Your 65th Birthday Is Coming Up. Now’s The Time To Enroll In Medicare.
When you are young and healthy, preparing for Medicare is just about the furthest thing from your mind. After all, Medicare has little if any relevance to you when your health insurance coverage comes either through your Arizona employer’s group plan or through an individual plan you purchased on your own. But now, as your 65th birthday approaches, Medicare is about to become a big part of how you stay healthy and address your healthcare needs.
Medicare is unlike any health insurance you have ever had. The terms are different, the coverage options are unique and plentiful, and the enrollment process isn’t the same as for private plans. And, given that you’ve probably spent no time learning how this unique and vital program works, you need to face your future and get up to speed on what Medicare is, how it works, and what you need to do to enroll in coverage.
So, as experienced Medicare brokers, our early 65th birthday gift to you is information about how you should be preparing for Medicare.
The Basics of Medicare
Medicare is a federal program established in 1965 that pays most – but not all - healthcare costs for Americans 65 or older, as well as those younger than 65 who have certain disabilities. Eligibility for Medicare is unrelated to your assets or income. That distinguishes Medicare from Medicaid, which is a state and federally funded program that provides medical care and financial assistance for low-income individuals.
While Medicare will pay for most of your medical expenses, there are out-of-pocket costs. As is likely the case with your current coverage, you will likely still be responsible for premiums, deductibles, coinsurance, and copays for many of the services you receive. The good news, however, is that enrolling in private supplemental insurance plans — called Medigap plans — can help you fill in these gaps in your Medicare coverage.
Medicare Parts A, B, C, and D
To understand the different types of Medicare coverage, start with the ABCs – and Ds. Medicare has four separate parts, each of which addresses different healthcare needs and involves unique issues:
Medicare Part A
Medicare Part A covers inpatient hospital stays, skilled nursing facility stays, some home health visits and hospice care.
Medicare Part B
This Medicare program covers physician’s visits, outpatient care, preventive care services, and some home healthcare visits.
Medicare Part C
Medicare Part C refers to Medicare Advantage, which are Medicare-approved private health insurance plans. Medicare Advantage plans combine coverage for doctor visits, hospital care, and other medical services in one comprehensive plan that offers all of the benefits provided by Medicare Parts A and B (with the exception of hospice care).
Medicare Part D
Established in 2006, Medicare Part D provides coverage for outpatient prescription drug costs through private plans that contract with Medicare. These include stand-alone prescription drug plans (PDPs) and plans covering prescription drugs as part of broader coverage (MA-PDs). Participation in Medicare Part D is optional.
What You Need to Do To Enroll In Medicare
A Medicare card is like a gift we receive from the United States government as we approach 65. Generally, you can enroll in Medicare:
- When you turn 65, no matter your spouse’s age;
- Regardless of whether you are collecting Social Security benefits yet; and
- Even if you work past age 65 and keep your employer coverage or have coverage through your spouse’s employer.
Enrollment in Medicare is automatic for some folks, but not for everyone. The government will enroll you in Medicare Parts A and B automatically, and you will receive your Medicare card in the mail, if:
- You are turning 65 and are receiving Social Security or Railroad Retirement Board benefits;
- You are under 65 and have received disability benefits for 24 months; and/or
- You have Lou Gehrig’s disease (ALS) and start getting disability benefits.
If you do not fit into one of the above categories, you will need to enroll yourself during what’s called the Initial Enrollment Period (IEP). Typically, your IEP starts three months before your 65th birthday and ends three months after. While you can still enroll in Medicare after the end of your IEP, there are penalties involved.
Preparing For Medicare Doesn’t Need To Be Hard. Anderson Insurance Services Can Make It Easy.
Between the different Medicare Parts and trying to choose the right supplemental Medigap plan for you, preparing for Medicare may seem like a daunting task. But it doesn’t have to be.
Like any journey into uncharted territory, you don’t need to, and shouldn’t, begin your Medicare journey without a knowledgeable guide. At Anderson Insurance Services, our experienced, independent Medicare brokers can help you with all of your Medicare needs, from plan selection to enrollment to education and more.
Contact Anderson Insurance Services today to schedule a free consultation to discuss your Medicare questions and needs.