Are you new to Medicare and wondering about the healthcare options available to you?
We’ll explain Original Medicare (Parts A and B) and private insurance plans that supplement it..
Enrolling in Medicare Parts A and B
Most people are automatically enrolled in Medicare Part A.
If you are not receiving retirement benefits when you turn 65 you will need to manually enroll. You’ll do so during your initial enrollment period.
Your initial enrollment period (IEP) is a seven-month period that begins three months before you turn 65 and ends three months later.
You can enroll in Medicare at www.socialsecurity.gov, by calling them at 1-800-772-1213, or in person at your local Social Security Office.
What Medicare Part A covers
Part A is Medicare’s inpatient care coverage. Specifically, its benefit is for:
- Inpatient care in a hospital — When you’re admitted to the hospital as an inpatient after an official doctor’s order, which says you need inpatient hospital care to treat your illness or injury.
- Skilled nursing facility care
- Hospice care
- Home health care
What Medicare Part B covers
Part B is Medicare’s medical insurance. It covers:
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
What are Medicare Advantage plans?
Also known as Medicare Part C, Medicare Advantage plans take over your Part A and B benefits as well as providing additional benefits.
Your plan will have different benefits based on where you live, but they often include:
- Adult day-care services
- Fitness club memberships
- Prescription drug coverage
- Services and supports for those with chronic conditions
- Transportation to doctor visits
What are Medicare Supplements?
Medicare Supplements, also known as Medigap, are private insurance plans that cover out-of-pocket expenses associated with Medicare like coinsurance, copayments, deductibles, and more.
There are 10 lettered plans, A-N, that each cover a different percentage of the cost-sharing responsibilities associated with your Medicare-related healthcare coverage.
Medigap plans are standardized, meaning they have the same coverage no matter which company you buy them from. The only difference there will ever be is price.
Supplement plans will each cover a different percentage of:
- Medicare Part A coinsurance or copayment and hospital costs
- Medicare Part B coinsurance or copayment
- First three pints of a blood transfusion
- Part A hospice care coinsurance or copayment
- Skilled nursing facility coinsurance
- Medicare Part A deductible
- Medicare Part B deductible***
- Medicare Part B excess charges
- Foreign travel emergency (up to plan limits)
*** Those who turn 65 after January 1, 2020 are not eligible for plans that offer this benefit
What is Medicare Part D?
Part D is another private insurance plan. It provides coverage for your prescription drugs. You can get it as either a standalone plan or as part of your Medicare Advantage plan.
You will want to decide during your initial enrollment period whether you want it or not because there is a late enrollment fee if you decide to enroll later.