Understanding Medicare

Over the last few weeks we’ve discussed different insurance products in hopes of making them a little less confusing. We’ve covered Auto, Home, Life, Renters, Mobile Home and although it isn’t actual insurance, SR-22 filing.

With Medicare’s Annual “Open” Enrollment (AEP) barreling down upon us (Oct. 15 through Dec. 7th), I thought I’d take a moment to talk about what, exactly, Medicare is.

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To begin with, Medicare is a federal system of health insurance provided to people aged 65 and older and to some younger than 65 who have certain disabilities. This insurance is paid for by payroll taxes and is offered to every legal citizen who has worked, or whose spouse has worked, and paid into the system.

Original Medicare consists of 2 parts: Part A which takes care of inpatient hospital, skilled nursing facility, hospice & home health services and Part B which covers doctors and other outpatient services. In addition to Original Medicare (Parts A & B) there is Part D for prescription drugs and Part C which combines A & B and/or D.

Part A is usually free of charge, although some people will have to pay premiums due to extenuating circumstances.

Parts B, C and D may require a premium, have deductibles and/or co-insurance amounts. 

Now that we’ve covered the basics of what Medicare is, let’s see how and when you should apply for your coverage.

If you are “aging in” (turning 65) you have a 7 month window in which to get your Medicare coverage in place. This period begins 3 months before your birth month and extends three months after. As mentioned, most people automatically get Part A at age 65, but in order to have Parts B and/or C and/or D, you must enroll within the above-mentioned time frame.

If you are under age 65, have been collecting disability benefits for 24 months, and qualify, you will automatically receive Medicare Part A. At this time, you should contact your local insurance agent to see what Medicare plans you qualify for and whether or not to enroll in Parts B and/or C and/or D. Actually, it is in your best interest to contact your local insurance agent as soon as you receive a letter informing you of Medicare Part A eligibility.

Once you are enrolled in a Medicare plan and unless you qualify for a special enrollment period (SEP), you are locked into that plan until Dec 31st, with an AEP (Oct. 15 – Dec. 7th) at which time you can change your plan for the upcoming year OR Medicare annual disenrollment period (Jan 1 – Feb 14) at which time you can dis-enroll from your plan and return to Original Medicare (Parts A & B with or without D). That said, there are a few situations that put you into a Special Enrollment Period (SEP).

#1: You move out of your Medicare Plan’s service area.

#2: You become eligible for Medicaid or some other financial assistance that helps with your Medicare and/or health care costs (losing eligibility for this assistance also garners a SEP).

#3: You had group insurance through your (or your spouses) employer but are losing that due to actual retirement or company changes.

#4: You gain or lose VA benefits.

Like a relationship, Medicare can be tricky with subtle differences and shades of gray instead of plain black and white. For your own peace of mind, it is always best to sit and talk with a licensed and trained agent to help you get the most out of your Medicare benefits. For more information check out our Medicare FAQ or give us a call and set an appointment with one of our agents today.

Until later, take care and remember – An informed decision about any major life issue is always the best decision!

Tommy Curtis and Staff
 
Disclaimers:

• Medicare has neither endorsed nor reviewed this information.
• Not connected or affiliated with any United States Government or State agency.
• Calling this number will direct you to a licensed Agent/Broker.

 
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