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New To Medicare
If you are nearing or new to Medicare, we have the resources and expertise to assist you in navigating the world of Medicare.
What is Medicare?
The Parts of Medicare
Between the parts and plans, Medicare can seem confusing at first. What you need to know is, there are 4 different parts of Medicare.
Medicare Part A
Part A is for Hospitalization Coverage. This includes room and board if you are hospitalized. Part A also has auto renewal
Medicare Part B
Part B is for normal health care coverage, or outpatient medical services. This includes doctor visits, labs, some surgeries. Part B has auto renewal with paid premiums.
Medicare Part C
Part C is for Medical Advantage and requires enrollment in Part A and Part B. This is a private insurance with a network of providers.
Medicare Part D
Part D is for prescription drug coverage. This is location based, and requires enrollment in Part A and Part B. Also, Part D benefits can change each year.
How do you know if you're eligible for Medicare coverage? Medicare eligibility begins for most people at age 65. You can qualify for Medicare at 65 or older, whether you're retired or still working. You should also be a US citizen or a permanent resident within the US for a continuous 5 years or more.
You may also qualify for Medicare coverage under the following conditions, regardless of age:
1. If you are permanently disabled and have been receiving Social Security disability for 24 months.
2. If you have end stage renal disease, kidney failure requiring dialysis or transplant
3. If you have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease.
If you already receive Social Security benefits when you turn 65, you may be automatically enrolled into Medicare. It is recommended you speak with a Medicare expert to ensure you have the proper coverage, as you are not auto enrolled in all parts of Medicare.
It is your responsibility to obtain Medicare coverage when you are eligible. When to register for Medicare Parts A, B, and D depend on whether Medicare will be your primary coverage, or if you still have coverage from an employer.
When Turning 65 Years Old,
If you're still working and choose to maintain primary coverage through your employer . . .
If you're retired or choose to make Medicare your primary coverage . . .
You can delay your enrollment in Medicare Part B without penalty.
When you plan to no longer us employer benefits coverage you will need to follow your Initial Enrollment Period (IEP) unless it has already passed - then you would be eligible for a Special Election Period.
You can enroll for Medicare Parts A, B, and D by following your Initial Enrollment Period (IEP).
It is important to know your coverage start date is determined by your application date.
By following your IEP you can also avoid late penalties and pre-existing condition waiting periods.
Initial Enrollment Period
Your Initial Enrollment Period (IEP) for Medicare Parts A, B, and D is a specific 7 month period based on your 65th birthday, unless you qualify early due to disability.
There are some important facts you should know to understand and best utilize your Initial Enrollment Period (IEP).
The government expects you to know when to enroll for Medicare.
By enrolling in Medicare during your IEP you avoid late penalty fees.
Your coverage start date depends on your application date, even when you apply during your IEP 7 months.
If you do not have health insurance and fail to enroll during your 7 month IEP, you may be subject to a Part B late enrollment penalty and will have to wait until the General Enrollment Period (GEP) to apply, resulting in even further delayed coverage.
Understanding When Your Coverage Starts
When you enroll during the first 3 months of your IEP, before the month of your 65th birthday, your coverage starts on the 1st day of your birthday month.
If you enroll during the month of your 65th birthday, your coverage will start 1 month after you enroll.
If you enroll during the first month following your 65th birthday, your coverage will start 2 months after you enroll.
If you enroll during the last 2 months of your 7 month IEP, your coverage will start 3 months after you enroll.
If you are already a Medicare beneficiary, our team of Medicare experts can assist you with reviewing your coverage and options to ensure you have the best plan for your needs.
Each Fall you have the opportunity to select a new Part D plan or Medicare Advantage Plan for the upcoming calendar year.
Reasons to Consider Changes:
Don't like the plan changes expected in the coming year.
You've learned one of your doctors will no longer be in network.
Monthly premiums are going up.
Plan is dropping one of your important medications next year.
You want more comprehensive coverage by a Medicare supplement plan.