantages and disadvantages, and just like any other health insurance, the better the coverage the higher the premium. So you get to weigh premium price against deductible amount, etc., just like signing up for any other insurance.
As mentioned above, both Medicare Part C (‘Advantage’) and the Medicare Supplemental (‘Medigap’) plans are provided by private insurance companies and so for this reason you will need to work with an insurance broker for either your Medicare supplemental insurance (again, also known as “Medigap” or “the Plans”) or for your Medicare Part C (“Advantage”) (if you are going to go that route).
You can sign up for the government-provided Medicare Part A + Part B (also known as “Original Medicare”) on your own at the link that I’m about to give you, that elusive link that allows you to sign up for your government-provided Medicare.
Note: You have to sign up for Parts A+B before your broker can sign you up for your supplemental ‘Medigap’ insurance.
It’s important to understand that there is a set commission amount that brokers get whenever they write a Part C Advantage policy, or a Medigap (the Plans) policy, which in theory means that it doesn’t matter to them financially which one you choose, they will make the same commission. This sounds good on its face as it means they will be agnostic about which policy you choose. However, where they make that up is in volume. The more policies they write for Medicare-eligible people, the more money their brokerage makes.
I have talked with a lot of insurance brokers about this, and for the most part I needed to shower afterwards because I felt like I had just got done talking with a used car salesman (this may actually be an unfair comparison… to the used car salespeople). You can definitely tell which ones work for big brokerages where brokers are urged to write as many policies as possible, maybe even with sales quotas to fill, because some of these places really give you the hard sell.
The one broker with whom I spoke who did not leave me feeling like that, and who was the most helpful (truly) was Joel Rosenblum. Joel was recommended to me by a friend, and he is awesome (and he runs his own insurance brokerage business, so you aren’t bombarded with lots of spam trying to get you to sign up, etc.). Happily, he can work with people in all 50 states when it comes to Medicare, so wherever you are, I can highly recommend him. Here is his info:
Where to Sign Up for Medicare: the Direct Link
Here’s that darned direct link:
The direct link to sign up for Medicare is: https://www.ssa.gov/medicare/sign-up
One last thing: You have a window within which to sign up for Medicare. That window is 3 months before the month in which you turn 65, and 3 months after the month in which you turn 65, for a total of a 7-month window. When you sign up during the 3 months before the month in which you turn 65 your Medicare will become effective in the month in which you turn 65, not before.