If you’re new to Medicare and would like to start taking advantage of your benefits, you may be surprised to learn you may not be covered. Your Medicare effective date, specifically for both Part A and Part B, will determine when you can get the medical attention you need. Here’s everything you need to know.
Your Medicare effective date pinpoints the exact date in which your coverage begins. Depending on when you enrolled, your coverage may be delayed, which is why it’s important to enroll the moment you become eligible. Once your Medicare goes into effect, you’ll be able to seek out medical attention, whether it be preventive or urgent, and have your Medicare
If you are automatically enrolled in Original Medicare, your Medicare effective date will begin on the first day of the month in which you are eligible. Meaning, if your 65th birthday is in the middle of the month, October 15, your coverage will begin on October 1. However, if your birthday happens to fall on the first day of the month, like October 1, your Medicare effective date will actually fall on the first of the month prior, September 1.
For beneficiaries of Original Medicare, your effective date for Part A and Part B is on the lower right corner of your Medicare card. You can also find it on the letter you received from the Social Security Administration or from the Railroad Retirement Board. If you enrolled in a Medicare Advantage or Medicare Prescription Drug Plan, your effective date will depend on when you enrolled and which election period you qualify for.
When you turn 65 there is a 3 month period for Medicare enrollment. This is how it will affect your coverage:
It really depends on your Medicare enrollment. If you were automatically enrolled, then you Medicare part A effective date will be the same as your Medicare Part B effective date. That’s because you started them at the same time. However, For some people, their effective dates could be different.
You may have opted out of Medicare Part A because you are still working and not receiving Social Security or because you are contributing to an HSA which prohibits yours from receiving Medicare Part A benefits. If you opted out of Medicare Part A when you were eligible, and later enrolled, then your Medicare Part A effective date would be different than your Medicare Part B effective date.
When you do enroll in Part A, your benefits will be backdated six months. This could be good for you if you had a claim during that time. However, Medicare Part A disqualifies you from contributing to an HSA. If you delay Part A when you turn 65, then you need to stop making HSA contributions six months before Medicare enrollment. Otherwise, you will have to remove funds contributed to your HSA account for the previous 6 months to avoid being penalized.
The same would apply for Medicare Part B. If you opted out of Medicare Part B when you became eligible, and later decided to enroll, then your Medicare Part B effective date would be different than your Medicare Part A effective date. If you have exceeded the three month period after you turned 65, you will have to apply during the General Election Period.
This period is the first quarter of each year, January 1st to March 31st. Your Part B Medicare effective date will begin on July 1st of that year. However, if you have a qualifying event after 65, you will be able to immediately start Medicare Part B. You will not have to wait until the General Election Period.
If you need to speak to someone, you can contact the Social Security Administration at 1-800-772-1213, and for TTY services, call 1-800-325-0778. They are available to assist you Monday through Friday, from 7 AM to 7 PM. If you need to speak to someone at the Railroad Retirement Board, you can call 1-877-772-5772, and for TTY services, call 1-800-325-0778. They are available Monday through Friday, from 9 AM to 3:30 PM.
