Medicare Blog

what to consider first time medicare coverage

by Eudora Carter Published 1 year ago Updated 1 year ago
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When first thinking about signing up for Medicare, a person may wish to consider: the enrollment periods for different types of coverage whether or not financial assistance is available whether they would like original Medicare or Medicare Advantage comparing plan coverage and costs choosing a plan and signing up before the deadline

Full Answer

How to enroll in Medicare for the first time?

5 Tips for Enrolling in Medicare for the First Time 1. Find Out Your Medicare Initial Enrollment Period Dates. You have a set time period when you can first sign up for... 2. Find Out If You Can Delay Enrolling in Medicare. You may be able to delay enrolling in Medicare Part B, or both Parts... 3. ...

When does my Medicare coverage start?

Medicare coverage starts based on when you sign up and which sign-up period you’re in. Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the month.

How do I choose the best Medicare plan?

Your choices for Medicare coverage are: Get Part A to cover only hospital costs, which for most people is available with no additional costs. Enroll in the Original Medicare plan (Parts A and B, covering hospital and doctor visits).

How well does my Medicare plan cover the services I Need?

If you're in a Medicare plan, review the " Evidence of Coverage" (EOC) and "Annual Notice of Change" (ANOC) . How well does the plan cover the services you need? Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care settings. Services are either covered under Part A or Part B.

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What do I need to know before getting Medicare?

Medicare is health insurance for people 65 or older. You're first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig's disease).

What is the first step in getting Medicare?

Step 1: Find out if you need to sign up for Medicare Part A or B.Step 2: Decide if you want Medicare Part B benefits.Step 3: Decide if you want extra coverage with Medicare.Step 4: Decide if you want Medicare Part D, Prescription Drug Coverage.

Does Medicare Part B have to start on the first of the month?

Part B (Medical Insurance) Generally, you're first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. (You may be eligible for Medicare earlier, if you get disability benefits from Social Security or the Railroad Retirement Board.)

What is the most basic Medicare coverage?

At age 65, most people in America qualify for Medicare Part A and B (Original Medicare), which is basic Medicare coverage. Basic Medicare coverage provides hospital and medical insurance but leaves out coverage for many things, including most prescription drugs you take at home.

Will I automatically be enrolled in Medicare when I turn 65?

Yes. If you are receiving benefits, the Social Security Administration will automatically sign you up at age 65 for parts A and B of Medicare. (Medicare is operated by the federal Centers for Medicare & Medicaid Services, but Social Security handles enrollment.)

What documents do I need to apply for Medicare?

What documents do I need to enroll in Medicare?your Social Security number.your date and place of birth.your citizenship status.the name and Social Security number of your current spouse and any former spouses.the date and place of any marriages or divorces you've had.More items...

Does Medicare start on your birthday or the month of your birthday?

Your first chance to sign up (Initial Enrollment Period) It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the month.

How long does it take for Medicare Part B to be approved?

You can also call the Social Security Administration at 1-800-772-1213 or go to your local Social Security office. It takes about 45 to 90 days to receive your acceptance letter after submitting your Medicare application.

Can I get Medicare Part B for free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.

Does Medicare pay 100 percent of hospital bills?

According to the Centers for Medicare and Medicaid Services (CMS), more than 60 million people are covered by Medicare. Although Medicare covers most medically necessary inpatient and outpatient health expenses, Medicare reimbursement sometimes does not pay 100% of your medical costs.

What procedures are not covered by Medicare?

Some of the items and services Medicare doesn't cover include:Long-Term Care. ... Most dental care.Eye exams related to prescribing glasses.Dentures.Cosmetic surgery.Acupuncture.Hearing aids and exams for fitting them.Routine foot care.

Why do I need Medicare Part C?

Medicare Part C provides more coverage for everyday healthcare including prescription drug coverage with some plans when combined with Part D. A Medicare Advantage prescription drug (MAPD) plan is when a Part C and Part D plan are combined. Medicare Part D only covers prescription drugs.

Medicare basics

Start here. Learn the parts of Medicare, how it works, and what it costs.

Sign up

First, you’ll sign up for Parts A and B. Find out when and how to sign up, and when coverage starts.

Your first chance to sign up (Initial Enrollment Period)

Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

Between January 1-March 31 each year (General Enrollment Period)

You can sign up between January 1-March 31 each year. This is called the General Enrollment Period. Your coverage starts July 1. You might pay a monthly late enrollment penalty, if you don’t qualify for a Special Enrollment Period.

Special Situations (Special Enrollment Period)

There are certain situations when you can sign up for Part B (and Premium-Part A) during a Special Enrollment Period without paying a late enrollment penalty. A Special Enrollment Period is only available for a limited time.

Joining a plan

A type of Medicare-approved health plan from a private company that you can choose to cover most of your Part A and Part B benefits instead of Original Medicare. It usually also includes drug coverage (Part D).

What is the original Medicare?

Original Medicare. Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). After you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share (coinsurance and deductibles). (Part A and Part B) or a.

What is Medicare Advantage Plan?

Medicare Advantage Plan (Part C) A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits, excluding hospice. Medicare Advantage Plans include: Health Maintenance Organizations. Preferred Provider Organizations.

What happens if you don't get Medicare?

If you don't get Medicare drug coverage or Medigap when you're first eligible, you may have to pay more to get this coverage later. This could mean you’ll have a lifetime premium penalty for your Medicare drug coverage . Learn more about how Original Medicare works.

How much does Medicare pay for Part B?

For Part B-covered services, you usually pay 20% of the Medicare-approved amount after you meet your deductible. This is called your coinsurance. You pay a premium (monthly payment) for Part B. If you choose to join a Medicare drug plan (Part D), you’ll pay that premium separately.

Does Medicare Advantage cover prescriptions?

Most Medicare Advantage Plans offer prescription drug coverage. . Some people need to get additional coverage , like Medicare drug coverage or Medicare Supplement Insurance (Medigap). Use this information to help you compare your coverage options and decide what coverage is right for you.

Medicare Advantage (Part C)

You pay for services as you get them. When you get a covered service, Medicare pays part of the cost and you pay your share.

You can add

You join a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage.

Most plans include

Some extra benefits (that Original Medicare doesn’t cover – like vision, hearing, and dental services)

Medicare drug coverage (Part D)

If you chose Original Medicare and want to add drug coverage, you can join a separate Medicare drug plan. Medicare drug coverage is optional. It’s available to everyone with Medicare.

Medicare Supplement Insurance (Medigap)

Medicare Supplement Insurance (Medigap) is extra insurance you can buy from a private company that helps pay your share of costs in Original Medicare.

How long does it take to sign up for Medicare at 65?

Find Out Your Medicare Initial Enrollment Period Dates. You have a set time period when you can first sign up for Medicare (unless you qualify to delay). It’s called your Initial Enrollment Period and lasts 7 months.

What do you pay for Medicare?

You may pay premiums, deductibles, copays and coinsurance. Which type of costs you pay and how much will vary based on your coverage.

What is Medicare Made Clear?

Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.

Does Medicare cover dental?

Original Medicare doesn’t provide coverage for prescription drugs, dental, eye health, hearing, fitness and a few other benefits. In most cases, if you want Medicare coverage for all of these, you’ll need to look at getting a Medicare Advantage plan.

Does Medicare have an annual out-of-pocket maximum?

Financial Protection Tip: With a Medicare Advantage plan your annual out-of-pocket costs are capped with an annual out-of-pocket maximum. Each Medicare Advantage plan sets its own cost terms, and every plan must set an annual out-of-pocket maximum.

Can Medicare enroll you on your 65th birthday?

Just like your 65th birthday, Medicare enrollment can sneak up on you. Use the tips above and the exclusive resources available here to get a head start on learning about Medicare basics, enrollment, coverage options and more so you can make an informed decision when the time comes.

Key Points in Making Your Decision

There are many choices for health coverage in the Medicare system. You are eligible for Medicare Part A (hospital care) and Part B (doctor visits) when you turn 65. If you are already receiving Social Security benefits, you will automatically be enrolled in Medicare.

Medicare Information to Consider

Enroll in the Original Medicare plan. If you don’t sign up within seven months of turning 65 (three months before your 65 th birthday, your birthday month, and three months after), you will pay a 10% penalty for every year you delay.

When do you have to be 65 to get Medicare?

Most people in the United States become eligible for Medicare when they turn 65 years old. Having a Medicare checklist can help people keep track of the choices they need to make and the timeframes for doing so.

When does Medicare cover the Welcome to Medicare exam?

Medicare covers a “Welcome to Medicare” exam within the first 12 months of enrolling in Part B. This exam is optional and is often free when the healthcare provider accepts assignment, according to Medicare.

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