MEDICARE 101

 

When it comes to Medicare, one size does not fit all. What works for your neighbor may not be best for you. As an independent licensed broker, I am here to help you understand your needs, explain your options, and make Medicare as simple as possible to understand.

There is a lot to learn once you start exploring Medicare and the many options available. Here are some guidelines to help you get started.

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What Is Medicare?

 

Medicare is a federal health insurance program for individuals in the U.S. who are 65 and older as well as some younger people with disabilities. Original Medicare, Parts A & B, helps pay for hospital stays and doctor visits, but doesn't pay for everything. You may add coverage by enrolling in private Medicare plans. It's important to prepare yourself for enrollment and understand how your conditions and care will be covered. 

When To Enroll

You become eligible to enroll in Original Medicare (Part A and Part B) when you turn 65 years old, or you are under 65 and qualify on the basis of a disability. Your Initial Enrollment Period (IEP) begins 3 months before you turn 65, and continues for three months following your 65th birthday.

Other enrollment periods include:

  • Annual Enrollment Period (AEP) October 15 – December 7. During this period you may add, drop or switch your Medicare coverage.

  • Medicare Advantage Open Enrollment Period (OEP) January 1 – March 31. During this period if you are already Medicare Advantage plan member, you may disenroll from your current plan and switch to a different Medicare Advantage plan one time only.

  • Special Enrollment Period (SEP). Depending on certain circumstances, you may be able to enroll in a Medicare plan outside the initial enrollment or annual enrollment time frames. Some ways you may qualify for a SEP are:

  • Retire and lose employer coverage

  • Move out of the plan's service area

  • Qualify for extra help

  • Receive assistance from the state

  • Have been diagnosed with certain qualifying disabilities or chronic health conditions

Medicare Options

Original Medicare (Part A & Part B) helps pay for doctor visits and hospital stays, but it doesn't cover everything. Many people choose to enroll in additional coverage. The two most common options are Medicare Supplements or Medicare Advantage. 

 
YOUR MEDICARE CHECKLIST

 

Prepare (4-5 months before)

  • Learn about Medicare basics, including plan types and eligibility

Enroll (3 months before)

  • If you're collecting Social Security benefits, you should be automatically enrolled in Medicare Parts A and B

  • If you're not collecting Social Security benefits, go to www.ssa.gov to enroll in Medicare Parts A and/or B. 

  • If you have employer group health coverage you may qualify for a Special Enrollment Period. Fee free to contact me to learn about the Medicare rules and how they apply to employer coverage.

Don't delay ~

Enrolling before your birthday month ensures you have a Medicare plan on the first day of the month you turn 65. Your Initial Enrollment Period (IEP) starts 3 months before the month you turn 65 and ends 3 months after. Be sure to enroll during your initial enrollment period to avoid the late enrollment penalty. As soon as you are ready to enroll, I'm here to help!