When you start to inch toward the age of 65, or prepare to retire, you must start thinking about Medicare. But where do you start? You will definitely need to make several important decisions about your health coverage, so it’s imperative that you gather information and make informed decisions. Hopefully these steps recommended by Medicare.gov can help guide you through the process.
Learn about the different parts of Medicare
Medicare Part A (hospital insurance) covers inpatient hospital stays, temporary care in a skilled nursing facility, hospice care and some home health care. Medicare Part B (medical insurance) covers certain doctors’ services, outpatient care, medical supplies (like test strips and preventative services.
Medicare Part D (prescription drug coverage) — Part D adds prescription drug coverage to Original Medicare. These plans are offered by insurance companies and other private companies approved by Medicare.
Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans. MA plans (also known as Part C) is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B and usually Part D.
Find out when you can get Medicare
There are only certain times when people can enroll in Medicare. Some people may get Medicare automatically and others may need to apply. The first time you can enroll is called your IEP (or Initial Enrollment Period). For more people, this begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.
If you don’t enroll when you’re first eligible, you might have to pay a Part B late enrollment penalty and you may have gap in coverage if you decide you want Part B later.
Decide if you want Part A or Part B
Most people should enroll in Part A when they turn 65, even if they have health insurance from an employer. This is because most people paid Medicare taxes while they worked so they don’t pay a monthly premium for Part A. Certain people may choose to delay Part B. In most cases, it depends on the type of health coverage you may have. Everyone pays a monthly premium for Part B. The premium varies depending on your income and when you enroll in Part B. Most people will pay the standard premium amount of $135.50 in 2019.
Choose your coverage
If you end up deciding that you want to take out Part A and Part B, there are two main ways to get your Medicare coverage — Original Medicare or Medicare Advantage Plan (like an HMO). Some people get additional coverage like Medicare Part D or a Medicare Supplemental Plan (also called a Medigap). Most people who are still working and have employer based coverage won’t need additional coverage (BUT check with your human resources manager or benefits manager at your place of employment to check for sure, or call Medicare for clarification based on your specific situation).
In most cases, you will need to make a visit to an insurance agent. The Area Agency on Aging does not recommend any specific company or agent, but we do encourage the people we talk to to visit a local, brick and mortar based insurance agent to help you figure it out. We strongly discourage you from calling just one insurance company over the phone and signing up with a plan without comparing the prices with other companies. Purchasing Medicare Supplement plans, Medicare Part D plans and Medicare Advantage plans are somewhat like purchasing car insurance. You want to compare prices, and think about service after you actually buy it.
Sign up for Medicare if you don’t get it automatically
Some people automatically get Part A and Part B. In most cases, it depends on whether you’re getting Social Security benefits. If you’re automatically enrolled, you’ll get your red, white and blue Medicare card in the mail about three months before your 65th birthday month (or your 25th month of disability). If you don’t get enrolled automatically, you can apply for Medicare online at www.Medicare.gov or contact your local Social Security Administration for help enrolling.
Learn about tasks for your first year with Medicare
• Fill out an Authorization Form if you want your family or friends to call Medicare on your behalf. Medicare can’t give personal health information about you to anyone unless you give permission in writing first.
• Make a “Welcome to Medicare” preventive visit appointment during the first 12 months you have Medicare.
• Sign up for MyMedicare.gov to access your personal Medicare information 24 hours a day. By using this service you can track your health care claims, view your “Medicare Summary Notices” (MSNs), order a replacement Medicare card, check your Medicare Part B deductible status, view your eligibility information, track your preventive services, find information about your Medicare health plan or Medicare Prescription Drug Plan (Part D), or search for a new one.
• Learn what Medicare covers. Once you’re enrolled you should get a copy of the “Medicare & You” handbook in the mail. This will include a list of tests, items, and services that are covered no matter where you live. If your test, item, or service isn’t listed, talk to your doctor or other health care provider about why you need it and find out if Medicare will cover it.
• Decide if you want to go paperless, and get your next free copy of “Medicare & You” electronically, via email.
ALLISON RIDDLE is the community services director for AAAX.