Medicare Basics
Educating you on your options.
What is medicare?
Medicare is our country’s health insurance program for people age 65 or older and younger people receiving Social Security disability benefits. The more you understand your Medicare options, the easier it will be to choose a plan. No matter when your 65th birthday is, you can start planning for better health now.
Medicare Plans Types:
Part A
Covers:
Inpatient hospital stays
Skilled nursing facility care
Nursing home care (this does not include custodial or long-term care)
- Hospice care
Home health care
Part B
Covers:
Doctor visits
Outpatient care
- Medical supplies
Preventative services
- Mental health services
- Ambulance services
- Lab test and x-rays
- Rehabilitation services
Home health care
Part C
“Medicare Advantage”
Covers:
Part A
Part B
Most cover part D “drug coverage”
Offered by private health care companies
Often includes dental, vision, gym memberships, and no deductibles
Part D
(Prescription Drug Coverage)
Covers:
Medications
Drug plans are only offered through approved private insurance companies
Medicare Supplement Insurance
(Medigap)
Covers:
- Fills the gaps in Original Medicare and is sold by private companies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining healthcare cost, like:
- Copayments
- Coinsurance
- Deductibles
Does not cover:
Long-term care, vision or dental services, hearing aids, eyeglasses, or private-duty nursing
Dual Special Needs
Medicare / Medicaid
Chronic Special Needs
- Lung disease
- End stage renal disease
Diabetes
Congestive heart failure
Enrollment Periods
Enrollment periods occur throughout the year. Browse below to see if one might apply to you this coming year.
OCT. 15 – DEC. 7
Annual Enrollment
During annual enrollment, you can add, drop or switch your Medicare Coverage.
This is typically your one-time chance during the year to review your current coverage and make changes for the following year. It’s important to take a look and make sure you are maximizing the value and benefits of your health plan.
JAN. 1 – MAR. 31
Medicare Advantage Open Enrollment
If you’re already a Medicare Advantage plan member, you may dis-enroll from your current plan and either switch to a different Medicare Advantage plan one time only, or go back to Original Medicare during this period.
Occurs throughout the year
Special Enrollment Period
Depending on certain circumstances, you may be able to enroll in a Medicare plan outside of the initial enrollment or annual enrollment time frame. Some ways you may qualify for Special Enrollment Period are you:
- Retire and lose your employer coverage
- Move out of the plans service area
- Qualify for extra help
- Have been diagnosed with certain qualifying chronic health conditions.
BEGINS AROUND YOUR 65TH BIRTHDAY
Initial Enrollment Period
Beginning around your 65th birthday, you’ll have a 7-month window of time when you can sign up for Medicare. Your IEP includes your 65th birthday month, the 3 months before and after.
