Senior Providers Blog

Medicare Basics

Posted by Senior Providers Network on Apr 2, 2019 10:00:00 AM

Sign up for MedicareI want to apply for Medicare.  When do I apply for Medicare?  When do I sign up for Medicare Part D?  Questions, questions and more questions.  We are going to put together a series of blogs that will better help you understand Medicare basics.  Senior Providers Network is not going to make anyone an expert, but you will walk away with a better understanding.  We will be discussing Part A, B and D and even discuss Medicare Advantage plans (Medigap). 

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What is Medicare? 

Medicare is the federal health insurance program that started back in 1966 for people who are 65 or older, younger people with certain disabilities and people with End-Stage Renal Disease (ESRD).  Medicare has four (4) parts to it.  Part A, B, C and D.

Do I have to sign up for Medicare?

Some will and some will not have to.  If you’re already receiving benefits from Social Security or the Railroad Retirement Board (RRB), then no.  All others will have to apply. 

When do I sign up for Medicare?

Here is a good checklist:

7 – 9 months before your 65th Birthday

  • Contact the Social Security Administration Office to confirm your eligibility for Medicare benefits
  • Review your current health insurance coverage to find out what happens after you turn 65
  • Review and discuss how to help cover yourself where Medicare Stops.
  • Contact your State Health Insurance Assistance Program
  • Discuss and or enroll in a Medicare Supplement Insurance plan

4 – 6 months before your 65th Birthday

  • If you haven’t enrolled in a Medicare Supplement Insurance plan by now you need to contact your State Health Insurance Assistance Program representative and discuss options
  • Check with your current doctor (s) and see if they accept Medicare
  • Understand Medigap and how it works

1 – 3 months before your 65th Birthday

  • Enroll in Medicare Part A and Part B. If you haven’t received your automatic enrollment information in the mail, contact the Social Security Administration.  You can enroll three months before your birth month, during your birth month or three months after your birth month.
  • Enroll in a Medicare Supplemental Insurance Plan
  • Research and select a prescription drug plan (Part D)

What are the different parts of Medicare?

Medicare Part A (Hospital Insurance).  Also known as original or traditional Medicare.  Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance).  Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Medicare Part C (Medicare Advantage Plans).  Part C was added in 2006.  These plans, by law, cover the same services under Parts A & B.  Some of the Part C plans add different benefits like vision, hearing, dental and prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Medicare Part D (Prescription drug coverage).  Part D adds prescription drug coverage for outpatient services.  These plans are offered by insurance companies and other private companies approved by Medicare.  These plans operate differently than the traditional Part A & B Medicare. 

How much is Medicare?

Part A is FREE if you or your spouse paid Medicare taxes while working for 40 calendar quarters (10 years).  If you didn’t work 40 calendar quarters, you will likely have to pay a monthly premium for Part A. That premium will depend on how many years you or your spouse worked and if you paid Social Security taxes in the U.S.

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Topics: Medicare