Medicare
When and How
- For Medicare Part A and Part B, enrollment can occur automatically for some individuals while others must actively sign up. Factors such as whether you receive Social Security benefits and the duration of your contributions to Medicare significantly influence the application process. If you are automatically enrolled, you will receive your Medicare Card via mail three months prior to your 65th birthday. You can enroll in Medicare beginning three months before the month of your 65th birthday and continuing until three months after the month of your birthday. (unless your birthday is on the first day of the month. Then you may enroll starting four months prior to the month of your 65th birthday and up to two months after the month of your birthday).
- Applications can be submitted at your local Social Security Office, either online, by phone, or in-person.
Medicare Part A and B (Your Red, White, and Blue card)
Part A
- Part A covers inpatient hospital care, including medications, X-rays, lab tests, operations, and meals. It also pays for follow-ups like physical therapy or home nurse care, and hospice services for the terminally ill. Provided by the federal government, most people don't pay a premium. However, there are deductibles and cost sharing if admitted to a hospital.
Part B
- Part B includes coverage for doctor's care when a person is sick or has a medical condition. It funds outpatient hospital and clinic care, lab tests, and some nursing care at home if the individual is homebound. Part B generally facilitates access to preventative care, such as annual wellness exams, preventative screenings, and yearly flu shots. It may cover necessary medical equipment for the home and provide coverage for emergency room visits. Additionally, it covers most doctor services while the patient is in the hospital. The federal government administers Part B, and recipients are required to pay a monthly premium. For visits to the doctor, Part B has a deductible and cost sharing that the patient pays.
There are options provided by private insurance companies to assist
Part C: Medicare Advantage:
An All-in-One Option
- Medicare Advantage combines Part A and B coverage with extra benefits like prescription drugs, dental, and vision care. Some plans offer $0 premiums but require paying the Part B premium and may have copays for treatments. Plans set an annual limit for out-of-pocket costs, covering expenses beyond that limit.
- Medicare Advantage plans replace Parts A and B and don't pair with Medicare Supplement policies.
Medicare Supplement Plans for Part A and B
Part D: Prescription Drug Plans
- Part D covers prescription drugs and can be paired with Medicare supplement insurance. Coverage for prescriptions depends on the specific plan selected.
- Prescription Drug Plans must be obtained through private insurers. These plans require payment of a monthly premium and an annual deductible. Additionally, beneficiaries will pay either coinsurance (a percentage of the cost for prescriptions) or a copay (a flat fee for some prescriptions' cost).
Medigap: Medicare Supplement Plans
- Medicare Supplement (Medigap) covers costs that Original Medicare doesn't, like copays, deductibles, and coinsurance. It offers predictable monthly billing; it can't be terminated or changed except for non-payment of premiums. You can add Prescription Drug and Dental plans for more coverage. Medigap insurance is obtained through private insurers.