Turning 65 or Just Starting Medicare
1st) What is Medicare?
Medicare is the federal health insurance program, introduced in 1965, for people who:
- are 65 or older
- certain younger people with disabilities
- people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
2nd) What are the "parts" of Medicare?
Medicare Part A (Hospital Insurance)
Part A covers approved inpatient hospital stays, eligible care in a skilled nursing facility, hospice care, and some home health care.
In most circumstances, people who are eligible for Medicare generally begin Part A on the month they turn 65, or on the 25th month after qualifying for Social Security Disability.
Medicare Part B (Medical Insurance)
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. In most circumstances, Part B will begin automatically along with Part A if the eligible person is receiving Social Security. Otherwise they must actively enroll.
Medicare Part D (prescription drug coverage)
Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. Unlike Parts A & B, Part D plans do not come from Medicare, but rather are offered by private insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as other Part D Prescription Drug Plans.
3rd) Is that all I need?
Having original Medicare alone leaves you exposed to potentially catastrophic bills. In addition to various per-day copays, Part B also leaves a 20% gap in coverage and has no out-of-pocket maximum, meaning there is no limit to the costs you would need to pay. Here are the two Medicare health plan options:
Medicare Advantage Plans
(AKA "Medicare Part C")
(AKA "Medigap Policies")
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
Medicare supplements are also typically identified by a letter, A-N, but these should not be confused with Part A or Part B. Supplements work along side your Original Medicare to pay for some or all of the costs left behind by Original Medicare A & B - deductibles, coinsurances and copays. A supplement may also provide coverage for specific non-Medicare covered items such as Part B excess charges and/or foreign travel emergency coverage.
More information, quotes, or to enrollment...
4th) What's Next?
|New to Medicare and not sure what kind of coverage you need?
|Know exactly what you need?
The choices can be overwhelming!
Simply contact us to speak to a local expert:
(Not every carrier is available for online enrollment)