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What is Medicare?
Medicare is a federally-funded program that helps people age 65 or over manage their health care costs. Since Americans typically get their insurance through an employer, retirees need more options to make sure that they can still get preventive care and treatment for illness or injury without having to pay entirely out-of-pocket.
Medicare Advantage vs. Government Plans
While Medicare Advantage and Original Medicare aim to provide you with very similar coverage, there are reasons why you might choose either one. As a person enrolled in Original Medicare, you will have a monthly premium, plus a deductible and some copays for services. You may go to doctors, clinics and hospitals that cover Medicare. Some private insurance companies offer insurance for people who are eligible for Medicare, called Medicare Advantage. If your current doctor and hospital system does not accept Original Medicare, you may wish to use Medicare Advantage to have continuity of care. To select a Medicare Advantage plan, you must choose a program that is available in your area.
There are four components to Medicare coverage, which you should consider based on your personal eligibility:
Part A – Hospital Insurance: Part A provides you with coverage for inpatient stays, hospice care, and possibly home health care.
Part B – Medical Insurance: Part B covers outpatient care, preventive testing and treatment, medical supplies and some doctors’ appointments.
Part C – Medicare Advantage: Part C provides an alternative to Parts A and B, which are insured by the federal government. Medicare Advantage insurance is provided by private insurance companies.
Part D – Prescription Drug Coverage: Insurance companies offer coverage for prescription drugs that Medicare-enrolled patients need, which are not covered by Parts A and B.
Enrolling in Medicare
When you are ready to enroll in Medicare, you should follow these steps:
Determine Eligibility: First, you must determine when you will be eligible for Medicare. Generally, if you are over 65, under 65 but have a disability, or are already receiving Social Security benefits, you are eligible.
Find Enrollment Period: Your first option to enroll in Medicare happens in a seven-month period around your 65th birthday. This period starts three months before your birthday month and ends three months afterward. If you miss this period or choose not to enroll at that time, you may enroll during the general enrollment, which occurs January 1-March 31st of each year. You may also receive a special eight-month enrollment period that occurs when your current insurance coverage ends. Remember that the closer to your 65th, birthday that you enroll, the sooner your coverage begins.
Choose Parts to Enroll: If you choose to go through Original Medicare, you will typically want to apply for Parts A and B. Should you opt for Medicare Advantage, you must use the Plan Finder to locate a program in your area and complete and submit a paper enrollment form. If you want Part D prescription coverage, use Plan Finder to identify and apply for a program offering Part D coverage.
Consider Supplemental Coverage: Since Medicare coverage requires you to pay some portion of your medical expenses out-of-pocket, you may wish to obtain an additional plan, called Medigap, to cover these expenses. Medigap is provided by private insurance companies
Enroll Online: Online enrollment in Original Medicare is a simple process through the Social Security Administration. It takes about 10 minutes and requires no extra paperwork. You can also visit this site to check the status of your application.
Once you have followed these steps, you will be enrolled in Medicare and can receive benefits using your Medicare card.