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How to Change Medicare Plans

The step-by-step process for changing any Medicare plan.

Are you considering making a change to your Medicare insurance plan

Are you the type of client that wants to know more about the potential “what ifs” of changing Medicare plans before you enroll and/or choose a specific Medicare plan type? Maybe you would also like a step-by-step process guiding you through the process of changing each plan type? I would too! The process of how to change Medicare plans can be intimidating for many clients. Whether it be how to change Medicare Supplement Plans, how to change Medicare Advantage Plans, and/or how to change Medicare Prescription Drug Plans, I will mentor you through the process. 

Obstacles such as trusting the agent, the application process, waiting for the enrollment confirmation, and/or cancelling your current plan(s) can be stressful. Let’s create a plan of action for the process of changing plans, so you’re comfortable throughout the transition. 

Establishing a timelines and outlining the process of how to change Medicare plans are examples of best practices we use to ensure clients understand the expectations of the transition process. I want my clients to be able to anticipate the timing of how to change Medicare plans and what to expect along the way. 

Best practices for changing all Medicare plans

The floowing best practices apply to making changes to all three Medicare plan types–  How to change Medicare Supplement Plans, how to change Medicare Advantage Plans, and/or how to change Medicare Prescription Drug Plans. 

Understanding the process and outlining the timing of the change for any Medicare plan will allow you to be more confident with your decision when it comes to choosing a new plan option. Not only when you decide to transition plans, but I believe you should know your options before enrolling in your first Medicare plan. This may sway your decision to start in a Medicare Supplement Plan versus a Medicare Advantage Plan. 

Lower your Medicare Supplement Plan premium- guaranteed-issue.

Within 60 days of your birthday, use the California Birthday Rule to move to any carrier with a lower premium while keeping exactly the same coverage and access to your physicians. No health questions asked!

For example, Plan G to Plan G from company “X” to company “Y” and pay $20-45 less per month. Guaranteed-issue move within 60 days of your birthday!

How to change a Medicare Supplement Plan

The process of how to change Medicare Supplement Plans can be a very simple transition, or may take a few extra steps to accomplish the transition. This depends on whether or not your ability to transition is considered guaranteed-issue and/or you have an “open” window to make the change. These processes of changing Medicare Supplement Plans will assume you’ve already made a Medicare Supplement Insurance Plan selection before or during your guaranteed-issue period within 6 months of enrolling in Part B of Medicare. These best practices for changing plans does not necessarily apply to someone who is newly eligible to Medicare and enrolling for the first time (obviously). However, why not clarify how and when you’re eligible to change plans before making an enrollment choice? If you’re already in a plan, you’re likely here to view your options/process for changing plans. Let’s get started and walk you through the process!

Changing your Medicare Supplement Plan using Guaranteed-Issue

If you have guaranteed-issue rights, meaning you currently have a Medicare Supplement Plan and are seeking to move insurance carriers during your California Birthday Rule, or happen to have SEP status, the transition is very straightforward. Knowing you will be guaranteed-issue (accepted) into the new insurance carrier’s plan type is very reassuring for my clients. With guaranteed-issue rights, we can confidently enroll you, knowing the enrollment will be accepted. There is essentially, no risk to making the move, other than completing the application process correctly and submitting the proper forms on time. 

View the California Birthday Rule for Guaranteed Issue from an unbiased, CA based 501c3 non-profit if you would like additional resources to confirm my site’s content. Although my content is accurate and I believe it often times provides you with more detail from my perspective as a broker, I believe you deserve outside resources to confirm what I’m saying is true, accurate, reliable, etc. 

Changing your Medicare Supplement Plan without Guaranteed-Issue

If you are not guaranteed issue, meaning you will be subject to medical underwriting (health questions being asked on the application), the process can be stressful not knowing if you’ll be accepted into the plan. This is common among clients who currently do not have a Medicare Supplement Plan and/or are applying outside their guaranteed-issue enrollment window, and/ or do not have a SEP for guaranteed-issue into a Medicare Supplement Plan.  Without guaranteed-issue rights, the application process will take longer, as you’ll need to wait on the approval or denial to be determined through the underwriting process. Regardless of the final outcome, it’s best to apply an organized timeline to the enrollment process. This way, we can anticipate and plan for the next step– whether the final result is an approval or denial of coverage.

Regardless of your status (guaranteed-issue or not), it is best to take the same steps when transitioning to a new Medicare Supplement Plan.

The steps to change a Medicare Supplement Plan with Guaranteed-Issue

As I mentioned before, how to change a Medicare Supplement Plan with guaranteed-issue is very simple using the California Birthday Rule. For example, moving from the same Medicare Supplement Plan letter to same Medicare Supplement Plan letter with a new insurance company offering the same coverage at a lower premium. Win-win!

First – Shop all like Medicare Supplement Plans (same plan letter) within a 60 day window of your birthday (the exact day of your birthday, plus 60 days). For example, shop Plan G vs. all other Plan G’s or shop Plan N vs all other Plan N’s. 

Second – Apply with the new carrier. Skip medical underwriting section (health questions). Noting your guaranteed-issue rights which you qualify for having a current Medicare Supplement Plan and transitioning to a like plan with the same coverage with a new insurer with lower premiums. Set the date out the 1st of the following month, or the month after to give yourself even more of transition cushion for new cards and payment processes to be updated. (Ie. birthday is June 17th, set new start date for July 1 or August 1). The decision to start coverage the 1st of the month after your birthday or the 1st of the 2nd month following your birthday will be up to you. 

Third – Wait for confirmation. Usually, 3-7 days since there is no underwriting process. I can email you a confirmation from my broker portal so you have proof before cancelling the older more expensive Medicare Supplement Plan. This will reassure you of your acceptance into the same plan coverage with the new carrier offering lower premiums in your ZIP code at your age. I can provide you government issue proof of your right to guaranteed-issue as this will assure you of your right to the Medicare Supplement Plan with lower premiums. 

Fourth – Cancel your current Medicare Supplement Plan via fax. Fax cancellation showing the date of cancellation as the last day of the month prior to your new coverage start date (signed and dated). For example, the new plan is confirmed for a July 1st start date. We cancel your current Medicare Supplement Plan with higher premiums on the last day of the month (June 30th). There is no lapse in coverage. Continue seeking medical care with Original Medicare as your primary insurance and your Medicare Supplement plan as the secondary policy. The new policy kicks in on the 1st and continues to provide you with same coverage.

Lastly, continue using Medicare as the primary just as you had before. Your Medicare being the primary insurer of your health coverage will never be changed or altered in this process. We’re only changing the secondary “supplement” or the “trailer” following medicare wherever it goes. Your access to physicians, providers, etc. has never changed. Medicare continues to be primary with your new Medicare Supplement Plan. You likely saved $300-$500 for the year in premiums and continue to have the same coverage. Win-win!

The steps to change a Medicare Supplement Plan without Guaranteed-Issue

In this scenario, we are assuming you do not have a current Medicare Supplement Plan. You may have failed to apply during your guaranteed-issue window when you were first eligible for Medicare, or you may be attempting to transition from a Medicare Advantage Plan to a Medicare Supplement Plan after being in the plan for a couple years after realizing it isn’t what you expected. Regardless of why, the fact is, you’ll likely need to go through medical underwriting (health questions asked) if you do not have a SEP to bypass the approval process.

First – Shop Medicare Supplement Plans for your age/ ZIP code so you can choose to apply with the carrier that has the best rates for the level of coverage you are applying for. 

Second – Apply for the coverage (ie. Plan G or Plan N). Regardless of the plan coverage choice, aka. plan letter, the same underwriting process applies for acceptance into the plan. The health questions asked are the same on the application for Plan G as they are for say, a lower tier plan, Plan N. I recommend starting with Plan G and if you ever want to go lower, thats an easy process that does not require the medical underwriting approval as you’ll be able to lower coverage using the California Birthday Rule once you’re approved and active in a Medicare Supplement Plan. Each carrier may ask different questions on the application. However, as I stated before, the questions will be the same regardless of the Medicare Supplement Plan letter you are applying for if it’s with the same insurance company. 

Third – Wait to hear back from the insurance company. The process may take 10-14 days depending on the company’s ability to process the application and either confirm or deny you coverage based on the their underwriting process. 

If coverage is approved, and you do not have any other coverage. We will send you confirmation as well as the insurance company. Your new coverage will begin on the date you elected on the application. The newly approved Medicare Supplement Plan will begin to follow your Original Medicare as the secondary insurer– covering Medicare deductibles, copays, co-insurance costs (level of coverage depends on plan selection as price will depend on plan selection, age and ZIP code). 

If denied coverage, you may look for another company that has less questions, but may be charging a higher premium for the level of coverage you selected at your age/ZIP code. However, it is likely the same reason you were denied by the first insurance application, will be the same reason any additional applications will be denied as well. There are circumstances where clients are successful with certain carriers, but it depends on the specific questions asked as well as your medical history, etc. I can review this with you over the phone to clarify any questions on this subject.  

If enrollment in a Medicare Supplement Plan is unsuccessful, you may want to look into Medicare Advantage Plans. Apply during AEP– October 15th-December 7th for a January 1st start date. There is no medical underwriting with Medicare Advantage Plans. Unfortunately, not all counties in California offer Medicare Advantage Plans. Contact us if you would like us to look up this option for you and help compare plans during the Fall AEP or if you have a SEP open window to shop plans. 

Fourth – In either scenario, there is no prior or current Medicare Supplement Plan to cancel as you were applying for coverage through underwriting. You were either approved and now have coverage or were denied coverage. 

Note: If you are applying for Medicare Supplement Plan and are approved with the intent of leaving a Medicare Advantage Plan, please continue reading the process below to successfully transition plans, as the timing of when you change is important. 

If accepted, and moving from a Medicare Advantage Plan, or you’re planning on trying to transition from the MAPD plan, you should apply for the Medicare Supplement Plan in October. Your current Medicare Advantage Plan will run through the end of the year (December 31st). The trick is to apply during the first two weeks of October, but set the start date to January 1st of the next year. This way you can get an answer on whether or not you’re approved/denied during the Annual Enrollment Period. Why?

If you are accepted into the Medicare Supplement Plan in October or Early November, you can then enroll in a stand-alone Medicare Prescription Drug Plan (Part D). Enrolling into this Part D plan will effectively cancel the Medicare Advantage Plan on December 31st and allow you to transition back to having Original Medicare + Medicare Supplement Plan + Medicare Prescription Drug Plan on January 1st. 

If you are denied coverage for the Medicare Supplement Plan in October or Early November, you will have a 7 week period (Oct. 15th – Dec. 7th) to review any new Medicare Advantage Plans that are offered in your county that may be a better alternative than your current Medicare Advantage Plan for the next year. 

Note: You also have the option of applying for a Medicare Supplement Plan and returning to Original Medicare during MAOEP. This would be based upon the outcome of your Medicare Supplement Plan application during January 1- March 31. This is called the Medicare Advantage Open Enrollment Period. During this time you can change to another Medicare Advantage Plan, drop your Medicare Advantage Plan and/or enroll in a Part D Plan with Original Medicare. This enrollment window is somewhat similar to the AEP, but slightly different as you’re only allowed to make one election change.

Note: I do not recommend moving to Original Medicare and dropping a Medicare Advantage Plan without first being accepted into a Medicare Supplement Plan for the 1st of the year. Why? I do not think it’s financially responsible to have only Original Medicare by itself unless you have Medi-Cal as a dual eligible Medicare beneficiary– there is no stop loss for medical bills that could potentially reach tens if not hundreds of thousands of dollars without a cap on the 20%. Original Medicare itself doesn’t have an out-of-pocket limit. This is where the Medicare Supplement Plans come in a protect you from a potential life changing 20% share of the cost for your medical bills ($75,000 surgery – 20% = $15,000). 

How to change a Medicare Advantage Plan

The process of how to change your Medicare Advantage Plan is a fairly simple process. As to why someone may want to make a change the their Medicare Advantage Plan is covered in more detail under Comparing Plans – Medicare Advantage Plans and Change Plans- Medicare Advantage Plans.  

This section’s primary focus is the process of how to change a Medicare Advantage Plans and the best practices for doing so. Since there is no underwriting for Medicare Advantage Plans (health questions asked), and there is no guaranteed-issue status needed to be approved, as there is no health questions asked, it comes down to the period or “window” of time you can make a change to a Medicare Advantage Plan. 

Let’s jump right in. What are the best practices for changing Medicare Advantage Plans? 

First – We are assuming you are in a Medicare Advantage Plan, and therefore, already have an active Medicare Advantage Plan covering you up until December 31st of the year. This means that you’ll likely be looking to make a change for January 1st of the following year by applying within the AEP October 15th – December 7th. Also you have options in the early Spring if using the Medicare Open Enrollment Period to make a change (February 1, March 1, or April 1). Not ideal, but is an option for you. 

First things first! Shop MAPD plans in your county based on your ZIP code. Age does not play a factor in Medicare Advantage Plan availability, or the monthly premium charged for Medicare Advantage Plans available to you. Confirm the plan’s network (HMO or PPO). Review summary of benefits, compare co-insurance and review the OOP MAX. Review the “bundled” Part D Prescription Plan included in the MAPD Plan. Run your prescription list.  Find the plan that suits you. 

Second – Apply for the coverage. Fill out the application. If done in the appropriate window, you coverage will begin on the 1st of January if done during AEP (October 15th – December 7th). If done in the Spring for MAOEP (Jan 1 – March 31st) it will become effective the first of the month after the application was submitted–1st of February, 1st of March, or 1st of April (MAOEP). If SEP, it could be the 1st of any month. 

Third – Wait for your enrollment application to be approved. You must have Part A & B of Medicare, as well as continue paying for Part B of Medicare while in a Medicare Advantage Plan ($164.90.10 in 2023). You may receive an outbound call to confirm your intent to enroll in the new Medicare Advantage Plan. If you miss the call, you will receive confirmation in the mail. Plan information will be mailed directly to you from the insurance company–cards, proof of enrollment, etc. 

Fourth – You will not need to cancel you current Medicare Advantage Plan. Enrolling in the new Medicare Advantage Plan will discontinue the current plan on December 31st of the year if enrolling in the new plan during AEP. The new plan will start January 1st. You will have no lapse in coverage. The MAOEP is slightly different. See below.

If changing during MAOEP in the Spring (January 1-March 31st), the new plan will go into effect the 1st of the month after the application was submitted for the change. For example, if you applied February 7th, the new plan would be effective March 1 and effectively cancel the current plan the last day of February. If you applied March 27th, the new plan would be effective April 1st and the current plan would effectively be cancelled on March 31st. 

Note: The Medicare Advantage Open Enrollment Period (MAOEP) can be used to make changes just as the AEP can be used, however, there are differences– see below. 

Annual Enrollment Period

October 15th – December 7th each Fall. New plan starts January 1st of the new year.

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How to change a Medicare Advantage Plan - AEP vs. MAOEP

AEP (October 15th - December 7th)

Using AEP to make a change to your Medicare Advantage Plan – If you enroll at anytime during the window of October 15th December 7th (AEP), you’ll have a new plan effective date January 1st of the following year. For example, if you apply the first day, October 15th or the last day, December 7th, the new plan starts January 1st. 

During AEP, you are able to enroll/make changes to your Medicare Advantage Plans more than once before the deadline of December 7th. When changing plans, your intent should be do your research and make one elective change for the new year. However, if you need to make an additional change to another plan, this window allows you to do so make additional enrollments if you decide another Part C plan is better for you. The last plan you enrolled in will be the effective Medicare Advantage Plan come January 1 of the following calendar year. Since you may only be enrolled in one Medicare Advantage Plan at a time, your current plan will automatically cancel on December 31st and the last Medicare Advantage Plan you enrolled in during AEP will become effective January 1st. 

If you happen to need to make a change in the Spring, you may take “advantage” of the MAOEP from January 1-March 31st. However, the MAOEP works slightly different–see below.

MAOEP (January 1st - March 31st)

The Medicare Advantage Open Enrollment Period is a window of time to make one last change (if needed) to your Medicare Advantage Plan for the new year and/or return to Original Medicare and apply for a stand-alone Medicare Part D Plan that would effectively cancel the Medicare Advantage Plan at the end of the month you applied for the Medicare Part D plan. When you enroll in a Part D plan in this window it will cancel your current Medicare Advantage Plan on the last day of the month you applied for the new Part D plan. Be sure you have a confirmed approval for a new Medicare Supplement Plan if using this window to move away from a Medicare Advantage Plan, as enrolling in the Part D Plan will effectively move you back to Original Medicare on the 1st of the following month. You’ll want your Medicare Supplement Plan to begin on that same day as well. 

The difference between AEP and MAOEP is that the MAOEP only gives you a one time enrollment change to your Medicare Advantage Plan. If also has different enrollment effective dates depending when you submitted the application. If you were to use this enrollment window, the effective plan change would take effect the 1st of the month after the application was submitted. It is not like the AEP where all applications in the window fall to one effective date (January 1st). 

If you’re electing to return to Original Medicare with a stand-alone Prescription Drug Plan, you can do so during this enrollment window as well. You may be returning to Original Medicare for various reasons. A common reasons is, you’ve been accepted into a new Medicare Supplement Plan and need to cancel the Medicare Advantage Plan outside of the AEP. 

In this scenario, you would sign up for a new stand-alone Medicare Prescription Drug Plan to start the same day as your new Medicare Supplement Plan. You would likely want to apply for the Part D plan the month before the Medicare Supplement goes into effect. This way, the Medicare Advantage Plan would effectively cancel on that last day on the month before the Medicare Supplement and Stand-alone Medicare Prescription Drug plan go into effect. This being February 1, March 1 or April 1, depending on when you are timing the plan changes in the spring enrollment “window”. 

Get Organized with your Rx list.

Review your Medicare Prescription Drug Plan each Fall during the Medicare Annual Enrollment Period October 15th – December 7th. List your medications in the Medicare drug finder to shop Part D plans for the new year.

How to change a Medicare Prescription Drug Plan

The process of how to change a Medicare Prescription Drug Plan is a fairly simple process. Now, as to why you may be changing is a different story. Review in the navigation bar above, Comparing Plans- Medicare Prescription Plans and Change Plans- Medicare Prescription Plans for more in depth information on why clients change Medicare Prescription Drug Plans and how to compare them. 

In this section, I’ll be covering the process of how to change a Medicare Prescription Drug Plan. Refer to changing a Medicare Advantage Plan if you are intending to change your Part D plan that is included inside your Medicare Advantage Plan (Part C) or MAPD Plan. 

Now, what are the best practices for how to change a Medicare Prescription Drug Plan (Part D)?

First – Stand-alone Medicare Prescription Drug Plans run the entire calendar year. Therefore, you’ll likely be making a change for new plan to begin January 1st. To make the change, you’ll need to do so during the AEP, which runs October 15th – December 7th. 

Shop the available Medicare Part D plans for the upcoming year. There are likely 20+ Part D plans in CA to choose from. You’ll be best-off using a Medicare Drug Plan finder such as the one Medicare.gov provides. We use it for our clients because it provides objective plan information from all insurance carriers offering California based drug plans from one source. 

Shop the Part D Prescription Drug Plans based on the lowest estimated out-of-pocket costs (premium + copays) to find the plan that gives you the best value. Look the formulary, drug restrictions, and also the pharmacy networks during AEP to narrow down the best plan for you. Contact us if you would like help with this during AEP. 

Second – Apply for the new Part D coverage by filling an application between October 15 – December 7th (AEP). The new plan enrollment will go into effect January 1st of the following calendar year. 

Third – Wait for your enrollment application to be approved (which it will if you have Part A and/or Part B of Medicare). You may receive an outbound call to confirm your intent to enroll in the new Medicare Advantage Plan. If you miss the call, you will receive confirmation letter in the mail outlining the basis for the call (confirming intent to enroll in the plan). Plan information will be mailed to you from the insurance company directly– cards, proof of enrollment, etc. 

Fourth – You will not need to cancel you current Medicare Prescription Drug Plan. Enrolling in the new Medicare Prescription Drug Plan will discontinue the current plan on December 31st of the year if changing plans during AEP. The new plan will start January 1st. You will have no lapse in coverage. 

Note: If enrolling in a Medicare Prescription Drug Plan during MAOEP to return to Original Medicare, effectively dropping the Medicare Advantage Plan, the start date will depend on which month you apply for the Part D plan. The start date will then begin the 1st of the following month (February 1, March 1 or April 1). 

There are other scenarios, such as SEP windows that take place with Medicare Part D Plan cancellations. If you feel you have extenuating circumstances and were sent a SEP letter from CMS, contact us and we will walk you through your plan options and outline the best plan of attack for how to change a Medicare Prescription Drug Plan inside the SEP window. They usually give you an extended time to enroll, but ideally you want coverage to begin January 1, so the additional time is more of a “safety blanket” for those whose forget to address their dropped coverage within the normal AEP window. 

Need help with changing your Medicare Prescription Drug Plan?

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Welcome to MedicareSupplementMentor.com!

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Our Compensation

How are we compenated as Independent brokers?

Our agency works independently of each insurance company we represent to provide objective, unbiased options from a variety of insurance companies.  We do not receive a salary or any other form of payment other than what we make from the plans our clients choose to enroll in through our insurance agency. We are compensated for new clients who choose to work with us as well as current clients who maintain a plan through us. The commission we receive is paid directly by the insurance company for your enrollment. You do not pay us, ever. 

Premiums are exactly the same as going direct.

Medicare insurance products have different payment structures (ie. Medicare Supplement Plans, Medicare Advantage Plans, and Medicare Prescription Drug Plans). Our clients never pay us for any of the services or advice we offer. Medicare insurance plans are priced 100% the same as going direct. It’s a win-win for us and our clients. Monthly plan premiums are exactly the same as going direct to an insurance company’s call center. When you work with us, you get to work directly with the broker as opposed to an employee of the insurance company in a call center. 

Medicare Supplement Plan (Medigap) Compensation

When a client chooses us to help facilitate their enrollment into a Medicare Supplement Plan, we receive a monthly commission based upon a percentage of the monthly premium. You are not charged more than the companies premium for our service. The insurance company pays us a commission for the product you choose. Our clients never pay us for any of the services we offer. We are paid on a monthly or annual period depending on the insurance companies payout structure. 

When it comes to Medicare Supplements, our goal is to keep you in a product with competitive rates. Medicare Supplement Plans are standardized plans, therefore, there’s no reason to pay more for the same exact thing, right? We want you to be confident with any recommendation we make. Transparency is the key to our success. We know every insurance company is seeking your business during this transition to Medicare. When your rates increase, we are not paid on the new “increased amount”. We are paid on the initial premium. Therefore, it is in both our best interest to review your rates each year or every other year to find a new plan that provides you with better rates. We want our clients to be satisfied with the products we offer and the service we provide for our compensation.

Medicare Advantage Plan (Part C) Compensation

Just like Medicare Supplement Plans, we are paid directly from the insurance company for facilitating your enrollment with a Medicare Advantage Plan. Our clients never pay a cent more than going direct to the company’s call center. We are paid is fixed by the Medicare Advantage product and state it is issued through (CA). To be clear, we are paid the fixed amount regardless of the premium you pay for the Medicare Advantage Plan. We receive the same commission on the $0 premium plan as the $100+ plans. We will help you breakdown each plan option to find the best value for all plans available to you. You can simply choose the plan that works best for you. We are then compensated by the insurer of the plan you choose once your enrollment is complete.

The amount we are paid for helping you enroll in the plan of your choice is the same amount whether it is a new plan or a plan we recommend you consider moving to. I like to clarify this so our clients know that if we make a recommendation for a new MAPD plan, it has nothing to do with how we are compensated. We are compensated for helping you maintain your plan and answer questions about your coverage. We are able to offer independent advice because we can provide you will multiple plans from multiple companies. If you ever have a question about a new plan available in your area, or something you’ve seen on television,  please contact us.  We will help you review the plan to see if it’s something that would benefit changing to during the AEP for the following year. 

Medicare Prescription Drug Plan (Part D) Compensation

Similar to the Medicare Advantage Plans, we are paid a fixed amount from the insurance company. This commission we receive is not based on the premium you pay for the Medicare Prescription Drug Plan. We are compensated exactly the same for a $10 a month plan as a $100+ a month prescription drug plan. Monthly premiums our clients pay are exactly the same as premiums for those who enroll directly through a call center. Yes, 100% the same. We receive a commission for helping you initially enroll in the plan. We are also compensated each year you choose to stay in the plan.

When we recommend to move your plan during AEP (each Fall), it is likely because the plan you’re in has changed or it is not going to cover your prescription list as well for the following year. Medicare Prescription Drug Plans are the plan type that change most often year to year. You’ll likely be making updates to your drug coverage every year or every couple years to keep up with annual changes. We help our clients review Part D plans every fall. If you have more questions about how Medicare Prescription Drug Plans work or how we are compensated for providing them to you, please contact us. We would are more than happy to review your current plan and answer any questions you may have.

Transparency is Key.

5 Step Enrollment Guide Introduction

An Educational Approach to Medicare

Can I get a spousal benefit through Social Security and my spouse's quarters to qualify for Medicare?

Yes, to qualify for Medicare, you need to have paid into Social Security for 10 years or 40 quarters, or you can qualify under your spouse’s record of quarters paid to Social Security. Many times, in this scenario the spouse is/will be taking Social Security as well as Medicare through the other spouse. 

The important difference between taking Social Security and taking Medicare through a spouse, is that you must be 65 to qualify for the Medicare portion of benefits through your spouse. I only note this because taking Social Security through a spouse can take place before turning 65. In this situation, the timing of the Medicare benefit for the younger spouse can be mistaken as active when one spouse is over 65 and the other is under 65, yet taking Social Security benefits through the older Medicare eligible spouse. This isn’t a common mistake, but just a reminder. 

Typically, the younger spouse may start taking a portion of the older spouse’s Social Security benefit (allowing their benefit to grow to a certain point) At a later time, they may choose to elect to start their own Social Security benefit separately from their spouse. Timing the Social Security benefit and Medicare are separate enrollments, but many times this can overlap and seem complicated when enrolling in Medicare and changing Social Security benefits at the same time. 

If you have been taking benefits through a spouse (delaying your own benefit) and decide to elect to start your own Social Security benefit at a later date (ie. your SS benefit has been building on the side for you as you have been delaying it), remember to update Medicare and your Medicare insurance plans because it’s likely your Medicare ID# will be updated under your own benefit (you’ll get a new Medicare card). Medicare coverage should not be affected. Rather, just a new Medicare ID# to run your own medical billing through the same product you’re currently covered under. 

For more Social Security planning guidance, please refer to the Social Security 101 tab at the top of the home page or contact my office for one on one advice with John to talk through when its best for you to take your Social Security benefit. 

Are you working past 65, delaying your Social Security benefit, and enrolling in Medicare at a later date?

This is the most complicated election for timing your Medicare start dates, yet it is very common. I’ll walk you through each step to thoroughly cover exactly what you need to do to get Medicare started on time, without penalties, and without any hassles. I’ll assume a few things as we go through this step by step so you can put yourself in this scenario even if your situation is slightly different. 

This Medicare enrollment scenario assumes you are working past the age of 65, delaying your Social Security benefit, and covered through your employer sponsored plan with more than 20 employees or you are older than 65 and covered through your spouse’s employer sponsored plan with more that 20 employees. 

Note: Im very specific with the employer plan being more than 20 employees because if you or your spouse’s employer plan is more than 20 employees, then the employer group plan is primary to Medicare the month you turn 65 and after the age of 65 while you are working. This means that even though you are over the age of 65, you were able to skip enrollment into Part B (and technically Part A) of Medicare since it is not primary coverage (employer plan remains primary). Therefore, enrollment into Part B can be delayed in this scenario without penalty until transitioning to full Medicare A & B the 1st of the month following retirement/leaving the employer group plan. Part A may have been activated at 65 if you enrolled online for “Part A Only” and delayed Part B. Technically whether you enrolled in “Part A Only” or not with more than 20 employees in your group plan, “Part A Only” is just “sitting on the sidelines” until you elect to start Part B (they then both become primary once activated via your SEP).  

If your employer group plans is less than 20 employees, Medicare will be primary and the employer group plan would then act as the supplemental coverage to Medicare. If under 20 employees, you’ll be best off not delaying your Part B of Medicare. You’ll need to proactively enroll in Part B 3 months before turning 65 using IEP even though you are working. I recommend you try to negotiate with your employer to pay your Part B premium as well as the group plan coverage acting as your supplemental in this scenario. Many times the company may offer to pay for the Part B premium, the Medicare Supplement and your Part D plan while working. It is much cheaper for the employer if you to go off their group plan, so many times, they are happy to reimburse the Medicare Part B premium and Medicare insurance products for you each month.  

If you have more questions, call my office so I can go through this with you. It’s tricky, but I’m very familiar with timing these scenarios for my clients.  

Back to the scenario…. you are over 65, working, delaying Social Security, and wishing to enroll at some future date for Medicare to begin the day you leave your or your spouse’s employer group plan that is larger than 20 employees. Let’s assume, you’re 68 years old and wishing to retire in the month of September for a seamless transition to Medicare for October, 1 2022. In this scenario, your birthday is irrelevant when it comes to enrolling in Medicare with Social Security. Since you are outside the Initial Enrollment Period (IEP) (the 7 months surrounding your 65th birthday), you’ll need a different election tool to activate your Medicare properly. You’ll be using whats called, a Special Election Period or SEP. Since you have been covered on an employer group plan prior to the month leading to your 65th birthday, you’ve had what is called “credible coverage”. This credible coverage is going to allow you to enroll into Medicare on any retirement date in the future if you remain covered under that employer group plan while employed with the company. For this example, we are using 10/01/2022 as the preferred Medicare start date after retiring in September so I can be specific with dates for this illustration. 

In this specific scenario you would need to print forms on SSA.gov or print from the Resources Tab under Helpful Medicare Forms and Documents on this site. These forms are SSA form L564 and form 40B. 

40B is a form that you’ll use to “say” that you want to elect to start your Medicare Part B on “X” date. In this example, we are targeting 10/01/2022 for the start date. Print and fill out form 40B indicating your intended Part B start date of 10/01/2022. 

Now, to SSA form L564. This form is what activates the use of form 40B. L564 is a form that your employer administrator will fill out showing you’ve had credible coverage under their group plan from date “X” to date “Y” — signed by the benefits administrator in your company. You can get this form signed up to 8 months prior to your intended Medicare start date- 10/01/2022. 3-4 months prior to your start date is sufficient in my opinion. 

To continue the example, let’s say you filled out the 40B in June/July and had your employer sign off on your credible coverage on the L564 and returned the form to you. You can submit both forms to the Social Security office in person for your 10/01/2022 start date. If you’re working with me on this, I’ll be happy to guide you and fax the documents to the local Social Security office with your permission to get a hard copy receipt of SEP enrollment for 10/01/2022.  

Let’s assume for ease of the this example that you are still delaying your Social Security benefit. You’re Medicare is set for 10/01/2022. You’ll now receive a quarterly Part B billing statement for the Part B premium. Remember, Part A is “premium free” since you paid into the system for more than 10 years. If Part A was activated as “Part A Only” at 65 online it is still “sitting on the sidelines”. Once L564 and 40B go through both Part A and Part B will be activated to be primary on 10/01/2022, once the group employer ends the last day of September. No penalties!

Medicare is now primary and you can work with John to get quotes, pricing, and enroll yourself in the plan of your choice. You will have exactly the same guarantee issue rights as someone who went through the process when turning 65 (no health questions asked). You are not subject to late enrollment penalties for Part B or Part D because of the credible coverage you had through the employer group plan or your spouse’s employer plan. L564 took care of the proof for the Part B penalty, but you may need to show proof of “credible coverage” to the FIRST enrollment into a Part D plan you enroll into whether it be a standalone Part D or Part D included in a Medicare Advantage plan. After this initial Part D enrollment, you should not need to resubmit proof.

If you enroll in Medicare insurance products with my office, we will help you get this organized and submit it with your application before they even ask- avoiding any confusion as to whether you had credible coverage or not. Best to give them the proof ahead of time than deal with it at a later time. 

Once you elect to start your Social Security benefit at a later time (ie. 68-70 in this example), the Part B premium will then be withdrawn automatically each month prior to the monthly draft (your monthly Social Security benefit amount minus the Part B premium = monthly Social Security benefit draft into your account). The standard Part B premium for 2022 is again, $170.10 (more if subject to IRMAA).  

This is one example- please call if you want me to review your specific enrollment scenario so we can pin point the exact months you needs to complete each step to get it all coordinated correctly without penalties. 

Mentor One Insight

Mike is 68 (outside his IEP at 65), he is still working and delaying his Social Security. He is covered through a large employer plan (over 20 employees) so he can delay his Medicare Part B and use his group plan as his primary coverage while he works past 65. He has credible coverage through his employer plan for Part B and Part D. He can retire any month he wants and can elect to have Medicare begin without penalty on the 1st of the month he chooses. He wants to start July 1 – 07/01/2022. He is retiring June 5th -06/05/2022 and therefore, has coverage through 06/30/2022 with his employer plan (check with your benefits to be sure you’re covered through the end of the month- take advantage of this if you can). 

In March/April (3-4 months prior to his desired start date of July 1 – 07/01/2022), Mike printed off the forms 40B and L564 and reviewed the timing of his Medicare with John over the phone to pin point his exact dates. Since he settled on July 1 for his Medicare start date based on leaving his employer at 68 years old on June 5th. He filled out form 40B that indicated a 07/01/2022 Medicare Part B start date (Part A will become active on 07/01/2022 as well). Mike now contacts his employer benefits division to get a representative to sign off on his credible coverage with form L564 to allow him to activate his form 40B. He submits both forms to Social Security in the month of March or early April (depending on when his employer gets the L564 back to him). Mike gets confirmation of Part B effective 07/01/2022.  Part A may have an earlier date and it will always show the earlier date if elected “Part A Only”, however, Part A will become effective 07/01/2022 because the primary insurer (employer) drops 06/30/2022. Both Part A and Part B are coordinated and effective 07/01/2022.

He is now set for his Medicare start date of 07/01/2022 without penalty for his Medicare coverage at 68 years old. Mike meets with John to review Medicare insurance plans, pricing, and enrolls in the plan of his choice. Additional credible coverage proof is sent to the Part D plan of his choice– the Part D penalty is now not applicable to him. He is now fully covered without a lapse in his coverage. His group plan ends June 30th and his Medicare as well as his Medicare insurance product(s) all start July 1 without a lapse in coverage. 

Are you working until 65, delaying your Social Security, and plan to enroll in Medicare at 65?

This scenario is similar to the one above, but in this situation, you are currently working and covered under your employer group plan until the last day of the month you leave your group plan (or spouse’s) and retire. You are planning to retire the month prior to your 65th birthday and looking to time your Medicare start date the day after your employer health plan benefits end (last day of the month). Maybe you chose to work up to this date because you know the cost of insurance plans in your early 60’s are extremely expensive as an individual and you are timing your retirement to coincide with Medicare your 65th birthday IEP Medicare start date. 

In this scenario, you are delaying your Social Security benefit. Therefore, you will need to proactively enroll into Medicare (Part A & B) for coverage to start the 1st of the month you turn 65. It is best to do this 1-3 months before your 65th birthday month (The Part B Initial Enrollment Period starts 3 months before your 65th birthday). Most clients apply in the 1-3 month window prior to their birthday (plan ahead if possible). You can enroll online or in person with the Social Security office (pending appointment availability). We are available to help you through the enrollment process if you have questions at this stage in the process. Once enrolled online or in-person, always print a receipt of your enrollment date, write down and/or print the confirmation number from the Social Security. 

Since you are delaying your Social Security benefit, there is no monthly Social Security benefit check for the Part B premium to be withdrawn from, right? For this reason, you’ll be receiving a quarterly Part B bill. You will need to continue paying this bill to keep you Medicare Part B active until you elect to start your Social Security benefit and it’s automatically withdrawn. You will have the option to pay through a monthly checking account auto draft or monthly credit card. You’ll need to wait until you receive the quarterly bill to set up these other payment options. The standard Part B premium for 2022 is $170.10 (more if subject to IRMAA). Part A is again, “premium free” if you have fulfilled the minimum requirement of 10 years (40 quarters).

Once you elect to start your Social Security benefit at a later time (ie. 66-70), the Part B premium will then be withdrawn automatically each month (your monthly Social Security benefit amount minus the Part B premium = monthly Social Security benefit draft into your checking acct.) 

I chose to show this example because many times the SEP forms for Medicare enrollment for someone leaving an employer group plan AFTER the age of 65 can be mistakenly used in conjunction with IEP or in place of IEP (Initial Enrollment Period) 3 months prior to turning 65. 

IEP will take precedent over the SEP forms in this situation. To be clear, you do not want to use the SEP (leaving an employer group plan) enrollment unless you are outside the IEP period surrounding your 65th birthday. With that being said, for this example, he/she is enrolling prior to turning 65, yet still leaving an employer group plan. So, use the standard IEP enrollment period and proactively enroll directly with Social Security in-person or online for your Medicare (Part A & B) to begin on the 1st of your 65th birthday month. See SEP situation in the next example if you are curious how that works when enrolling in Medicare AFTER turning 65 and leaving an employer group plan outside your IEP. 

Mentor One Insight

Diane is approaching her 65th birthday –August 19th, 2022. Diane has been anticipating her retirement date since last year at 64, but after viewing the cost of medical insurance through the employer COBRA option or going on her own with an individual plan costing her approx. $1000 a month, this wasn’t an option for her. She decided to work another year with her current employer and plans to retire in July- the month before she turns 65. Since she is currently covered under her employer plan, she knows that if she retires the month prior to turning 65 (on the 10th of July and  her 65th bday is August 19th), her Medicare coverage starts 08/01/2022. If she leaves the employer plan on the 10th of July, she will have coverage through the end of the month through the employer plan. She will have no lapse in coverage. 

The day the employer plans ends, is the same day her Medicare activates as her primary coverage (08/01/2022). Diane is delaying her Social Security and plans to take it at a later date (ie.66-70). She is focused on Medicare timing at this time and can elect to start her Social Security at any point she sees fit in the future. Electing to start her Social Security benefit will not have an effect on her Medicare. It will only effect how her Medicare Part B premium is paid to Social Security (quarterly if delaying/monthly withdraw if taking the benefit). 

Three months before Diane’s 65th birthday month of August, Diane should proactively enroll herself into Medicare during her IEP (Initial Enrollment Period). Again, she is proactively enrolling in Medicare in-person or online because she has chosen to delay her Social Security benefit at this time. Once she has met with Social Security or confirmed her effective date/start date by enrolling in Medicare online, she is set to start her Medicare coverage – effective 08/01/2022.  

Now that Diane completed the first enrollment of coordinating her Medicare properly, she can comfortably continue reviewing the second enrollment process of reviewing Medicare plan paths and the insurance products to find the plan that best suits her coverage needs. After reviewing Medicare Basics 101 and the following steps of the process (5 Steps), Diane can now confidently contact John in May, June, or July to confirm her understanding of insurance products on her Medicare plan path as well as ask for quotes, pricing, and enrollment paperwork to start the enrollment process for the insurance products. Diane’s Medicare and Medicare insurance product(s) will all start 08/01/2022. Diane timed her retirement perfectly from leaving an employer group plan and transitioning to Medicare with no lapse in coverage. 

Are you delaying your Social Security benefit and plan to enroll in Medicare when you turn 65?

You will need to proactively enroll into Medicare (Part A & B) for coverage to start the 1st of the month you turn 65. It is best to do this 3 months before your 65th birthday month (The Part B Initial Enrollment Period starts 3 months before your 65th birthday). Most clients apply in this 1-3 month window prior to their birthday (plan ahead if possible).You are able to enroll up to the day prior to your 65th birthday month (ie. March, 31st– for an April 1 start date when 65th birthday is in April). If you apply the month of or just weeks prior to your 65th birthday month, you may not have your card in hand, but you will be covered- effective as of the 1st of your 65th birthday month.  You can enroll online or in person with the Social Security office (pending appointment availability). We are available to help you through the enrollment process if you have questions. Always print a receipt of your enrollment date, write down and/or print the confirmation number from the Social Security website if enrolling online. 

Since you are delaying your Social Security benefit, there is no monthly Social Security benefit for the Part B premium to be drafted from, right? With no Social Security benefit for you to withdraw your Part B, you will be receiving a direct bill in the mail. This bill will likely be quarterly, which you’ll need to continue paying to keep you Medicare active until you elect to start taking your Social Security benefit. The Part B premium will then be automatically withdrawn. 

Referring back to the quarterly Part B bill, you will have the option to pay through a monthly checking account, auto draft, or monthly credit card on the quarterly statements if you choose. You’ll need to wait until you receive the quarterly bill to set up these alternative payment options. The standard Part B premium for 2022 is 170.10 (more if subject to IRMAA). And as with all Medicare beneficiaries that worked for 10 years or 40 quarters and paid into Social Security, Part A is again, “premium free” to you.  

Once you elect to start your Social Security benefit at a later time since you are delaying it at this time, the Part B premium will then be automatically withdrawn each month (your monthly Social Security benefit amount minus the Part B premium = monthly Social Security draft into your account). Once this is set up, you should never have to update it. 

Mentor One Insight

Mark is currently retired. He works part time as a consultant, but continues to be covered through his spouse’s employer group health plan until he turns 65. He turns 65 on April 7th of 2022, so he wants his Medicare to start on the 1st of his 65th birthday month- 04/01/2022. Mark has savings and other forms of income through investments as well as his spouse’s income which is allowing him to delay his Social Security benefit to a later date. He has not decided exactly when he’ll take his benefit (he’s planning on a date between 66 and 70). For now, he is focused on only starting Medicare. Let’s assume it is early January, 2022 in this example. 

Mark will need to proactively enroll in Medicare for his Medicare to activate 04/01/2022. His Initial Enrollment Period for Part B (IEP) begins on January 1 of 2022 (3 months prior to his 65th birthday month). He can call Social Security to schedule an in-person appointment or can go online to SSA.gov to proactively enroll in Medicare prior to his desired April 1 start date. Mark and his wife show less income on their IRMAA than $182,000 so he will be paying the standard $170.10 per month for his Part B premium. He also fulfills the requirement for Part A after working for 45+ years. Therefore, Mark’s Part A is “premium free”. Since he has chosen to delay his Social Security benefit, there is not a monthly Social Security benefit to withdraw the $170.10 Part B premium. He will be mailed a Part B bill for $510.30 (quarterly). He can elect to pay this through his credit card or checking account auto draft as soon as he receives the quarterly statement and coordinates the payment option he prefers. Mark will likely receive this quarterly bill along with his Medicare card 2-4 weeks after coordinating his Medicare with Social Security for his 04/01/2022 start date.

Now that Mark has completed the first enrollment into Medicare (Part A & B) effective 04/01/2022, he can now move to the second enrollment and start reviewing Medicare Basics 101 to begin researching the “Parts” and Medicare plan paths and Medicare insurance products. Mark has a good idea of which “Plan Path” he prefers for his Medicare coverage. Mark scheduled an appointment in late January/early February to review his plan with John and to start the paperwork for completing applications for insurance products to start along with his Medicare on 04/01/2022. 

Are you actively taking your Social Security benefit and plan to enroll in Medicare when you turn 65?

You will be automatically enrolled in Medicare (Part A and B) qualifying by paying into Social Security for 10 years or 40 quarters. Your card will be mailed to you and it will indicate your Medicare coverage to begin on the 1st day of your 65th birthday month (ie. Birthday, March 21st– Medicare starts March 1, 2022). The card will typically be sent 3-4 months prior to your 65th birthday month. Assuming you’ve paid into Social Security for 40 quarters (or you qualify through your spouse), Part A is premium free to you (you were taxed!) Medicare Part B has a separate premium. The standard premium for 2022 is $170.10 (subject to change annually). The Part B premium will be automatically deducted from your Social Security benefit since you’ve already elected to start your Social Security benefit prior to your Medicare start date (you have a benefit amount established to deduct the $170.10 from monthly). 

If you happen to set up your Medicare at the same time you elected to start your Social Security benefit (simultaneously at 65), the Part B premium may be deducted as an automatic monthly draft (if set up in time for Social Security billing), or it may be billed to you as a quarterly statement until the payment deduction is processed. Review your Social Security benefits statement to confirm the Part B premium draft ($170.10 or more if subject to IRMAA).  Call your local Social Security office to confirm payment information or to coordinate the transition of the Part B premium payment. Once you’ve completed this enrollment, you can transition to planning out your second enrollment of choosing your Medicare insurance product(s) for that path.

Mentor One Insight

Roberta has been retired for a couple years and has been covered with an individual health plan until she is Medicare eligible. She is planning to transition to Medicare the month of her 65th birthday (when she is first eligible). She has already elected to start her Social Security benefit early at 62. Her birthday is February, 18 and wants to be sure her Medicare starts on the 1st of February (first possible day for her Medicare to begin). Let’s assume it’s the first week of November, 2021 in this example (3 months before her 65th birthday month).

Roberta will be automatically enrolled in Medicare since she is actively taking her Social Security benefit. She will get her Medicare card approximately 2–3 months prior to February. Since her Social Security benefit is already active, her Part B premium will be automatically deducted from her check each month starting in February of 2022. Her Part B premium will be the standard $170.10 and her Part A is “premium free” since she worked well over the 10 years to qualify. Her Part A and Part B effective dates on her Medicare card will both be 02/01/2022. She does not need to worry about the Part B Initial Enrollment Period (3 months before, the month of 65th bday, and 3 months after) for Medicare enrollment. Remember, Social Security automatically enrolled her using Roberta’s IEP and mailed her card directly to her. Roberta then can move on to the next step of enrollment into a Medicare insurance product of her choice. 

Roberta reviewed Medicare Basics 101 under the navigation bar and continued making her way through the 5 Step Medicare Enrollment Guide to find the Medicare plan path and insurance product that will give her the coverage that suits her healthcare needs. Roberta filled out the Help/Quote Request Form on the website in late November/early December. She now has an appointment scheduled to discuss plans and enroll into Medicare insurance products with John to get everything set up for her 02/01/2022 start date. 

Side-by-side comparison of Medicare Advantage Plans
(Medicare.gov - 95747, Placer, CA)

This screenshot was taken from Medicare.gov for educational purposes. The image above shows 3 of the 18 plans available in Placer County, California (95747) in 2022. These three plans were chosen to illustrate how to use the Medicare.gov plan finder as well as show Medicare beneficiaries how they can search for plans using Medicare.gov for side-by-side comparisons in groups of 3. 

The description of premium, deductibles, and OOP Max is intended to be used as educational examples of how the plans are presented by Medicare.gov. No sales material is provided on this site for Medicare Advantage Plans. Please contact my insurance agency directly, medicare.gov, or the insurance company for more plan details and/or to enroll a Medicare Advantage Plan. 

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Ask a Question.

Questions? We have answers.

Medicare Supplement vs. Medicare Advantage Plans?

At this point, you should have a decent grasp of Medicare Basics 101 and your path to a successful Medicare Enrollment with Social Security. Hopefully, you are planning ahead of your Medicare start date, as its best to give yourself plenty of time to get organized. At this point in the process, you may or may not have confirmation of your Medicare Part A & Part B effective dates. If you do, great. If your Medicare card is on its way, you should have confirmation of dates (online or in-person with SS office), which is just as good. If you’re still in the process of getting the enrollment process started (or planning it out), you’re still on the right track! 

Choosing between these two plan types will be the DECIDING FACTOR which will dictate how your Medicare will function. Try not to think about the insurance carriers yet– once you have a plan type in mind, we can then dig deeper to shop which carriers are offering what plans to find the best value for you. 

Choose your Plan Path:

Medicare (Part A & B) + Medicare Supplement + Part D Prescription Drug Plan

Medicare Advantage Plan w/ Part D Prescription Drug Plan Included (MAPD)

Keep in mind– as long as we get you enrolled in a Medicare Supplement + Part D Rx plan or a Medicare Advantage plan w/ a Part D Rx plan before your Medicare start date, either style of a Medicare insurance plan will be effective the 1st of the month you’re eligible to begin Yes, even if you were to enroll in a plan the day before your start date, although I don’t recommend waiting until the last minute. I only say this so if you’re being told to enroll months ahead by another agent/broker pressuring you, they’re full of it! 

Which Medicare plan type/design do you prefer? If you’ve made your decision, but still want to confirm with me over the phone to make sure you prefer that plan for the right reasons, I can do that for you. If you’ve gone through the plan types and are still unsure, and would like me to guide you through it step by step while you follow on your computer, then let’s do that. Contact my office to schedule a phone appointment and I’ll review anything you have questions about. In fact, talking briefly over the phone typically allows me to clarify questions in matter of minutes rather than both of us writing lengthly emails back and forth. A brief chat will also give you the opportunity to put a voice to your guide. You can then decide if you would like me to help assist you with plan selection as your Medicare insurance broker. I look forward to helping you through the insurance plan selection process.

CMS L564

For printable version-- see Medicare Forms & Documents

CMS- 40B

For printable version-- see Medicare Forms & Documents

CMS- 2022 Medicare Supplement Chart

Are you over 65, delaying your SS benefit, and starting Medicare after you retire?

4th month after turning 65 to any future date while covered under employer group plan.

Using a SEP to activate Medicare Start Date

Covered under an employer group plan after the age of 65. Using Form 40B and L564 to activate Medicare to begin any month you select.

4th month after turning 65 to any future date while covered under employer group plan.

1-8 months prior to desired Medicare start date

Submitting 40B & L564

You’ve signed off on 40B indicating your desired start date (1st of the month). Employer has signed off indicating you’ve had credible employer coverage on form L564. Submit both forms to Social Security to activate your Medicare on the future date-  1st of the month you chose within 8 months of submitting forms.

1-8 months prior to desired Medicare start date

1-3 months before Medicare start date-- after confirmation of Medicare start date with Social Security (SEP)

Enroll in Medicare Insurance Products(s) with Mentor One

Set appointment with John, confirm understanding of your preferred Medicare plans type, review Medicare plan quote, enroll in Medicare insurance product(s) of your choice by phone, in-person, or virtually. 

1-3 months before Medicare start date-- after confirmation of Medicare start date with Social Security (SEP)

Date of choice you indicated Medicare to start and your Medicare insurance product(s) to start.

You’re Covered!

Congratulations! You are covered and may use your Medicare and Medicare insurance product(s) as needed (no penalties applicable with “credible coverage”).

Date of choice you indicated Medicare to start and your Medicare insurance product(s) to start.

Working, delaying your Social Security benefit, and starting Medicare at age 65 (ie. August birthday)

May 1, 2022 - July 31, 2022 (3 months before 65th bday month).

Initial Enrollment Period (IEP) Medicare (Part A & B)

Working, yet retiring prior to 65th bday month. Delaying your Social Security benefit. You’ll be proactively enrolling yourself in-person or online with Social Security to have your Medicare begin on the 1st of your birthday month.

May 1, 2022 - July 31, 2022 (3 months before 65th bday month).

May 1, 2022 - July 31, 2022 (any day before August, 1).

Enroll in Medicare Insurance Product(s) with Mentor One

Set appointment with John, confirm understanding of your preferred Medicare plan type, review Medicare plan quote, enroll in Medicare insurance product(s) of your choice by phone, in-person, or virtually. 

May 1, 2022 - July 31, 2022 (any day before August, 1).

August 1, 2022

Medicare & Medicare Insurance Product(s) Start Date

Medicare (Part A & B) and your Medicare insurance product(s) start on the 1st of your 65th birthday month- 08/01/2022

August 1, 2022

August 1, 2022 - Future

You’re Covered!

Congratulations! You are covered and may use your Medicare card and Medicare insurance product(s) as needed. 

August 1, 2022 - Future

Delaying your SS benefit & starting Medicare at 65
(ie. April Bday)

January 1, 2022 - March 31, 2022 (3 months before 65th bday month).

Intial Enrollment Period (IEP) Medicare (Part A & B)

Since you are delaying your Social Security benefit, you’ll be proactively enrolling yourself in-person or online with Social Security to have your Medicare to begin on the 1st of your 65th birthday month.

January 1, 2022 - March 31, 2022 (3 months before 65th bday month).

January 1, 2022 - March 31, 2022 (any day before April, 1).

Enroll in Medicare Insurance Product(s) with Mentor One

Set appointment with John, confirm understanding of your preferred Medicare plan type, review Medicare plan quote, enroll in Medicare insurance product(s) of your choice by phone, in-person, or virtually. 

January 1, 2022 - March 31, 2022 (any day before April, 1).

April 1, 2022

Medicare & Medicare Insurance Product(s) Start Date

Medicare and your Medicare insurance product(s) start 04/01/2022. 

April 1, 2022

April 1, 2022 - Future

You’re Covered!

Congratulations! You are covered and may use your Medicare card and Medicare insurance cards as needed. 

April 1, 2022 - Future

Medicare Basics 101

Part A, Part B, Part C, Part D– Medicare Supplement plans & Medicare Advantage plans….Who came up with this system!? Well, it’s what we have to work with, so let’s break this down in stages to get a basic understanding of what each “Part” represents.  For starters, NO, you can’t have all 4 parts. As to why they choose to label them (A-D) as if they all fit together still puzzles me as well.  

Start by reviewing each category under Medicare Basics 101. Use this pop up to refer back to as needed:

Medicare Plan Map View how "Parts" interact with each Medicare plan path (two paths)

Original Medicare (Part A & B) The foundation of Medicare. Keep (w/ Medicare Supplement) or Sign Over (w/ Medicare Advantage).

Medicare Supplement Plans (Medigap) View the structure & functionality of the plan. (Keep Original Medicare Add Medicare Supplement).

Medicare Advantage Plans (Part C) View the structure & functionality of the plan. Sign Over to its own "Medicare Plan".

Medicare Prescription Plans (Part D) View the structure and functionality of the plan - Add (w/ Medicare Supplement) or Included (w/ Medicare Advantage).

Medicare Enrollment Planning Overview

First things first! Let’s take you through the enrollment process of activating your Part A & B of Medicare with Social Security. Start here with the Medicare Enrollment Planning section. In this section, you’ll be discovering when you’re able to enroll in Medicare and whether it will be automatic or you’ll need to be proactive with Social Security. You will also be able to view Timeline buttons under each enrollment scenario to reinforce the concepts (ie. IEP -3 months before your 65th birthday month, etc.).

Under this Medicare Enrollment Planning section, I’ve broken down the most likely Medicare Enrollment Scenarios, so you can read through each and find the one that best applies to your situation. The timing will depend on whether you have already started or delayed your Social Security benefit. Are you actively receiving a SS benefit, delaying the benefit, maybe undecided and still working? Every Medicare beneficiary’s goal is to activate their Medicare properly on the day they intend to take benefits, however, each person’s path may differ. Here is an outline of the enrollment scenarios:

- Have you taken your Social Security benefit and plan to enroll in Medicare when you turn 65?

- Are you delaying your Social Security benefit and plan to enroll in Medicare when you turn 65?

- Are you working until 65 or later, and delaying your Social Security benefit and enrolling in Medicare at age 65?

- Are you working past 65, delaying your Social Security benefit and moving to Medicare at later retirement date (leaving a group employer health plan upon retirement)?

- Can I get a spousal benefit through Social Security and my spouse's quarters to qualify for Medicare?

After this initial step of finding your Medicare enrollment path with Social Security, you’ll be ready to confirm your start date with Social Security and/or organize yourself so you’re ready for when the time comes to enroll (depends on how early you’re starting the planning process). After this first step, start the process of reviewing the “Parts” of Medicare and the “Plan Types” being offered to you under Medicare Basics 101.

Medicare Checklist for medicare enrollment.

John V. Crump

Broker | President

Welcome,

I would like to take the opportunity to share with you a little more about myself, John Crump, broker and mentor for MedicareSupplementMentor.com. First and foremost, I believe it’s important that you meet the person delivering the content that may influence your enrollment and/or coverage decision(s). I’ve built this site to help you navigate Medicare and Medicare insurance plans in a pressure free environment.

Us my Medicare Video Library, Map, Checklist, and 5 Step Enrollment Guide to process everything you need to know about “all things Medicare”. Here is a brief outline of what my site will help you with as you weigh your Medicare enrollment options and decide with whom you want to set up your Medicare insurance coverage:

- Coordinating Medicare with Social Security- Medicare Enrollment Planning

- Clearly define and explain to the "Parts" of Medicare- Medicare Basics 101

- Breakdown the Medicare plan paths & Medicare "Plan Types" - Compare Medicare Plans

- Objective Medicare plan quoting & Medicare insurance plan enrollment - Contact John

- Medicare & Medicare insurance product education from a broker's perspective.

As an independent insurance broker, I will be transparent with you. I am in the insurance business of brokering Medicare Supplement Plans for retirees. I make my living off of helping new clients enroll into Medicare insurance plans. My mission is change the high pressure sales environment most retirees are subject to surrounding their transition to Medicare with call centers. MedicareSupplementMentor.com was designed to change the way in which Medicare beneficiaries have access to accurate and trustworthy sources of information. You deserve to have access to information that is clear and direct. The accessible and comprehensive design will allow you to review the Medicare plan material at your own pace without an any agent’s “enroll now” sales pressure. If you found the material on my site useful, I do ask that you give me an opportunity to help you enroll in the Medicare Supplement Plan, Medicare Prescription Drug Plan , or Medicare Advantage Plan of your choice. 

Please take your time reviewing the layout and design of the site’s content. It’s all been constructed with you in mind. Take advantage on the “pop up” informative material, “maps”, and “buttons” which are all accessible throughout the site. Look for my Mentor One Insight, which will provide you with more details on each Medicare topic by applying hypothetical scenarios and examples throughout the site. 

I look forward to guiding you through the maze of Medicare plans when you’re ready.  

Thank you,

John V. Crump

AARP UnitedHealthcare

Aetna

Anthem Blue Cross

Blue Shield of California

Cigna

Authorized to Offer

Continental Life

Combined

Coventry

Health Net

Humana

IAC

Mutual of Omaha

National Guardian Life

Transamerica

Wellcare 

Actively taking Social Security & starting Medicare at 65
(ie. February birthday)

November, 1 2021 - January, 31, 2022 (3 months before 65th bday month)

Initial Enrollment Period (IEP) Medicare Part (A & B)

You’ll have automatic Medicare enrollment since your Social Security benefit is active. Medicare will begin on the first of the month you turn 65.

November, 1 2021 - January, 31, 2022 (3 months before 65th bday month)

November 1, 2021 -January 31, 2022 (any day prior to February, 1).

Enroll in Medicare Insurance Product(s) with Mentor One

Set appointment, confirm understanding of preferred Medicare plan type, review Medicare plan quote, enroll in Medicare insurance product of your choice by phone, in-person, or virtually.  

November 1, 2021 -January 31, 2022 (any day prior to February, 1).

February 1, 2022

Medicare & Medicare Insurance Product(s) Start Date

Medicare and your insurance product(s) start 02/01/2022.

 

February 1, 2022

February 1, 2022 -Future

You’re Covered!

Congratulations! You are covered and are ready to use your Medicare card and Medicare insurance cards as needed.

February 1, 2022 -Future

Medicare Plan Map

Medicare Map - choose your Medicare Plan path.

Medicare Planning Made Simple Booklet

Mailed directly to your mailbox.