There is a lot to know about Medicare, and it can be daunting. Check out this article on enrollment periods for Medicare to learn more. Here are ten basic things to know about Medicare to get you started.
To be eligible for Medicare, there are a few requirements. First, you must be 65 years of age and a United States citizen. You can also be eligible for Medicare before you turn 65 if you have been disabled for 24 consecutive months or have End Stage Renal Disease (ESRD).
2. Different Parts of Medicare (A, B, C, D)
There are four different parts of Medicare: Parts A, B, C, and D. Part A is hospital insurance while Part B is medical insurance. These are the two required parts of Medicare, but the requirement can also be filled by a Part C plan. Part C combines Parts A and B into one plan and is administered by private insurance companies. These are known as Medicare Advantage plans. Part D is prescription drug coverage and is also provided by private insurance companies. There are different costs associated with each part, from monthly premiums and deductibles to coinsurance and copays. Learn more about what Medicare covers and costs here.
3. Enrollment Times
You can only enroll in Medicare during specific times of the year and you must enroll initially during the seven-month period surrounding your 65th birthday. Check out these other articles to see all the important dates and enrollment periods for Medicare.
4. Enrollment Penalties
If you do not enroll in Medicare during your Initial Enrollment Period, you could be penalized. However, if you work past 65, you will have a Special Enrollment Period after your company’s health insurance coverage stops during which you can enroll in Medicare. If you don’t enroll during this time, you might also face penalties. Often these penalties will apply to your monthly premium for the rest of the time you are enrolled in Medicare. Read more about penalties here.
5. Working Beyond 65
If you plan to continue working beyond the age of 65 and not enroll in Medicare at that time, you still need to take some steps to ensure you are ready when you do retire. Doing these things will reduce stress and help you avoid penalties later.
6. Retiring Before 65
If you plan on retiring before the age of 65, Medicare will not cover you until you turn 65. However, there are still options for health insurance through the Health Insurance Marketplace, also referred to as Obamacare or Affordable Care Act plans.
7. Medicare Supplement Plans
Private insurance companies provide Medicare Supplement plans that fill some of the payment gaps left by Medicare. These plans can cover deductibles, coinsurance, and copay costs but for a higher monthly premium typically. To learn more about Medicare Supplement plans, read this article.
8. In- and Out-of-Network Providers
As mentioned before, Part C, or Medicare Advantage (MA), plans are provided by private insurance companies. These companies have networks of hospitals, doctors, and healthcare providers that accept the plan. If you have an MA plan, you could be restricted to only use providers within this network. Use of providers outside the network for anything other than emergency coverage could result in increased cost share or denial of services. Learn more about in- and out-of-network providers here.
9. Social Security Benefits and Medicare
If you are enrolled to receive Social Security benefits before you turn 65, you will automatically be enrolled in Medicare Parts A and B once you turn 65. A part of your benefits check will be applied toward the Medicare premiums each month.
10. Medicare Choice Group can help with all of this!