Medicare is a federal government health insurance program generally for those turning age 65.
Your initial enrollment period is called the “Initial Election Period” and runs for 7 months, which are the three months before your birth month, your birth month, and the three months after your birth month.
For example, if you were born in July, your Initial Election Period would be April through October.
Be forewarned that as you near your 65th birthday, you will start being inundated with marketing materials for Medicare plans. This can be overwhelming and confusing for most people. We are here to help.
Let’s review the different parts of Medicare:
Part A: Hospital Insurance. This covers inpatient hospital stays, skilled nursing care, hospice care, etc. Part A has no premium cost.
Part B: Medical Insurance. This generally covers doctors’ visits and outpatient care, and other services. Part B has a premium cost which starts at $174.70 for 2024, and it is income tested so you could pay more.
Part D: Drug Coverage. This is your prescription drug plan. This has a premium cost which depends on where you live, the insurance company you select, and the drug plan option you select.
Medicare Parts A & B have certain coverage gaps, so most people buy a Medicare supplement plan also known as a Medigap plan. Medigap plans are sold by private insurance companies.
In summary, your first option is to enroll in Part A, Part B, and buy a Part D drug plan along with a Medigap Plan.
Original Medicare is the term used when an eligible person enrolls in Medicare Parts A & B, and then purchases a Medicare Supplement (or Medigap plan), and a Part D prescription plan.
The primary advantage of going the Original Medicare route is that you can schedule care with any doctor or hospital that accepts Medicare, anywhere in the USA.
A second option is to select a Part C plan, also known as Medicare Advantage. A Medicare Advantage plan “bundles” Part A, Part B, and Part D, and often includes some extra benefits like dental and vision coverage.
Medicare Advantage plans can provide more coverage than Original Medicare, however there could also be network restrictions that allow you access only to certain doctors and hospitals in the network.
For more details go to: www.medicare.gov
After you have enrolled into Medicare the first time via your Initial Election Period, you will have an annual open enrollment from October 15 through December 7, to change your Medigap plan effective for January 1.
If you work for a large employer, are part of a union health plan, or work for the federal government, your enrollment options can be different, so this takes extra study and research. But a Medicare specialist can be helpful in this process.
After an initial basic overview, we’ll connect you with a Medicare enrollment specialist; a licensed and certified insurance agent who will discuss with you in detail the options in your area and the premium costs. This will include determining if the doctors you now see are available, and what medications you are taking, and the estimated annual costs.