Malti Patel

Q. When can I sign up for my Medicare drug coverage?

A. If you are newly entitled or enrolled in Medicare, you may enroll during your initial enrollment period for Medicare. If you do not join during this period, your next chance to join will be during the annual coordinated election period (AEP) between Nov. 15 and Dec. 31 each year. There also will be special enrollments periods (SEPs) if you lose your employer-based coverage, move from your prescription drug provider's (PDP) or Medicare-Advantage Plan that offers prescription drug coverage (MA-PD) service area and when a provider goes out of business or is decertified by Medicare.

Q. Do I automatically get Medicare benefits if I'm eligible for disability benefits?

A. You will be automatically enrolled in Medicare after you get disability benefits for two years. Start counting the 24 months from the month you were entitled to receive disability, not the month when you received your first check.

People with amyotrophic lateral sclerosis (Lou Gehrig's disease) get Medicare beginning with the month they become entitled to disability benefits.

Medicare has two parts - hospital insurance and medical insurance. Hospital insurance helps pay hospital bills and some follow-up care. The taxes you paid while you were working financed this coverage, so it's premium free. The other part of Medicare, medical insurance, helps pay doctors' bills and other services. You will pay a monthly premium for this coverage if you want it.

Q. If I retire at age 62, will I be eligible for Medicare at that time?

A. No. Medicare benefits based on retirement do not begin until a person is age 65. If you retire at age 62, you may be able to continue to have medical insurance coverage through your employer or purchase it from a private insurance company until you turn age 65 and become eligible for Medicare.

Q. Is there an increase in premiums if I enroll in Medicare after age 65 and what is a special enrollment period (SEP)?

A. Your premium will be increased if you do not apply at age 65.

Enrollment rules are strict. Initially, you have seven months to sign up for medical insurance (Medicare Part B). This seven-month period begins three months before your 65th birthday, includes the month you turn 65 and ends three months after that birthday. If you enroll during the first three months of your enrollment period, your medical insurance protection will start with the month you are eligible. If you enroll during the last four months, your protection will start one to three months after you enroll.

If you do not enroll during this initial enrollment period, each year you are given another chance to sign up during a general enrollment period from Jan. 1 through March 31. Your coverage begins the following July.

Your monthly premium increases 10 percent for each 12-month period you were eligible but didn't enroll.

EXCEPTION: If you are covered by an employer or union group health plan through your or your spouse's current or active employment, you may qualify for a special enrollment period (SEP).

The special enrollment period is a period of time, during which you may enroll. Also, you did not enroll during your initial enrollment period because you are covered under a group health plan based on your own current employment or the current employment of any family member.

The special enrollment period may occur during any month you are covered under a group health plan based on current employment, or during the eight-month period that begins the first full month after employment or group health plan coverage ends, whichever comes first.

Q. Does a spouse, age 62, receive Medicare benefits when his/her aged 65 husband/wife does?

A. Generally not. The minimum age for Medicare eligibility is 65. But, if you've been getting Social Security disability benefits for 24 months, you can receive Medicare at any age.

These questions and answers are courtesy of Malti Patel, 1607 Wood Creek Lane, Allen, Texas 75002. Patel recently published a book "Lifting the Mists: A simple guide to a complex welfare system for elderly immigrants and their families." Contact Patel at [email protected] to order the book.