Medicare Options

What is Medicare?

Medicare is the largest government-sponsored health insurance program in the United States. It is administered by the Centers for Medicare & Medicaid Services (CMS) under the U.S. Department of Health and Human Services (HHS).

Eligibility

Only certain people are eligible for Medicare. The following individuals are allowed to enroll:

People age 65 or older
People under age 65 with certain disabilities
Any age individual with End-Stage Renal Disease

Types of Medicare Benefits

There are four types of Medicare benefits:

Part A is Hospital Insurance, where your hospital visits are covered under certain circumstances.
Part B is Medical Insurance, where services and products not covered in Part A are offered. These include physician and nursing services, x-rays, and blood transfusions.
Part C is Medicare Advantage plans, where you can choose to be taken care of by a private health insurance plans. This part is fairly new.
Part D, the newest, includes Prescription Drug plans. This plan is not standardized.

Once You Become a Beneficiary

There are several enrollment periods for a Medicare plan that you should always remember. There is the Initial Coverage Election Period, the Annual Election Period, and the Open Enrollment Period.

When Can I Enroll in A Medicare Plan?

Initial Coverage Election Period

The initial election period occurs when a Medicare beneficiary begins Medicare coverage and makes the first enrollment decision. You can enroll in Medicare for the first time about three months before you turn 65, the month you turn 65, or three months after you turn 65. The decision is up to you.

Annual Election Period

The Annual Election Period for Medicare enrollment occurs in the last few months of every year, from November 15 through December 31. It is encouraged to mark your calendar! During this time, Medicare members can make changes to their Medicare health insurance plans. Make sure to utilize this period in order to make adjustments necessary to make your plan work best for you.

Open Enrollment Period

The Open Enrollment Period occurs in the first few months of every year, from January 1 through March 31. During this time, Medicare beneficiaries can only make one choice to change plans. The change must be from like coverage to like coverage. For example, perhaps you would like to change from one Medicare Advantage plan to another MA plan. Another example includes switching from a Medicare Supplement plan with a stand-alone Prescription Drug Plan to a Medicare Advantage plan with prescription drug coverage.

Disability

Finally, you can enroll in Medicare after you’ve received disability benefits from Social Security or the Railroad Retirement Board for at least 24 months if you have not yet reached the age of 65.

What are Some of My Medicare Options?

Original Medicare

You can enroll in Original Medicare which provides Part A and Part B coverage. See the explanation of the different types of Medicare benefits for an overview of Part A and B.

Unfortunately, Original Medicare does not include prescription drug coverage. However, you can add drug coverage (Part D) by joining a stand-alone Prescription Drug Plan. These plans are run by private insurance companies approved by Medicare.

Medicare Advantage Plan

There is another plan that can be chosen to fit you better. You can enroll in an all-in-one plan called a Medicare Advantage Plan. This is a convenient way to get your Medicare benefits in addition to perks and extras: annual physical exams, wellness programs and coverage when you travel.

These plans can lower your out-of-pocket expenses while offering more benefits. Medicare Advantage plans offer options with or without prescription drug coverage.

Medigap Plans

Medigap plans - or, Medicare Supplement Plans - are another option you may want to take into consideration. These are health insurance policies sold by private insurance companies to help fill the "gaps" in Original Medicare coverage. Medicare Supplement insurance policies work only with Original Medicare.

There are several options to choose from and you’ll want to make sure that you make the right decision. Choosing the right plan will directly affect your health - it will be a decision that will affect the way you live!