There's a lot to consider before enrolling in Medicare, and you probably have a lot of questions. Asking questions is the best way to uncover all you need to know about enrolling in the right Medicare plan, and we've got all the answers.
When can I first enroll in a Medicare plan?
Typically, you're first able to enroll in a Medicare plan when you turn 65. You can sign up for Medicare Part A (hospital insurance), Medicare Part B (medical insurance), Medicare Part C (Medicare Advantage, which includes Medicare Parts A and B), and Part D (prescription drug coverage) during your Initial Enrollment Period (IEP). This period consists of seven months. It begins three months before you turn 65 and ends three months after your 65th birthday.
If you already get benefits from Social Security, you'll get Medicare Part A and Part B automatically when you're first eligible, so you won't need to sign up for a Medicare plan when you turn 65.
If you don't sign up for a Medicare plan during your IEP, you may be responsible for paying late-penalty premiums, so it's best to take advantage of this time to enroll.
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Do I have to pay for Medicare?
Like other insurance, Medicare comes at a price. What you pay, however, varies greatly depending on the Medicare plan you enroll in.
If you enroll in Medicare Part A, you'll be responsible for paying a Part A hospital inpatient deductible and coinsurance. You likely won't have to pay a premium for Part A if you or your spouse paid Medicare taxes for a certain amount of time while working. If that's not the case, you will be responsible for paying a monthly premium for Part A along with the hospital inpatient deductible and coinsurance.
If you enroll in Medicare Part B, you'll have to pay a monthly premium, deductible, and coinsurance. Most Medicare prescription drug plans (Part D) charge a monthly fee that varies by plan. You pay this in addition to your Medicare Part B premium if you choose to enroll in a Part D plan.
What you pay for a Medicare Advantage plan (Part C) changes from plan to plan, so it's best to do your research and compare your options to make sure you enroll in a plan that fits your health and financial needs.
What does Medicare cover?
Medicare covers a lot, but it doesn't cover everything. What is and isn't covered all depends on the Medicare plan you enroll in. Here's a breakdown of the different parts of Medicare and what they may cover:
Medicare Part A (hospital insurance):
- Covers inpatient hospital care, skilled nursing facilities, hospice, lab tests, surgery, and home health care.
Medicare Part B (medical insurance):
- Covers medically necessary services, such as services or supplies needed to diagnose or treat your medical condition and preventive services.
Medicare Part C (Medicare Advantage):
- Medicare Advantage plans must cover all of the services that Original Medicare (Parts A and B) covers. Some Medicare Advantage plans may also include additional benefits like prescription drug coverage, eye care, dental care, hearing aids or exams, and wellness services. All Medicare Advantage plans cover you for emergency care.
Remember, costs, coverage, rules, and restrictions vary across all Medicare Advantage plans, so it's important to check the details of the plans you're interested in before enrolling.
Medicare Part D:
Whether you get prescription drug coverage through Medicare Part D or through a Medicare Advantage plan, each Medicare drug plan must give at least a standard level of coverage set by Medicare. However, the list of prescription drugs covered (called a formulary) will vary from plan to plan. So it's important to check a drug plan's formulary before enrolling to make sure your prescription is covered.
How can I switch Medicare plans?
If you're not happy with your current Medicare coverage, you can switch plans during certain enrollment periods during the year. The Medicare Annual Enrollment Period (AEP) is one of these periods. It begins October 15 and ends December 7. You can also switch plans during the Medicare Advantage Open Enrollment Period. It begins January 1 and ends March 31. What you can join, drop, or switch to during these enrollment periods depends on your current coverage.
The rules and time frames for switching Medigap policies are different. In most cases, you won't have a right under federal law to switch Medigap policies unless you're within your six-month Medigap open enrollment period or you're eligible under a specific circumstance or guaranteed issue rights.
Still have questions? Head over to the Medicare Resource Center to learn more about enrolling in Medicare and finding the best plan for you.
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