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Medicare: into the unknown benefit!

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Medicare is a complicated benefit of aging, so let’s try and break it down…

What is Medicare?

It is a National Health Insurance Program started in 1966 by the United States Government. It is strictly for Americans 65 and older and for people who have been on Social Security disability for 24 months.

Types:

  • Original Medicare: Part A(Hospital visits and stays) Part B(Medical Insurance)
    • Part D: prescription drug coverage. (There will be penalty fees if one chooses to enroll in this later on instead of during initial enrollment.)
  • Medicare Advantage (also known as Part C):
    • An “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
    • Plans may have lower out-of-pocket costs than Original Medicare, and you will need to use providers in the plan’s network for the lowest costs.
    • Most plans offer extra benefits that Original doesn’t cover—like vision, hearing, dental, and more.

Initial Enrollment begins at age 65.

During your 65th year of life, you have seven months, around your date of birth, to initially enroll… with caveats!

Most people need to sign up (Initial Enrollment), however some may be automatically enrolled.

Here are three enrolling scenarios:

  1. Three months before your birth month. This will allow you to start receiving benefits on the first of your birth month.
  2. During your birth month will push the start date of benefits to the first of the following month.
  3. The three months following your birth month will push the start date to two months after the month in which you enrolled. (For example: if your birthday is March 10th, and you enroll on May 1st, you will start receiving benefits on July 1st.)

You will benefit the most by enrolling prior to your birth month, so add it to your calendar!

Those automatically enrolled receive Part A and Part B if they have:

  • Disability benefits from Social Security for 24 months
  • Certain disability benefits from the Railroad Retirement Benefits for 24 months

Annual Enrollment is October 15th through December 7th.

Once enrolled, you need to keep up on it annually, for there are many changes that take place regarding prescription plans and medical plans(Annual Enrollment).

  • For those that are already enrolled, for seven weeks you can switch your prescription plan, advantage plan, or provider as many times as you want depending on your financial and medical needs.
  • Your last submission on or before December 7th is the plan you will be on for the year, until the next October.

Medicare Advantage Open Enrollment (OEP)

The period of January 1st through March 31st is your annual opportunity to switch to another Medicare Advantage Plan or leave the Advantage Plan and return to Original Medicare with or without standard Part D coverage. (Medicare Advantage Open Enrollment).

Types of Medicare Advantage Plans to choose from:

Need someone to help you?

There are agents all over the country with so much more knowledge on Medicare than I can ever understand. Please ask around for referrals and open those mailers you receive. Not only do they know Medicare, but will find you the best plan depending on your personal needs, health factors, and finances.

Click here for a short video to learn more about Medicare.

If you need a good calendar to keep all of these dates in order, my affiliate Erin Condren has beautiful ones to purchase.

Courtney

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