Understanding Medicare Enrollment

There are a number of different options to consider when signing up for Medicare. Understanding Medicare enrollment begins with understanding the different parts and your enrollment responsibilities for each.

Understanding the Different Parts of Medicare

     Part A – Hospital Insurance
  • Helps cover inpatient care in hospitals
  • Helps cover skilled nursing facility, hospice and home health care
     Part B – Medical Insurance
  • Helps cover doctors’ services, hospital outpatient care and home health care
  • Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse
    Part C – Medicare Advantage Plans (e.g. HMO or PPO)
  • Health plans run by Medicare approved private insurance companies
  • Medicare Advantage Plans (also calledPart C) include Part A, Part B, and may also include additional coverage (like Part D), sometimes for an extra cost
    Part D – Medicare Prescription Drug Coverage
  • A prescription drug option run by Medicare approved private insurance companies
  • Helps cover the cost of prescriptions drugs
  • May help lower your prescription drug costs and help protect against higher costs in the future

Medicare Enrollment 

Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you don’t need to do anything. You will automatically be enrolled in Medicare Parts A and B effective the month you turn 65. If you do not receive Social Security benefits, then you will need to sign up for Medicare online through the Social Security Administration or by calling 800-772-1213. It is best to do it as early as possible so your coverage begins as soon as you turn 65.

If you are still working and have an employer or union group health insurance plan, it is possible you do not need to sign up for Medicare Part B right away. You will need to find out from your employer whether the employer’s plan is the primary insurer. If Medicare, rather than the employer’s plan, is the primary insurer, then you will still need to sign up for Part B. Even if you aren’t going to sign up for Part B, you may still enroll in Medicare Part A, which may help pay some of the costs not covered by your group health plan.

If you don’t have an employer or union group health insurance plan, or that plan is secondary to Medicare, it is extremely important to sign up for Medicare Part B during your initial enrollment period. (Note: COBRA coverage does not count as a health insurance plan for Medicare purposes. If you do not sign up for Part B right away, then you may be subject to a penalty.

With all the deductibles, co-payments and coverage exclusions, Medicare pays for only about half of your medical costs. Much of the balance not covered by Medicare can be covered by purchasing a so-called “Medigap” insurance policy from a private insurer. You can search online for a Medigap policy in your area.

 

If you’d like further help navigating through the different parts of Medicare, you can contact Virginia Van Haren.

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