What is Medicare?
Medicare is the federal health insurance program for people who are 65 or older, persons with End-Stage Renal Disease and certain younger people with disabilities.
There are four main parts to the Medicare system:
- Part A (Hospital Coverage)
- Part B (Medical Coverage)
- Part C (Medicare Advantage)
- Part D (Prescription Drug Coverage)
When Do I Signup for Medicare?
You need to sign up for Medicare about three months before you turn 65. You are eligible for premium-free Part A if you are 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. Part A has a deductible that changes each year.
Medicare Advantage Plans
In order to enroll in a Medicare Advantage Plan you must be:
- Enrolled in Medicare Parts A and B
- Permanently reside in the service area
- Must not have End-Stage Renal Disease (ESRD) unless:
- You have another health plan from the same organization within the same state, or you were enrolled in a Medicare Advantage plan that was terminated or discontinued after December 31st, 1998 and this is your first election since that happened.
What are the 3 Enrollment Periods set by Medicare?
- Initial Enrollment period
A person first becomes eligible for Medicare, either because of turning 65 or qualifying for Medicare due to disability, or is late in enrolling in Part B and does so during the General Enrollment period from January 1st to March 31st for coverage to begin July 1.
- Open Enrollment Period
October 15th to December 7th– During this time, changes can be made to Prescription Drug Coverage, you may join a Prescription Drug Plan if not already enrolled, or change a Medicare Advantage Plan, either with a drug plan or a Medical only Medicare Advantage.
- Special Enrollment Period
Certain qualifying events allow you to obtain coverage during a Special Election period, such as losing group health coverage, moving out of your current plans service area, qualifying for Medicaid or qualifying for extra help paying for your premium through a Low Income Subsidy.