Navigating Medicare can feel overwhelming, but understanding your options ensures you get the right coverage for your needs. If you're turning 65 soon, start exploring your choices today to make a smooth transition into Medicare!
When do I enroll?
You can enroll in Medicare during your Initial Enrollment Period (IEP), which starts three months before your 65th birthday, includes your birth month, and ends three months after.
If you miss this window, you can sign up during the General Enrollment Period (January 1 – March 31), though late penalties may apply. You can enroll for both Parts A and B in person or online through the Social Security office.
What is Medicare?
Medicare is a federal health insurance program for people 65 and older, as well as certain younger individuals with disabilities, End-Stage Renal Disease (ESRD), or ALS. It has four parts: Part A (hospital coverage) and Part B (medical coverage) make up Original Medicare. Medicare Advantage (Part C) is a private plan that replaces Original Medicare and often includes Part D (prescription drug coverage). Since Medicare doesn’t cover all healthcare costs, some people with Original Medicare may choose supplemental insurance or Medigap policy to help with out-of-pocket expenses. Here's a deeper look at each part:
ORIGINAL MEDICARE
Medicare Part A (Hospital Insurance)
Part of Original Medicare, this part covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. It does not cover 100% of your medical cost or prescription drugs. Additional coverage will be needed. Deductibles and coinsurance apply for hospital stays and there is limited coverage for long-term care.
Medicare Part B (Medical Insurance)
Also part of Original Medicare, Part B covers doctor visits, outpatient care, preventive services, and some home health care. Preventive services (like screenings and vaccines) are often covered at no cost. It requires a monthly premium, which may vary based on income.
NOTE: If you are already receiving Social Security, you will automatically be enrolled in Medicare Part B.
SUPPLEMENTAL COVERAGE OPTIONS
Medicare Part C (Medicare Advantage)
Known as Medicare Advantage, Medicare Part C is an alternative to Original Medicare, offered by private insurance companies. It combines Part A and Part B coverage, often including additional benefits not offered by Original Medicare, like vision, dental, and hearing. Many plans include prescription drug coverage (Part D). Costs and coverage vary by plan and provider but are often lower out-of-pocket costs than Original Medicare.
Medicare Part D (Prescription Drug Coverage)
Medicare Part D helps cover the cost of prescription medications. This is also offered through private insurance companies approved by Medicare. Plans have a list of covered drugs and may include tiers with different costs. Monthly premiums, deductibles, and copayments will vary by plan.
It’s wise to review your choices every year.
Medical expenses in retirement can take people by surprise. Your health can change from year to year, which is why it’s important to look at your health care coverage every year to make sure it meets your needs. While everyone has the same benefits available to them through Original Medicare, Medicare Advantage and Prescription Drug Plan benefits may vary.
Medicare Annual Enrollment happens each year from October 15 to December 7. You may change your coverage choices during this time.