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Turning 65 and Medicare Coverage

Medicare and You

You probably never thought about Medicare until you started to get close to age 65. (Don't worry, no one does!)

But making the right Medicare coverage choices might be among the most important decisions of your life.

All of the different choices can seem a little confusing and intimidating, but they don’t have to be.

What is Medicare?

Medicare is the federal health insurance program for people who:

Are age 65 and older, or
Are younger than 65 but have specific disabilities, or
Have end-stage renal disease (permanent kidney failure require dialysis or a transplant)

Medicare parts A & B cover 80% of the cost of Medicare covered services. The remaining 20% is your responsibility. In the table below we have summarized your main options to receive coverage.

Medicare Part A
(Hospital Insurance)

Part A Covers:

Hospital stays
Skilled nursing fascilities
Hospice care

Medicare Part B
(Medical Insurance)

Part B Covers:

Doctor services
Outpatient care
Prevententive services
Medical supplies

Original Medicare (also called Traditional Medicare)

Medicare Part D
(Prescription Drug Plans)

Part D Covers:

Prescription Drugs not included in part B

Medicare Part C
(Medicare Advantage)

Part C Covers:

Everything covered by part A & B
Additional benefits not coverd by Medicare (may include Dental, Vision, and Hearing)
Typically included prescription drug coverage

Medicare timeline - when can I enroll?

3 Months Before Your 65 Birthday Month 3 Months After

Usually you should enroll in Medicare three months before your 65th birthday. You could also be entitled to special enrollment periods.

What are my different Medicare options after turning 65?

You have two options to receive your Medicare coverage. Both require that you have Medicare Part A and Part B.

	Original Medicare Parts A & B	Original Medicare & Medicare Supplement	PPO	HMO
	Original Medicare		Medicare Advantage
Summary	Covers 80% of Medicare Approved Services	Fills gaps in Original Medicare	Out of network benefits	Predictable Costs
Premium ***Estimated Cost	Monthly Part B premium (*$144.60)	Monthly Part B premium ($144.60) & Cost for *Medigap Plan	Monthly Part B premium ($144.60) & Plan Premiums Starting at *$0	Monthly Part B premium ($144.60) & Plan Premiums Starting at *$0
Prescription Drugs	Not covered	Requires a PDP at additional cost	Typically included	Typically included
Network	Providers that Accept Medicare Assignment (No Referrals)	Providers that Accept Medicare Assignment (No Referrals)	Provider Network & Out-of-Network option at higher cost (No Referrals)	Must Use Provider Network (Referrals may be required)
Additional Benefits	None	Limited Benefits	Dental, Vision, Hearing, OTC, Gym and more	Dental, Vision, Hearing, OTC, Gym and more

	Original Medicare Parts A & B
	Original Medicare
Summary	Covers 80% of Medicare Approved Services
Premium ***Estimated Cost	Monthly Part B premium (*$144.60)
Prescription Drugs	Not covered
Network	Providers that Accept Medicare Assignment (No Referrals)
Additional Benefits	None

	Original Medicare & Medicare Supplement
Summary	Fills gaps in Original Medicare
Premium ***Estimated Cost	Monthly Part B premium ($144.60) & Cost for *Medigap Plan
Prescription Drugs	Requires a PDP at additional cost
Network	Providers that Accept Medicare Assignment (No Referrals)
Additional Benefits	Limited Benefits

	PPO
	Medicare Advantage
Summary	Out of network benefits
Premium ***Estimated Cost	Monthly Part B premium ($144.60) & Plan Premiums Starting at *$0
Prescription Drugs	Typically included
Network	Provider Network & Out-of-Network option at higher cost (No Referrals)
Additional Benefits	Dental, Vision, Hearing, OTC, Gym and more

	HMO
Summary	Predictable Costs
Premium ***Estimated Cost	Monthly Part B premium ($144.60) & Plan Premiums Starting at *$0
Prescription Drugs	Typically included
Network	Must Use Provider Network (Referrals may be required)
Additional Benefits	Dental, Vision, Hearing, OTC, Gym and more

*2020 Part B monthly premium. This amount can be higher based on income.

**This is the monthly premium for the health coverage.

***These costs vary per plan. Speak to a Connie Advisor for details.

Learn more about Medicare

Turning 65: Medicare and You

Learn about how to approach Medicare decisions as you turn 65.

Learn more

A Guide to Medicare Networks

Learn more about the differences between networks.

Learn more

Have questions? Our team is here to answer!

We frequently answer questions about Medicare enrollment and eligibility. You don't have to figure it out on your own.

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Terms

Connie Health’s Medicare website is owned and operated by Connie Health Inc, a licensed health insurance agency. The website and our content are for informational and educational purposes to support our mission of making Medicare less complicated. The purpose of this website is the solicitation of insurance. We offer plans from a number of insurance companies. Contact may be made by an insurance agent/producer. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.