Medicare

Getting Started with Medicare

Whether you’re new to Medicare, getting ready to turn 65, or preparing to retire, you’ll need to make several important decisions about your health coverage. If you wait to enroll, you may have to pay a penalty, and you may have a gap in coverage. Use these steps to gather information so you can make informed decisions about your Medicare:

Step 01

Learn about the different parts of Medicare

The different parts of Medicare help cover specific services. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part A (Hospital Insurance) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Medicare Part B (Medical Insurance) covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Step 02

Find out when you can get Medicare

There are only certain times when people can enroll in Medicare. Depending on the situation, some people may get Medicare automatically, and others need to apply for Medicare. The first time you can enroll is called your Initial Enrollment Period. Your 7-month Initial Enrollment Period usually:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

Get an estimate of when you can enroll in Medicare. If you don’t enroll when you’re first eligible, you may have to pay a Part B late enrollment penalty, and you may have a gap in coverage if you decide you want Part B later.

Step 03

Decide if you want Part A & Part B

Most people should enroll in Part A when they turn 65, even if they have health insurance from an employer. This is because most people paid Medicare taxes while they worked so they don’t pay a monthly premium for Part A. Certain people may choose to delay Part B. In most cases, it depends on the type of health coverage you may have. Everyone pays a monthly premium for Part B. The premium varies depending on your income and when you enroll in Part B. Most people will pay the standard premium amount of $144.60 in 2020.

Step 04

Choose your coverage

If you decide you want Part A and Part B, there are 2 main ways to get your Medicare coverage — Original Medicare or a Medicare Advantage Plan (like an HMO or PPO). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Most people who are still working and have employer coverage don’t need additional coverage.

LET ME AS YOUR AGENT ASSIST You Through Step 5

Sign up for Medicare

Some people automatically get Part A and Part B. Find out if you’ll get Part A and B automatically. If you’re automatically enrolled, you’ll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.

Automatic Enrollment if:

  • I’ll be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least 4 months before I turn 65.
  • I won’t be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least 4 months before I turn 65.
  • I’m under 65 and have a disability.
  • I have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease).
  • I have End-Stage Renal Disease (ESRD).

If you don’t get Medicare automatically, you’ll need to APPLY!

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Step 06

6 things to look for when choosing Medicare drug coverage

Prescription drug coverage can vary by cost, coverage, convenience, and quality. Here are 6 common situations to consider before making a decision about Medicare drug coverage.

  • I take specific drugs.
  • I want extra protection from high prescription drug costs.
  • I want my drug expenses to be balanced throughout the year.
  • I take a lot of generic prescriptions.
  • I don’t have many drug costs now, but I want coverage for peace of mind and to avoid future penalties.
  • I like the extra benefits and lower costs available by getting my health care and prescription drug coverage from one plan, and I’m willing to accept the plan’s restrictions on what doctors, hospitals, and other health care providers I can use.

Step 07

Learn about 5 tasks for your first year with Medicare

  1. Fill out an Authorization Form if you want your family or friends to call Medicare on your behalf. Medicare can’t give personal health information about you to anyone unless you give permission in writing first. Get this form in Spanish.
  2. Make a “Welcome to Medicare” Preventive Visit Appointment during the first 12 months you have Medicare. This free, one-time comprehensive preventive visit puts you in control of your health and your Medicare from the start.
  3. Sign up for MyMedicare.gov to access your personal Medicare information 24 hours a day, every day. Through this secure online service, you can:
    • Track your health care claims
    • View your “Medicare Summary Notices” (MSNs)
    • Order a replacement Medicare card
    • Check your Medicare Part B Deductible status
    • View your eligibility information
    • Track your Preventive services.
    • Find information about your Medicare health plan or Medicare Prescription Drug Plan (Part D), or search for a new one
    • Keep your Medicare information in one convenient place
  1. Learn what Medicare covers. You’ll get a list of tests, items, and services that are covered no matter where you live. If your test, item, or service isn’t listed, talk to your doctor or other health care provider about why you need it. And, ask if Medicare will cover it.

Decide if you want to go paperless, and get your next free copy of “Medicare & You” electronically. Next October, you’ll get an email linking you to “Medicare & You” instead of a paper copy in your mailbox

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