Medicare as easy as A, B, C and D
You may know that when you turn 65 you qualify for Medicare. But did you know that when it comes to Medicare, you have choices?
From reviewing Original Medicare (Parts A and B) to understanding Medicare supplement insurance plans, Medicare Advantage (Part C) and stand-alone prescription drug plans (Part D), this guide breaks it all down for you.
Medicare helps millions of Americans get the health care they need. Just as important, it offers you a choice of how you want to receive your benefits.
Medicare is a federal health insurance program for people 65 and older and others with disabilities.
- Medicare Parts A and B are considered Original Medicare.
- Part A pays for hospital care and Part B pays for doctor visits and other outpatient care.
Original Medicare doesn’t cover everything
Original Medicare helps you get the coverage you need, but you should expect to pay some of the costs. You can enroll in a Medicare supplement plan to help pay for costs and benefits that aren’t paid by Original Medicare Parts A and B. You can also enroll in a stand-alone Medicare Part D plan for help with prescription drug costs.
Some of the elements Original Medicare (Parts A and B) does not cover are:
You can also enroll in a Medicare Advantage Part C plan offered by private insurance companies. Part C plans give you all of the coverage provided by Parts A and B, as well as additional benefits:
- Combines hospital costs and doctor and outpatient care in one plan.
- Can include Part D prescription drug coverage.
- May include additional benefits such as dental, vision or hearing services.
When are you eligible?
If you’re turning 65, you can enroll in a Medicare plan. You can enroll three months before the month you turn 65, the month of your birthday and three months after. If you wait to enroll in a plan after this time, you may have to pay more.
Your plan choices don’t have to be permanent.
If your health care needs change over time, so will the health plans you want to choose.
You’re not locked in to one plan permanently. You’ll have an opportunity to change plans at least once a year during the Medicare Open Enrollment Period (October 15 – December 7).
10 Tips About Medicare
1. There are two main ways to get Medicare.
- You can choose Original Medicare (Parts A and B), which is provided by the federal government.
- Or choose a Medicare Advantage plan (Part C). These plans are offered through private insurance companies.
2. With Original Medicare, you’ll pay a share of the cost.
- You contributed to Medicare by paying taxes. That’s why you’re eligible for Medicare when you turn 65.
- Original Medicare doesn’t pay for everything. You still pay a share of the cost in monthly premiums and copays.
3. Medicare supplement insurance helps control out-of-pocket costs.
- If you need a lot of medical care, you may end up with big bills. Medicare supplement insurance plans help with some of the expenses Medicare
- Parts A and B don’t pay, like copays and deductibles.
4. Prescription drug coverage helps limit drug costs.
- As a Medicare member you can get optional prescription drug coverage (Part D).
- You can enroll in a stand-alone Part D plan to go with your Original Medicare coverage.
- Or you can enroll in a Medicare Advantage plan that includes prescription drug coverage.
5. Know the choices in your state.
- Original Medicare (Parts A and B) is the same across the United States.
- Medicare Advantage (Part C) and prescription drug (Part D) plans are offered by private insurance companies and may be available only in certain counties, states or regions.
- Medicare supplement policies offer nationwide coverage and are available by state.
6. Enroll at the right time.
- The Initial Enrollment Period (IEP) is your first chance to enroll in Medicare. It’s the three months before your 65th birthday month, the month of your birthday, and the three months after your birthday month.
- If you enroll before the month you turn 65, coverage starts on the first day of your birthday month.
- If you enroll during your birthday month or later, coverage starts on the first day of the month following the date you enroll.
7. Review your choices once a year.
After you choose your Medicare coverage, you can make changes each year during the Medicare Open Enrollment Period (OEP), October 15 – December 7. Review your coverage to see if it still fits your needs.
8. Special Election Period (SEP).
In some cases you may be able to enroll in, or switch, plans outside of the IEP and OEP. This includes changes in your life situation, such as:
- You retire and leave a health care plan through your employer or union.
- You move out of your current health plan’s service area.
9. Review your current coverage.
For example, if you have group coverage from your job, orretiree insurance from a former employer, you’ll want to see how it fits with Medicare.
10. Help is available.
Medicare can be complicated, but help is available. You may even qualify for financial help. Visit MedicareMadeClear.com for details.