In life, there are many different stages where our medical needs change…
As we grow older, one of the most important changes is that we become eligible for Medicare. You must enroll and sign up in order to receive full Medicare benefits. Read these 5 tips to help you learn more about the Medicare program and your Medicare options.
1. When to Enroll: There are three enrollment periods during which you can sign up for Medicare.
- Initial Enrollment The first time you can sign up for Medicare is called the Initial Enrollment Period. This is a 7-month window that begins 3 months before your 65th birthday and ends 3 months after your birthday. If you sign up during the Initial Enrollment Period, you can sign up for a plan without answering any medical questions.
- General Enrollment Period If you don’t sign up before you turn age 65 there is General Enrollment Period in which you can sign up between January 1-March 31 each year. (If you enroll during the General Enrollment Period instead of during the IEP, you could face late-enrollment penalties.
- Special Enrollment Period Is only available to individuals that meet certain requirements.
2. Basic Medicare explained- Part A and Part B
- Medicare Part A helps cover your inpatient care in hospitals. Think of it as hospital insurance. Medicare Part A will help cover your medical costs when you are already sick. This also includes coverage in critical access hospitals and skilled nursing facilities, hospice, and home health care. It does not cover long-term care.
- Medicare Part B covers preventative care and is medical insurance. Think of Part B as in the word Before. Medicare part B covers the costs before you become sick or injured. Routine check-ups with your doctor are the types of expenses covered by Part B.
3. Supplemental Medicare Insurance – Do I need it?
Sometimes there is confusion as to what Medicare will and will not cover. Medicare only covers 80% of the cost for Medicare-covered services. For example, if you are hospitalized and leave with a bill of $10,000 Medicare will only cover 80%, leaving you with a $2,000 bill. You will have to pay that bill out of pocket. In addition, basic Medicare does not include drug coverage. You would have to cover your medication costs out of pocket if you do not have a prescription drug plan.
Types of Medicare Supplemental Plans:
- Medicare Advantage or Part C: Medicare Advantage plans combine your Part A and Part B coverage and act as your primary insurance. Private insurance companies provide the Medicare Part C coverage. They typically include prescription drug coverage.
- Medicare Supplement or Medigap: These plans are also known as Medigap Plans because they cover the 20% of costs that Medicare does not cover. There are different plans that provide different levels of coverage.
- Medicare Prescription Drug or Part D plans help offset the costs associated with your medications. There are different plans with varying costs and coverage. Speak with a Medicare specialist in order to help you find the right plan.
4. Make sure your doctor accepts Medicare.
When you enroll in Medicare or any Medicare program, you should ensure that your doctor accepts Medicare insurance and payments.
5. Review your plan annually. The Annual Enrollment Period each year runs from October 15 – December 7.
Insurance plans can change yearly so you cannot just “set it and forget it”. The Annual Enrollment Period is your chance to review your plan and make changes. An annual review of your health insurance can help you understand your current coverage decide better options suited for your needs. You will want to look for a health insurance company that specializes in senior health insurance.
Medicare Insurance can be confusing and overwhelming. It is a very important decision for the future of your health and wellbeing. For this reason, it is a good idea to learn much as you can about Medicare to help you make an informed decision about your health care needs.
At the Putnam-Record Agency, Danielle Marx is available if you would like to schedule an appointment to review Medicare Advantage, Medicare Supplement, or standalone Drug Plan coverage. Feel free to email: Danielle@putnamrecord.com, or call (716) 366-2744.