AHCP Blog

CMS Fact Sheet Helps Clients Determine Whether to Enroll in Medicare

Written by AHCP | 10/29/21 1:09 PM

The annual election period for Medicare Advantage and Medicare Part D plans began on October 15, and with more people working past age 65, you may run into some individuals who are trying to determine whether they should sign up for Medicare or stay on their employer-sponsored health plan. To help them make that decision, CMS has created a checklist-style “Fact Sheet” that you may want to share with them.

You can access the Fact Sheet here: https://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Employers-and-Unions/FS3-Enroll-in-Part-A-and-B.pdf

The decision tool is long—15 pages, which may be off-putting to some clients—but there is a lot of white space so it’s pretty easy to read and won’t take long for your clients to complete.

How will this Fact Sheet help me? 

Here are the three “selling points” at the top of the fact sheet. CMS says the fact sheet is designed to help:

  1. Determine your Initial Enrollment Period
  2. Decide whether to enroll in Medicare Part A and Part B when you turn 65 
  3. Find out how to sign up for Medicare Part A and Part B (or opt out of Part B)

The tool then walks readers through these three steps one by one.

Determining your Initial Enrollment Period

This step is pretty short. The fact sheet explains that an individual’s “7-month Initial Enrollment Period usually begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.” It then points visitors to a link that will help them estimate their Medicare eligibility and premium. 

Brokers should consider clicking the link and walking through the process. It’s fast and easy and provides additional information at the end about how the premium is determined, including an explanation of the Income-Related Monthly Adjustment Amount (IRMAA), if applicable.

Deciding whether to enroll in Medicare at age 65 

This is the longest step because there are a number of items to consider when making this decision. To help people with this decision, the fact sheet provides an overview of Medicare Parts A and B. This is important because, even though Medicare has been around for 56 years and we pay for Part A during our working years, many people are still very unfamiliar with Medicare and how it works. The fact sheet does state that most people should enroll in Medicare parts A and B when they turn 65, but it then walks readers through as number of scenarios where delaying Medicare enrollment may be a good idea.

It’s also important to point out that readers do not need to read the entire document. Once they find a situation that applies to them, the fact sheet tells them they’ve completed task two and that they can skip ahead to task three.

Find out how to sign up for (or opt out of) Medicare

Once a decision has been made, it’s time for Medicare-eligible individuals to either sign up for or opt out of parts A and B of Medicare. In section three, the fact sheet tells them how to do this. Readers are directed to the appropriate page depending on what they’d like to do:

  • I want BOTH Part A and Part B to start when I turn 65 (Go to PAGE 8)
  • I want to DELAY Part B, but START Part A when I turn 65 (Go to PAGE 10)
  • I want to DELAY BOTH Part A and Part B (Go to PAGE 12)

Again, the ability to skip ahead to the appropriate page shortens the amount of reading your clients will need to do.

A useful tool for Medicare-eligible clients

The reason we like this tool and would encourage you to share it with clients who are trying to make a decision about Medicare enrollment is because 1) it is easy to use, 2) it’s fairly comprehensive, and 3) it was created by CMS, which should add to the credibility of the tool. If you do decide to share this with clients, please let us know how it goes.