How to Change From HMO to Medicare

Upon attaining age 65, American citizens and permanent residents who have worked for 10 or more years in Medicare-covered employment qualify for Medicare benefits. Changing from an HMO to Medicare is a fairly straightforward process, but it is important to begin the process before age 65 if you are not already receiving Social Security benefits so there is no interruption in your medical coverage. Those retirees already receiving Social Security benefits before reaching age 65 are automatically enrolled in Medicare and don't need to do anything to change from their HMO to Medicare.

Difficulty:

Easy

Instructions

Things You'll Need

• Social Security number

Before Turning 65

1. Apply for Medicare three months before turning 65 if you are not already receiving Social Security benefits. This three-month period is part of the Initial Enrollment Period, and you can elect to begin receiving Social Security benefits at the same time as Medicare benefits, but it isn't mandatory. To apply, visit your local Social Security Office or call toll-free [phone].

2. Decide whether you want Medicare Part B. Medicare is compose of two parts, Part A and Part B. Everyone who qualifies for Medicare qualifies for Part A at no cost. Part A is insurance that covers hospitalizations of various types, but not doctors or outpatient care. Part B covers routine medical expenses and is not free.

3. Verify that your Medicare is in place the month you turn 65. You should receive a Medicare card in the mail before your 65th birthday. If you have not received your card, call the toll free number or visit your local Social Security office.

Upon Turning 65

1. Verify the cancellation of your existing HMO or other medical coverage upon turning 65. Private health insurance automatically terminates on the insured's 65th birthday, but it is important to ensure that you are no longer being billed for insurance you are no longer receiving. This is especially important for those insureds who have their insurance premiums automatically debited from a checking account, as these auto-debits can take up to 60 days to cancel.

2. Decide on a Medicare supplement policy. Private insurers offer different options to supplement Medicare and cover the expenses that are not covered by Medicare. These are known as Medigap policies. The policies range in cost and coverage from very simple to very comprehensive, and are identified by a letter designation from A to L (A being simplest, L being most comprehensive). The policies are the same for every insurance company, but the cost of the policies varies from company to company and not every insurance company offers every Medigap policy.

3. Inform your physician's billing office of your switch to Medicare.

Tips & Warnings

• Some people qualify for Medicare before reaching age 65. Check with your Social Security office to determine your eligibility.

References

• Medicare.gov
• Medicare Eligibility Tool
• Medicare.gov:: Medigap (Supplemental Insurance) Policies