Medicare Parts B or C, and D are not mandatory, just absolutely essential for anyone without equivalent coverage through an ongoing group plan (a rare retirement benefit these days).

Each person has a seven-month window in which to make his or her original Medicare choices for outpatient care and prescription drugs without incurring a penalty for delaying - the month he or she turns 65, the three months prior to that and the three months afterward.

"You will get a letter about three months before your 65th birthday, letting you know about the benefits, and you have until three months after your birthday month to enroll in Medicare Part B, basic medical coverage, so you won't be penalized," Jeffrey Hall said.

The penalty - 10 percent increased monthly premiums for each year signing up for Parts B, C or D is delayed - is to discourage people from undermining the insurance by waiting until they are ill to sign up for the coverage.

Signing up for Social Security results in automatic enrollment in Medicare Part B for most, so if they have other equivalent health insurance - from a spouse or retirement plan - they can opt out within the seven-month window. Most equivalent plans, however, require a Part B signup and make that the primary insurer with the private plan secondary.

That is how it works for Joyce Vitulli, a retired teacher in Manahawkin. She has prescription drug coverage through her teacher retirement plan, but it counts her Medicare Part B as her primary insurance and pays what that does not cover, typically 20 percent.

The main choices for most people are whether to get the added coverage of Part C, a Medicare Advantage plan, and which private insurance provider to pick for Part D, prescription drug coverage.

County-specific lists of all available options for those are online at

- click on the link, "Learn more about plans in your area."

In Atlantic County, for example, there are 52 prescription drug plans and 16 Medicare Advantage health plans available, along with ratings, costs and other information. The state PAAD program will pay the premium for basic Part D drug plans costing no more than $30.99 per month.

The information also is available through the State Health Insurance Assistance Program, or SHIP, New Jersey's Medicare outreach program, by calling 800-792-8820.

SHIP representatives are available in each county, at offices for the aging and disabled.

Medicare recipients also may choose to buy Medigap coverage for costs not covered by regular Medicare - for example, the 20 percent typically not paid by Medicare, or the $267 to $534 per day deductible for hospital stays lasting longer than 60 days.

Hall said new Medicare recipients have 60 days to sign up for Medigap coverage, and then a period to enroll or make changes from Nov. 15 to Dec. 31 each year.