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Frequently Asked Questions

If you are turning 65 and already taking Social Security, you will be automatically enrolled in Medicare Part A and B.  You should receive your card in the mail about 3 months ahead of your 65th birthday.

If you are turning 65 and not currently taking Social Security, you must apply for Medicare yourself.  This can be done in four ways:

  1. Apply online through Social Security at https://www.ssa.gov/benefits/medicare or https://www.ssa.gov/retireonline/. You will be required to set up a “My Social Security” account if you don’t already have one.
    2.    
  2. Apply in person by going to your local Social Security office.  Find your local office here: http://www.ssa.gov/.
    3.    
  3. Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).  You will be able to make an appointment to apply on the phone or in your local office.
    4.    
  4. If you worked for a railroad, call the Railroad Retirement Board (RRB) at 1-877-772-5772.

When you are retiring or leaving your current coverage, you must fill out the Part B application form and send it to Social Security either via fax to 1-833-914-2016 or mail to your local Social Security office.  This should be done before you retire or lose your current coverage to avoid any lapse in coverage.  Currently there is no online enrollment option.  You may also be required to provide proof of your employer coverage.

Part B Enrollment Form: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS017339.html
Proof of Employer Coverage: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf

Part A is free if you have worked and paid Medicare tax for 40 quarters which is the equivalent of 10 full years.

Part B monthly premium for 2025 is $185. The premium changes yearly but usually by only a few dollars. Some people with higher incomes may be required to pay an Income Related Monthly Adjustment Amount (IRMAA) ($106,000 annually if you file a single tax return & $212,000 annually for those filing jointly in 2025). If you think this may apply to you, go to https://www.medicare.gov/basics/costs/medicare-costs for summary information and https://www.ssa.gov/benefits/medicare/medicare-premiums.html for detailed information.                  

The late enrollment penalty for Part B is 10% for each full 12 month period that you could have had Part B but did not enroll and did not have creditable coverage.

The late enrollment penalty for Part D is 1% of the national average beneficiary premium for each month that you did not have Part D or creditable coverage.

Please note that if you can provide proof that you have maintained creditable coverage you should not be subject to penalty.                  

There is a Federal Program called Extra Help or Low Income Subsidy (LIS) to help with Part D (prescription drug) costs. Either call Social Security at 1-800-772-1213 or go online to https://secure.ssa.gov/i1020/start.

Medicaid is a state program to help with overall health care costs. Call DSHS at 1-877-501-2233 or go online to https://www.dshs.wa.gov/altsa/home-and-community-services/how-apply-medicaid.

No, you must apply for Medicare. Call Social Security at 1-800-772-1213 or go online to https://www.ssa.gov/retireonline.

As your local Medicare consultant, I am available to help in any way I can.  Please feel free to call me at 509-992-4872.

                     Other options:
 
  • Local HealthMarkets Advisor or other local professional
    •                            
  • Medicare & You Publication
                               -    Mailed out every year in September to beneficiaries
    •                          
  • ANOC- Annual Notice of Change
                                -    Sent every September from your current insurance plan
    •                           
  • Medicare.gov
                                -    Contains multiple on-line publications and information
    •                          
  • SocialSecurity.gov
                              -    For contact information, publications and instructions

No, working with me will not cost you in any way.  If you choose to work on your own, you will still pay the same amount.