9 Things You Should Know About Medicare

Medicare is a federal health insurance program for people age 65 and older, and under 65 with certain disabilities. If you’re turning 65 soon, you’ll probably get a lot of mailers and see many TV commercials about Medicare (if you haven’t already). With all this information being thrown at you and the number of insurance companies trying to earn your business, it can be confusing and overwhelming. That’s where we come in. Here are 9 things you should know about Medicare.

1. Eligibility Is Mostly Based on Your Age

Most people are eligible for Medicare at age 65. However, Medicare is available for certain folks with disabilities who are under 65. These people must have received Social Security disability benefits for two years or have End-Stage Renal Disease (ESRD), or Amyotropic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).

2. Medicare Is Divided into 4 Main Parts

Part A is your inpatient hospital insurance.

Part B is your outpatient medical insurance.

Part C is Medicare Advantage, an alternative to Original Medicare.

Part D is your prescription drug coverage.

3. Some People Are Automatically Enrolled

If you’re on Social Security, you’ll be automatically enrolled in Medicare Parts A and B. If not, you’ll need to actively enroll yourself. By the way, it’s easy to enroll. Just visit www.ssa.gov/benefits/medicare and follow the instructions.

4. There Are Certain Enrollment Periods

There are certain periods when you can sign up or change your Medicare coverage.

Your Initial Enrollment Period (IEP) is a seven-month window surrounding your 65th birthday.
People who have Medicare can make changes to their coverage during the Annual Enrollment Period (AEP), from October 15 to December 7 every year.
If you miss your initial enrollment, you can sign up for Medicare during the General Enrollment Period (GEP), from January 1 to March 31.

When certain events happen, you may qualify for a Special Enrollment Period (SEP). The rules about what changes you can make and when you can make them will differ for each SEP.

5. Don't Enroll in Part B Too Early

We see this scenario often. Somebody turns 65 but they’re still working and have group health insurance through their employer. If this is you, and you intend to stay on that group health plan, you do NOT need to enroll in Medicare Part B.

Part B comes with a monthly premium, so it doesn’t make sense to pay for this when you already have group health coverage through your employer. In this case, delay Part B and don’t pay the added monthly premium until you retire.

6. You Choose How You Get Your Coverage

When it’s time to choose your Medicare coverage, you have two primary options: (1) you can enroll in Original Medicare with the option to add Part D (prescription drug plan) and/or a Medicare Supplement (Medigap) policy, OR (2) you can join a Medicare Advantage (Part C) plan.

Medicare Advantage combines Parts A and B, and most plans include prescription drug coverage. If not, you may be able to add it.

7. Medicare Doesn’t Cover Everything

Since Original Medicare (A and B) only covers 80% of your out-of-pocket costs, you can add a Medicare Supplement plan to pay some or all of the remaining 20% — including deductibles, copayments, and coinsurance.

8. Ancillary Products Can Help

There are many things that Medicare doesn’t cover that people usually want to find coverage for. Medicare doesn’t pay for dental, vision, hearing, or cancer plans. And many folks want to look into hospital indemnity plans.

Ancillary products are policies that give you coverage on top of Medicare, and they can really help you in case of a life event or a health situation emerges.

9. Your Policies Can Change Each Year

Whatever policy you have with Medicare, you need to review it each year to make sure that you’re in the right product for the right price. Each of your policies can change. For example, if you have a Medigap plan, your premium will increase.

If you have a prescription drug plan, the premium, network or pharmacies, and/or how the plan covers your medications can all change from year to year. Or, if you have a Medicare Advantage plan, they can change their deductibles, copays, or maximum out-of-pocket amounts. So, it’s important to review your policies to ensure that you’re not overpaying for coverage that you could get cheaper somewhere else.

Schedule a FREE Consultation With Us.

Now that you understand the basics of Medicare, it’s time to discuss your options and find the best plan for your needs and budget. The licensed experts at Turning 65 with Jonny are ready to help. Contact us to schedule your FREE, no-obligation consultation!