How to Get Started With Medicare 

Taking your health seriously is something that people of all ages should do, but health and wellness tend to become a stronger focus with age. It’s no secret that health problems often become magnified in both intensity and frequency with age. The body also has a harder time coping with things like injuries as we get older.

The good news is that seniors today live longer lives overall compared to previous generations in large part due to advances in medical science and technology. Prescription drugs and diagnostic testing also play pivotal roles in catching diseases sooner, helping doctors to begin treatment for medical concerns earlier than in the past. Additionally, access to health insurance through programs like Medicare has provided seniors with more options to receive treatment for healthcare conditions.

What is Medicare?

Medicare is a health insurance program utilized by tens of millions of seniors in the United States. Individuals under 65 years of age may qualify due to certain long-term disabilities. Medicare benefits can be used to help pay for a wide range of medically necessary services and supplies,  from a visit with your doctor for a routine screening exam to surgery and hospital care.

The parts of Original Medicare

Medicare coverage is divided into three different parts, each of which is designed to help pay for different types of medical care. Medicare A covers inpatient care, Medicare Part B covers outpatient care and Medicare Part D covers prescription medications.

Additional Medicare plans and products

Medicare Advantage, sometimes referred to as Medicare Part C, is a type of Medicare plan that includes at least the same Part A and part B benefits as Original Medicare, but usually includes access to additional benefits. MA plans are offered by private insurance companies who contract with Medicare. There are different plans available based on where you live, so comparing plans before enrolling is an important part of the process of signing up for Medicare. 

Medigap or Medicare Supplement Insurance is a secondary Medicare product that helps to pay for some of the costs associated with using Original Medicare benefits. You cannot have Medigap if you have enrolled in a Medicare Advantage plan. 

When do you qualify? 

To get started with Medicare, you first want to make sure you qualify. In order to be eligible for Medicare benefits, you need to be a United States citizen who is age 65 or older. You can qualify for Medicare coverage below the age of 65 if you have receive Social Security Disability Insurance (SSDI) or have end-stage renal disease or ALS. For some who qualify for Social Security benefits, there is a 24-month waiting period from the time you become eligible for SSDI and the time you become eligible for Medicare.

Enrollment in Medicare Part A is usually automatic

Next, you need to sign up for a Medicare plan. If you already receive Social Security benefits, you will automatically be enrolled in Medicare Part A. There generally is no monthly cost for this since Medicare premiums for Part A have been deducted from your paycheck during your working years. If you do not qualify for premium-free Part A, you may be able to pay for it. 

Enrolling in Medicare Part B and Part D

Although Medicare Part B and Medicare Part D are optional benefits that require a monthly premium to be paid, most people enroll when they are first eligible unless they already have creditable coverage.  You can also speak with an independent Medicare insurance broker who can provide guidance for navigating Medicare benefits and help you find the coverage that meets your needs at a price you can afford. 

Deciding to go with a Medicare Advantage plan

If you choose to enroll in Medicare Advantage, an independent broker can also help you find options available in your state and compare plans. Each state regulates its own insurance products, so what is available in one state may not be available in another. An independent broker for Medicare Advantage plans can impartially shop plans to help you find options that meet your needs.

Getting started with Medicare Supplement insurance

If you want to carry Medigap coverage, you will need to get your Part A and Part B benefits through Original Medicare. You cannot have both a Medicare Advantage plan and Medigap at the same time.

Medicare Supplement Insurance plans are sold through private insurers. As mentioned, each state’s insurance regulations are different, but Medigap plans are standardized. You’ll have a 6-month window for during your Medigap Open Enrollment Period which starts when you turn 65 and have Part B. During that time, you can buy any Medicare Supplement policy sold in your state. When that period ends, you may be subject to medical underwriting and may be charged more or even turned down for a policy. An independent broker can once again provide guidance to help Medicare recipients find the right insurance products for their needs.

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