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)
(Hospital Insurance)
PART A COVERS:
- Hospital stays
- Skilled nursing facilities
- Hospice care
(Hospital Insurance)
PART B COVERS:
- Doctor services
- Outpatient care
- Prevententive services
- Medical supplies
(Prescription Drug Plans)
PART D COVERS:
- Prescription Drugs not included in Part B
(Medicare Advantage)
PART C COVERS:
- Everything covered by Part A & B
- Additional benefits not covered by Medicare (may include Dental, Vision, and Hearing)
- Typically included prescription drug coverage
Medicare timeline - when can I enroll?
Usually you should enroll in Medicare three months before your 65th birthday. You could also be entitled to special enrollment periods.
The signup period for Medicare begins three months before the month you turn 65, during the month of your 65th birthday and for three months after…a total of seven months.
If you are eligible to receive premium-free part A coverage you will be notified by mail 90 days before your 65th birthday. To receive part B coverage you have to apply for it.
If you apply for Social Security during this time period you will automatically be enrolled in Medicare parts A & B.
If you don’t enroll when you first become eligible, you may have to wait until later in the year and may incur a penalty. In some cases you can delay your part B enrollment without a late enrollment penalty. You might do this if:
- You are still covered by your Employer Group Plan
- You are still covered by your spouse’s Employer Group plan
- You have retiree coverage and your employer has more than 20 employees
Medicare plans are often more cost-effective than an employer group plan. You should consult with a licensed insurance agent, however, before deciding to either delay your part B enrollment or leave your employer’s group plan. We also recommend you speak with your Group Insurance Administrator to make sure there are no disadvantages to leaving your employer’s group plan.
For example, if you have non-Medicare eligible dependents on your employer group plan their coverage would be terminated along with yours and they would be left without coverage.
If you haven’t received your Medicare information by your enrollment period, contact the Social Security Administration directly. You can also visit their website to do so. We can also help answer your Medicare questions or guide you through the steps to get you Medicare coverage. Our service is free to you. Talk to a member of our team
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 |
Medicare Advantage | |||
|---|---|---|---|---|
| Original Medicare Parts A & B | Original Medicare & Medicare Supplement | PPO | HMO | |
| 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) and cost for **Medigap Plan | Monthly Part B premium (*$144.60) and plan premiums starting at **$0 | Monthly Part B premium (*$144.60) and 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 and out-of-network options 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 |
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
SUMMARY
Fills gaps in Original Medicare
PREMIUM ESTIMATED COST
Monthly Part B premium (*$144.60) and cost for **Medigap Plan
PRESCRIPTION DRUGS
Requires a PDP at additional cost
NETWORK
Providers that accept Medicare Assignment (no referrals)
ADDITIONAL BENEFITS
Limited Benefits
SUMMARY
Out of network benefits
PREMIUM ESTIMATED COST
Monthly Part B premium (*$144.60) and plan premiums starting at **$0
PRESCRIPTION DRUGS
Typically included
NETWORK
Provider network and out-of-network options at higher cost (no referrals)
ADDITIONAL BENEFITS
Dental, Vision, Hearing, OTC, Gym, and more
SUMMARY
Predictable costs
PREMIUM ESTIMATED COST
Monthly Part B premium (*$144.60) and 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
Visit our Medicare Resource Center which provides helpful articles on everything you need to know about Medicare.