Your mailbox will be full of advertisements from all the different Medicare options available to you. It’s about three trees’ worth of paper and it can get confusing. But you don’t have to navigate it alone. I can help.
This might help simplify things.
The Center for Medicare & Medicaid Services is the primary source of information. These are government programs.
Enrollment periods:
- Initial Enrollment Period is a total of 7 months – 3 months before you turn 65, the month of your birthday and 3 months after
- Annual Election Period runs Oct 15th to Dec 7th each year
- Special Enrollment Period exists if you have a qualifying life event that allows you to enroll at a different time
Part A Hospital Insurance – Most people don’t pay a premium for Part A because they, or a spouse, already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.
Part B Medical Insurance – Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors’ services and outpatient care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.
Caution: If the beneficiary didn’t take Part B when they were first eligible, the cost of Part B will go up 10% for each full 12-month period that they could have had Part B but didn’t sign up for it, except in special cases. They will have to pay this penalty as long they have Part B.
Prescription Drug Coverage – Most people will pay a monthly premium for this coverage, which may help lower prescription drug costs and help protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.
Simply put, you have choices when you turn 65:
- Original Medicare Part A and/or Part B
- Add a drug plan to that with Part D
- Choose a Medicare Advantage Plan known as Part C (not to get confused with Supplement plans, they are different). These are offered by private insurance companies based on your zip code. They work with CMS to provide a more robust insurance plan. Some Part C plans include drug coverage. Some don’t.
- Medicare Supplement Plans. These are the ones with all the letters. Each letter has a consistent coverage level. These plans offer the highest level of coverage and pay for services Medicare does not. They do not come with a prescription drug plan so that would be purchased separately.
I am a licensed insurance broker and certified to sell Medicare Advantage, Supplement, and Drug Plans.
I can help you navigate the process.
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