Medicare- Getting Started

(Originally featured in our newsletter 6/15/2016)

The first thing you have to do is either be 65 years of age or qualify for enrollment due to disability or other special situation.

Qualifications- You must have “A” or “B” on your red, white, and blue Medicare card from the social security administration. You must also be a United Sates citizen or a legal resident who has lied in the United States for at least five consecutive years.

Types of Medicare- Part A is government-provided and helps with hospital care; Part B is also government-provided and helps with doctor’s visits and outpatient care; Part C is Medicare Advantage, Part D is prescription drug coverage. Both C and D are offered by private companies. Medicare Supplement (also called Medigap) plans are also offered by private companies.

Your biggest decision, and one to make first, is whether you want original Medicare, an Advantage plan, or a full supplement. If you decide to stay on original Medicare, you will need to add a Medicare Part D to cover your prescription drugs; the same applies to full supplements. If you choose an Advantage plan, offered by private companies, and most of them cover prescription drugs. You’ll need to choose from several companies and plans to purchase the one that best fits your needs. It would be advisable to make an appointment with a broker/agent to go over all of your options.

Enrollment- You can sign up for a Medicare plan three months before your 65^th birthday, the month of or three months after giving you a seven month window. If you miss the enrollment window, you must wait to enroll between October 15^th, and December 7^th unless you qualify for an exception. Enrolling later could mean higher premiums.

Cost- You’ll pay a premium for Part B. The amount depends on your yearly income and can be automatically deducted from your Social Security benefits. You may pay a penalty if you don’t sign up for Part B when you are eligible. Your cost for Part B may go up 10% for each full 12-month period that you don’t participate in Part B. You will pay that penalty for as long as you’re enrolled. This penalty may not apply to you if you are still working for an employer who provides group health coverage.

What isn’t covered- Part B focuses on helping you pay the costs of medically necessary care when you’re sick. Only in very limited situations does it cover any care for your eyes, teeth, or hearing. Part B does not cover medical care you receive outside the United States, except in a few very limited situations. Part B also doesn’t cover the cost of help with the activities of daily life, like eating, bathing, or getting dressed.

-Bev Cline