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New to Medicare?

New to Medicare?

Congratulations on reaching the age of eligibility for Medicare! As you embark on this new chapter of your life, it’s essential to understand how this federal health insurance program works and how it can benefit you. Medicare provides coverage for millions of Americans aged 65 and older, as well as certain individuals with disabilities. This short article aims to provide an overview of Medicare and help you navigate through its various parts.

 

Understanding the Basics

Being new to medicare can seem like this big looming monster. In short, Medicare is a federal health insurance program established in 1965 by the U.S. government. It primarily serves people aged 65 and older, but it also covers younger individuals with specific disabilities or those with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). You become eligible to enroll in Medicare 3 months prior to your birth month. In some cases Medicare coverage may be better than employer group coverage (if you are still working). If you do not enroll in Medicare Parts A & B, and are not receiving “Credible Coverage” then you may be subject to late enrollment penalties when you do enroll later on.

 

Medicare Parts

Medicare is divided into different parts, each covering specific services:

Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services.

Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and durable medical equipment.

Part C (Medicare Advantage): Private insurance plans approved by Medicare to provide Part A and Part B benefits. Some plans may offer additional coverage, such as prescription drugs and vision or dental services.

Part D (Prescription Drug Coverage): Provides prescription drug coverage through private insurance companies approved by Medicare.

 

 

Enrollment

You become eligible when you turn 65, and enrollment usually begins three months before your 65th birthday and continues for seven months. You would be considered “new to medicare” during your first eligible enrollment. If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Part A and Part B. Otherwise, you’ll need to sign up through the Social Security Administration. Or, it can be done here https://www.ssa.gov/medicare/sign-up

To sign up in person, locate the nearest Social Security office near you -> https://secure.ssa.gov/ICON/main.jsp 

Costs and Coverage

Medicare provides valuable healthcare coverage, but it’s essential to be aware of the associated costs. Each part may have different premiums, deductibles, and co-payments. Additionally, it may not cover all medical expenses, so many beneficiaries opt for supplemental insurance, known as Medigap, to help fill the gaps in coverage.

 

Open Enrollment Periods

Each year, there are specific periods during which you can make changes to your Medicare coverage. The Annual Enrollment Period (AEP) occurs from October 15th to December 7th, during which you can switch Medicare Advantage or Part D plans. The General Enrollment Period (GEP) from January 1st to March 31st allows individuals to sign up for Part A and/or Part B if they missed their initial enrollment. A deeper dive for enrollment periods can be found HERE.

Understanding Medicare Advantage (Part C)

Medicare Advantage plans are an alternative to Original Medicare (Part A and Part B) offered by private insurance companies. These plans often include prescription drug coverage and may offer additional benefits such as vision, dental, and hearing services. Keep in mind that not all plans are the same, so it’s essential to compare options in your area. To learn more-> HERE.

Medicare is a valuable resource that provides essential health coverage to millions of Americans. As a new beneficiary, understanding the program’s parts, enrollment periods, and associated costs will help you make informed decisions about your healthcare coverage. Don’t hesitate to reach out to Medicare representatives or licensed insurance agents to clarify any doubts you may have. Welcome to Medicare, and may it bring you peace of mind and access to quality healthcare as you enjoy your golden years.

 

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