Initial Enrollment in Medicare

Are you turning 65 soon?

Congratulations and a happy early birthday to you!  Did you know that you’ll soon have access to Medicare benefits?  Turning 65 is considered “aging in” to Medicare, and it’s an important time in your life, as you make some crucial decisions on how your healthcare will work as you enter your golden years.  We’re here to help bring you up to speed on everything you’ll need to know about the changes Medicare enrollment will bring to your life.  First let’s talk a little bit about what Medicare is and what it means to you.

What is Medicare?

Medicare is health insurance program created by the Federal government.  Medicare primarily serves U.S. citizens 65 and older, though people with certain disabilities and End-Stage Renal Disease may also qualify.

You have a 7 month window during which you can enroll in Medicare for the first time, starting 3 months before your 65th birthday.  Not enrolling during this window can incur financial penalties later on, so it’s important to get your enrollment taken care of in a timely fashion.

Medicare was signed into law by President Lyndon B. Johnson in 1965, and is currently administered by the Centers for Medicare and Medicaid Services (CMS), which is itself a division of the U.S. Department of Health and Human Services.

How Does Medicare Work?

Anyone who meets the requirements for Medicare is eligible to receive certain health benefits from the Federal government.  Certain parts of Medicare will require you to pay a monthly premium, dependent on several contributing factors.  If you aren’t sure about whether you’re eligible for Medicare and/or have not received a Medicare card yet, you can contact the Social Security Administration at 1(800) 772-1213.

 

I have received my red, white, and blue Medicare card in the mail.

I have NOT received my red, white, and blue Medicare card in the mail.

Sample Medicare Card

A sample red, white, and blue Medicare card.

 I have received my Medicare Card. Now what?

If you have received your Medicare card, now is the time to start getting educated on what options are available to you, and how you’d like to proceed with your healthcare choices.  It helps to first understand how Medicare benefits are structured.  If you’d rather skip this light reading, please give us a call, and one of our licensed Medicare specialists will be happy to educate you over the phone on everything you need to know about your Medicare benefits.

Original Medicare

The Original Medicare Plan is the program started by the government in 1965.  Original Medicare is made up of several Parts that offer health coverage with certain limitations.

Part A covers hospital stays and inpatient care.  Many people do not pay a monthly premium for Part A, though some people who have not paid into the Medicare system through their employment may need to pay a premium to receive benefits under Part A.  Part A can also cover Hospice and in-home care.

Part B is insurance for outpatient care, office visits, and things like physical therapy.  Most beneficiaries will have to pay a monthly premium to receive Part B benefits.  It is important to note that people who do not sign up for Part B coverage or comparable Part C coverage will have to pay a penalty if and when they do sign up for coverage under Part B.  This is why it’s critical to make sure you get the proper education during your Initial Enrollment Period.

Private Insurance and Supplemental Coverage

Part C is coverage that combines the coverage of Parts A and B into one policy, with the key difference being that Part C can only be obtained through a private insurance carrier.  Part C coverage often includes increased or expanded benefits, and can help lower your monthly premiums and/or out-of-pocket costs.

Part D is prescription drug coverage, and more often than not, you will have to pay a monthly premium for it.  Some Part C plans come with Part D coverage.  Be sure to discuss this component of coverage with a licensed Medicare specialist before you complete your enrollment in any Medicare plan.

Medicare Supplement Plans, also known as Medigap, are plans available to help with costs that are not covered by Parts A and B.  Medigap coverage is only for people who use Part A and B coverage, and is not necessary for people who elect to enroll in Part C coverage.

What’s my next step?

There are a number of important decisions you have in front of you, and you can only make changes to your Medicare coverage once a year, so it’s a good idea not to make your decisions in a hurry or without consulting a licensed Medicare specialist to educate you on your options and answer any questions you might have about your needs and your coverage options.

  • Medicare parts A & B (the government option) or part C (private insurance).  
  • Medigap coverage to supplement parts A & B
  • The choice of plan and provider for part C
  • The choice of a Prescription Drug Plan
  • PPO or HMO — This can affect whether you are able to keep your current doctor(s).
  • What level of coverage you need for hospital stays, office visits, and other services
  • What you can afford to pay for premiums and out-of-pocket costs

Answering these and other Medicare questions is very important, but it doesn’t need to be difficult.  To get started, give us a call or fill in our contact form so that you can have a free in-depth consultation with one of our licensed Medicare specialists.

I don’t even have my Medicare card!  What do I do??

Don’t panic.  If you don’t have your red, white, and blue Medicare card yet, you can call the Social Security Administration at 1(800) 772-1213 to make sure you’re eligible and to obtain your Medicare card.  If you were or are a railroad employee, you will need to contact the Railroad Retirement Board.  If you were or are a Federal employee, you will need to contact the Office of Personnel Management.

Once you have obtained your Medicare card from the appropriate government office, give us a call or fill out our contact form and one of our licensed Medicare specialists will provide you with a free consultation to help you understand your Medicare benefits.