Below is a general overview of the basics of Medicare. Feel free to reach out to us for additional information. There is no cost or obligation for this personalized service!
What is Medicare?
Original Medicare is a federal health insurance program for:
People who are 65 or older.
OR
Certain younger people with disabilities or other special circumstances.
When can I enroll in a Medicare plan?
Initial Enrollment Period
If you’re enrolling in Medicare for the first time, you have an Initial Enrollment Period (IEP) that begins three months before and ends three months after you turn 65.
Annual Enrollment Period
October 15 – December 7
During the Annual Enrollment Period (AEP) you can add, drop or switch your Medicare coverage.
Open Enrollment Period
January 1 – March 31
If you already have a Medicare Advantage (MA) plan, you may enroll in another MA plan or go back to Original Medicare during the Open Enrollment Period (OEP). You may only make one change within this period.
Special Election Period
A Special Election Period (SEP) is an opportunity to change your MA plan outside the AEP due to a qualifying life event – without penalty. You generally have two months after the month the qualifying event occurs to make a switch.
Examples of qualifying life events are:
- Certain chronic diagnoses
- Moving
- Qualifying for Extra Help
- Qualifying for a State pharmacy assistance program
- Qualifying for Medicaid / Medicare Savings Program
Understanding your Medicare options
Step 1: Enroll in Original Medicare
Original Medicare includes:
- Medicare Part A helps cover hospital, skilled nursing, home health and hospice care.
- Medicare Part B helps cover doctor visits, outpatient, and preventative care. If you sign up late for Part B, you may pay a late enrollment penalty. Special rules apply if you or your spouse are still working and have health insurance through your employer
- In addition to the premium for Medicare, you may pay deductibles and coinsurance.
Step 2: Explore additional coverage-offered by private companies:
Medicare Part C – Medicare Advantage (MA). MA plans are offered by private companies and cover all Part A and Part B benefits. MA plans may also cover additional benefits such as fitness programs, vision, hearing, dental services, transportation, and over-the-counter supplies. Many plans include prescription drug coverage, also known as Medicare Advantage Prescription Drug (MAPD) plans. There are Special Needs Plans available to individuals with Medicare and Medicaid, specific diseases, or certain health care needs.
Medicare Part D – Prescription Drug Coverage. Medicare Part D plans are offered by private insurance companies. A prescription drug plan enhances Original Medicare with drug coverage. If you sign up late for Part D, you may pay a late enrollment penalty. Special rules apply if you or your spouse are still working and have health insurance through your employer.
Medicare Supplement – Medicare Supplement insurance plans, also known as Medigap, help pay for some of Original Medicare’s out-of-pocket costs.