Medicare has multiple special enrollment times for different people and different situations and you have to be aware when your time has come. If you or your spouse was working AND had group health coverage through a current employer or union or you are disabled and working, or you have coverage from a family member there are special enrollment rules. There are a few situations where the special enrollment period applies.
If you are still covered by an employer or union group health plan or through your spouse’s employer you can enroll in the special enrollment period. Or, if you are in the 8 months following the month when the employer or union group health plan coverage ended or when the employment ends. This may be confusing, but a Medicare specialist at your state insurance office should be able to provide guidance.
Medicare enrollment is a very confusing and intense time for many people because the decision is so important to your well being. The choices that you make in Medicare enrollment will affect the rest of your life, for the year you are enrolled, because you will have certain benefits available to you or not available to you based on your choices. So, then when will your Medicare benefits begin in your life?
Here is the exact definition of when your Medicare enrollment begins if you already receive social security benefits:
“If you already get benefits from Social Security or the Railroad Retirement Board, you are automatically entitled to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) starting the first day of the month you turn age 65. You will not need to do anything to enroll. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If your 65th birthday is February 20, 2010, your Medicare effective date would be February 1, 2010. (Note: if your birthday is on the 1st day of any month, Medicare Part A and Part B will be effective the 1st day of the prior month. For example, if your 65th birthday is February 1, 2010, your Medicare effective date would be January 1, 2010.)”
There are other extenuating circumstances where your Medicare enrollment may be even earlier, for more just continue reading this website.
Your Medicare enrollment is by far the most important time of your health care during your lifespan as an eligible member of Medicare. With Medicare enrollment you make the choices that will affect your health for the next year or more and you don’t want to make the wrong choices. Below you will find a couple of important things to remember when it is time for your Medicare enrollment to begin.
Those who are looking to enroll in Medicare Part B may be very confused by the fact that there are very specific enrollment dates that must be followed to enroll in the benefits. If this confusion has caused you to miss the initial time period to enroll in Medicare Part B you don’t need to worry because it is possible to enroll in the coverage. However, you may be forced to pay a penalty for being late on your enrollment.
The “General Enrollment” period for Medicare Part B is from January 1st to March 31st every year and those who enroll during this time will have to pay a penalty. Enrolling in Medicare Part B at this time will allow you to start using the benefits of the coverage on July 1st of the same year.
The rules for “Special Enrollment” for Medicare Part B are quite complicated so who better than Medicare to explain it to you directly.
“If you wait to sign up for Part B because you or your spouse is currently working, and you are covered by a group health plan based on that work, or if you are disabled and you or a family member is working, and you are covered by a group health plan based on that work. You can sign up for Part B anytime while you have group health plan coverage based on current employment or during the 8-month period that begins the month after the employment ends, or the group health plan coverage ends, whichever happens first. If you have COBRA coverage, you must enroll during the 8 month period that begins the month after the employment ends. This Special Enrollment Period doesn’t apply to people with End?Stage Renal Disease (ESRD).”
Many people are unsure how to go about the Medicare enrollment process due to the fact that there are so many different choices and plans to possibly enroll in. While there are multiple options available to you during Medicare enrollment it is relatively easy to decipher which is best for you. However, if you cannot make the decision and don’t choose which way to go during Medicare enrollment your mind will be made up for you.
If you don’t enroll in a plan during Medicare enrollment you will automatically be enrolled in “Original” Medicare. Here is what you should know about original Medicare:
Because of both the confusing nature of Medicare itself and the impact that the right insurance coverage can have on your life Medicare enrollment is a big deal. Since Medicare enrollment is such a big deal it is worth it to you to study hard to keep from making decisions that will negatively affect you and/or your family.
Here are a few things to consider when going through Medicare Enrollment:
What You Need Covered: If you are already suffering from some lingering ailments it is worth it to you to make sure that you have the right coverage on your Medicare policy.
Other Coverage: If you intend on supplementing your Medicare policy with other coverage from another insurer then be sure to speak about this with your insurer before going through Medicare enrollment.
How Much Can You Afford: Like any other insurance policy it is very important that you consider how much your premiums and deductibles will be when going through Medicare enrollment to make sure you can afford your coverage.
Are You On Prescription Drugs? If you need a constant supply of prescription drugs then you need to look into getting the coverage on your Medicare policy when going through Medicare enrollment.
Is Your Doctor Covered? It is all well and good to have the coverage you think you need, but if you can’t go to the doctor you trust then you failed in your Medicare enrollment.
As it is with all insurance plans regardless of who they are offered by, it is important to review every year what has changed with the plan that you are on. With Medicare enrollment in full swing it is time to review each part of the plan and one that is drawing much attention is Medicare Part D.
For those who don’t know, Medicare Part D is the part of Medicare that deals with prescription drugs, offering a chance that otherwise may not be available to help pay for drugs. In 2009 the plans start at around $31.94 and are attached to a yearly deductible that will be $310 for 2010.
According to the Henry J. Kaiser Foundation, the premiums for Medicare Part D will rise about 11% in 2010 which will put them at roughly 50% higher than they were in 2006. Considering that 2006 was the first year that Medicare Part D was offered the reasons for considering where you stand with your Medicare enrollment becomes abundantly clear.
The experts say that Medicare enrollment for 2010 will list roughly 1,576 options to those who are eligible. Region-by-region Medicare enrollment will give between 41 and 55 different options to those who qualify and will be enrolling. All the more reason to really look into what appeals to you and your situation.
A Medigap Policy is insurance created to supplement your Original Medicare Plan. It helps to cover some limitations of the plan’s coverage.
Policies will, of course, vary by available plans, coverage, and price. Therefore, before enrolling, make sure you spend time researching the plans and providers available to you, and choose the one that best fits your needs and budget. After you’ve selected the plan and company you are going with, it’s time to apply.
To apply, contact the company directly. They are required to provide you with a coherent summary of your policy, so spend some time reading it and ensuring that you understand it. If you don’t, feel free to ask as many questions as you need to ask. Never sign anything without knowing exactly what you are agreeing to. Once you’ve read the summary and are certain you understand it, fill out the application fully. Be as truthful and thorough as possible. If someone else fills your form out for you, go over it and make sure it is completely correct.
After applying, your policy will usually start the first month after you apply. You can request a specific start date if you like as well. If you don’t get your policy within 30 days you should definitely call the insurance company, and if you still haven’t gotten in within 60 days, you should call the State Insurance Department in your area.
When you pay for your Medigap policy, you can use a bank draft, a check, or a money order. Don’t make your payment out to the agent who was helping you with your enrollment. Rather, make it out directly to the company providing you with your coverage.
Many Medicare beneficiaries choose to enroll in Medicare Part D in order to meet medication needs. Part D is especially important for people who require significant prescription medication. It can help reduce your out-of-pocket costs and make necessary drugs more accessible and affordable.
If you have the Original Medicare Plan, you may choose to enroll in a prescription drug plan to add coverage. You can also enroll to add coverage to certain Medicare Private Fee-for-Service Plans, certain Medicare Medical Savings Account Plans, and certain Medicare Cost Plans. Another way to gain Prescription drug coverage is to choose a Medicare Advantage Plan that includes this drug coverage.
When you enroll in a drug plan, you will usually pay considerably less for your prescriptions, although you will sometimes be required to cover copayments, coinsurance, or deductibles. The overall cost of your plan will depend on a number of factors, such as whether or not you are eligible for extra help, if you are willing to forgo brand-name drugs, what type of drugs you require, the quantity of medication you need, what your plan coverage gap is, and, ultimately, what prescription drug plan or provider you choose.
To enroll in a prescription drug plan, you may want to call the plan directly. That way, you can ask them any pertinent questions you may have about the plan you’ve chosen. You can also call Medicare for assistance, at 1-800-633-4227.
Your Medicare Part D is the component of your plan that will provide you with your prescription drug coverage. It is an essential element of many people’s health care, and if you have medication needs – or think you may in the future – it is strongly advised that you sign up as soon as you become eligible.
If you fail to sign up during your initial enrollment period, and if you don’t have prescription drug coverage for 63 days or more, you will likely be responsible for a permanent late-enrollment penalty when you later join. The late-enrollment penalty changes each year, and will be charged to you for the duration of your drug coverage.
To figure out roughly how much your penalty will be, take 1% of the “national base beneficiary premium” and multiply it by the number of the full months you didn’t join when you were eligible. The amount will be added to your drug plan monthly premium.
If you didn’t sign up for a Medicare Prescription Drug Plan when you were first eligible and you’d like help figuring out what your late-enrollment penalty will be, there are some sources available to you. You can call 1-800-MEDICARE for help, or contact your State Health Insurance Assistance Program.
If you are considering enrolling in a Medicare Advantage Plan, you need to meet a few specific requirements in order to be eligible to join. You need to have Part A and Part B – Hospital and Medical Insurance. You also need to live in the plan’s service area. You usually can’t have End-Stage Renal Disease, and it must be within the plan’s enrolment period.
In many cases, you will need to pay your Part B premium in addition to your Medicare Advantage Plan premium. It’s also essential that you follow your plan’s specific rules and are aware of necessary out-of-pocket costs, like deductibles and copayments.
Sometimes, depending on the plan or company you choose, you might be required to use specific health care providers, belonging to the plan’s network – or be charged a higher fee if you don’t. If you enroll in an Advantage Plan, you won’t be able to buy a Medigap policy – and you won’t really need one, either.
When you join a Medicare Advantage Plan, you are, of course, still in the Medicare Program. Advantage Plans, although run by private insurance plans, still follow Medicare rules, are approved by Medicare, and receive funding from Medicare. They are not even considered supplemental insurance plans – they are a part of Medicare. Consequently, when enrolled in a Medicare Advantage Plan, you have Medicare rights and protection, including privacy rights and the right to appeal. You also will still receive Medicare Parts A and B, and can usually get prescription drug coverage through your Medicare Advantage Plan. It is important to note that you can’t join a Medicare Prescription Drug Plan with most Medicare Advantage Plans unless you cancel your Medicare Advantage Plan and sign up instead for Original Medicare. Signing up for a Medicare Advantage Plan also often affords you other optional benefits, such as dental or vision.
To enrol in a Medicare Advantage Plan, fill out an application, call the plan, or visit them online.
If you are eligible for automatic enrollment in Medicare Part A, you will start getting it the first day of the month you turn 65, or, if you are disabled and under 65, after you have been receiving disability benefits from Social Security or Railroad Retirement Board for 24 months. If you are not eligible for automatic enrollment, you should sign up when you’re close to 65. However, if you miss your initial enrollment period, there are some other times when you may be able to enroll.
Starting January 1st and running until March 31st each year, the General Enrollment Period is the next best thing. When you sign up during the General Enrollment Period, your coverage will start on July 1st. The drawback for waiting until the General Enrollment Period, of course, is that you may be responsible for paying a late-enrollment penalty. Unfortunately, you might need to pay the late-enrollment penalty for as long as you have the plan.
Another time you might be able to enroll is during a Special Enrollment Period. You may be eligible for a Special Enrollment Period if your or your spouse have a group health plan based on your current work. You can then sign up for Part B at any point during your workplace coverage or in the eight-month period that starts when the employment (or group health plan coverage) ends. Finally, if you didn’t enroll in Medicare Part B during your initial enrollment period because you were volunteering in a foreign country and already had health insurance for that reason, you may qualify for a Special Enrollment Period For International Volunteers. Usually, when you are enrolling during a Special Enrollment Period, you won’t need to worry about a late-enrollment penalty.
While there are, then, ways for you to enroll in Medicare Part B outside of your initial enrollment period, the optimal time is, of course, when you are first eligible.
In the past, Social Security benefits began at 65. Currently, however, your full retirement age depends on the year you were born. A question this raises for many of us is – “how will this affect my Medicare coverage?”
The changes to the age of Social Security retirement benefits took place in 2003. Now, your retirement benefits begin at age 65 only if the date of your birth is 1937 or earlier. If you were born after 1937, your full retirement age will vary according to the year you were born. For instance, if you were born between 1938 and 1959, your retirement age (for full benefits) ranges from age 65 and 2 months to age 66 and ten months. If you were born in 1960 or later, your full retirement age is 67.
Does this mean, then, that if you were born after 1937, you can’t retire at 65 with benefits? Of course not! But if you do retire before your full retirement age (after age 62) and begin to receive your Social Security benefits, your benefits will be reduced.
Fortunately, even with the changes to full retirement age and Social Security, the Medicare eligibility age has not changed. If you have paid into Medicare for the required amount of time (ten years or more), you are eligible for Medicare benefits when you turn 65. To enroll, the ideal time to contact Social Security is three months before your birthday month to three months after. The earlier you sign up, the sooner your Medicare Coverage can begin.
To enroll in Medicare or to find out your full retirement age, contact Social Security at 1-800- 772-1213
Medicare Part A is the component of a Medicare Plan that deals with your Hospital Insurance. It helps to cover your inpatient care, skilled nursing facility care, hospice care, and some home health care. Most people enrolled in Medicare Part A don’t pay premiums for this insurance.
Depending on what circumstances surround your enrollment, how you sign up for Medicare Part A will vary. For the majority of people, enrollment is automatic.
One of the most common situations in which automatic enrollment takes place is if you are currently receiving retirement benefits from Social Security or the Railroad Retirement Board. In such cases, enrollment will begin at the start of your 65th birthday month. Your Medicare card will be mailed out approximately three months before, and will indicate the coverage start date.
Another situation in which you will be automatically enrolled in Medicare Part A is if you are under 65 and disabled, and are receiving disability benefits from Social Security or the Railroad Retirement Board, and have been for 24 months. Approximately three months before your 25th month of disability benefits, you will be mailed your Medicare card. In the case of ALS, the process is much faster; you will receive Medicare Part A the first month of your disability benefits.
There are situations, of course, in which enrollment in Medicare Part A is not automatic, like if you haven’t yet filed for Social Security or Railroad Retirement benefits and are nearing 65. You will also need to apply if you have ESRD, and may apply upon diagnosis. To enroll, call Social Security Administration at 1-800-325-0778.
Look at your personal situation and decide whether or not you qualify for automatic enrollment, or if you will need to take steps to sign up. Be proactive. After all, your health matters!
Medicare Part B is an important component in your health care coverage. It is your Medical Insurance, and helps to cover things like doctor’s services, outpatient services and supplies, some physical or occupational therapy, some home health care, diagnostic tests, durable medical equipment, and various other medically necessary services and supplies.
Depending on what the circumstances surrounding your enrollment are, how you enroll in Medicare Part B will vary. For example, if you are already getting benefits from Social Security or the Railroad Retirement Board, you are automatically enrolled in Medicare Part B the first day of your 65th birthday month. Approximately three months before you turn 65, your Medicare card should come in the mail. If you don’t want Medicare Part B, you can, at this time, choose not to accept coverage. There will be instructions on your Medicare Card, detailing how to opt out.
Another situation in which you can be enrolled in Medicare Part B is if you are under 65 and disabled. In most cases, you will be automatically enrolled after 24 months of receiving disability benefits from Social Security or the Railroad Retirement Board. You should get your Medicare card around three months prior to your 25th month of disability benefits. However, if you have ALS, you will be enrolled in Medicare Part B the first month of your disability benefits.
A third situation in which you can enroll in Medicare Part B is if you have End-Stage Renal Disease. In this case, you can apply at the same time as you apply for Medicare Part A. Your Part B coverage will begin, in most cases, the fourth month of dialysis treatment or the first month of a kidney transplant.
Finally, if you’re nearing 65 and you don’t get Social Security or Railroad Retirement benefits yet, you can enroll in Medicare Part B when you sign up for Medicare Part A or when you apply for retirement benefits. If you don’t want Medicare Part A and if you’re not eligible to receive it without paying a premium, it is also possible to enroll in only Medicare Part B.
If your situation doesn’t allow you to receive automatic enrollment in Medicare Part B and you want to sign up, contact the Social Security Administration at 1-800-772-1213.
If you are receiving Social Security benefits, a Medicare enrollment package will be mailed to you three months before you turn 65. In addition, Social Security will automatically enroll you in Medicare Part A (which is premium free), and Part B. If you choose not to enroll in Medicare Part B, you will need to opt out.
However, not everybody is eligible for Social Security benefits at 65. In fact, some people will not be eligible until they are 67. For these people, enrollment in Medicare is not automatic.
If you will not be receiving Social Security retirement benefits when you are 65 years old, you will need to contact Social Security to sign up for Medicare. It’s important to do this as soon as possible, so you don’t miss your initial enrollment period.
The earliest you can sign up for Part A is three months before you turn 65. For up to six months after, coverage can retroactively begin at age 65.
Your initial Part B enrollment period extends from three months before to three months after your 65th birthday. It’s definitely a good idea to enroll in Part B as soon as possible, to avoid delayed coverage. If you don’t enroll until you turn 65, your coverage will begin the next month. If you enroll the month after your birthday, your coverage will begin two months later. If you enroll in the last two months of your initial enrollment period, your coverage will begin three months after. If you don’t sign up for Part B during your initial enrollment period (unless you or your spouse are still working), your coverage will be further delayed, and you likely will need to pay a penalty for your Part B premium.
Signing up for Part D, Prescription Drug Coverage, works much the same way. Your initial enrollment period is three months before until three months after you turn 65, and late enrollment often results in a premium penalty.
If you don’t expect to receive Social Security benefits by age 65, contact Social Security to apply for Medicare, at 1-800-772-1213
Most people know that Medicare is health insurance designed for people 65 and over, or under 65 with certain disabilities. What a number of people don’t realize is that Medicare also covers individuals at any age who have End-Stage Renal disease, or ESRD (permanent kidney failure requiring dialysis or a kidney transplant).
In order to receive Medicare coverage for ESRD, if you need regular dialysis or have had a kidney transplant, you must be enrolled in Medicare Parts A and B. To be eligible to receive Medicare Part A, you or your spouse (or your parent, if you are a dependent child) need to have worked the required time under Social Security, the Railroad Retirement Board, or as a government employee, or you need to be getting or eligible for Social Security, Office of Personnel Management, or Railroad Retirement benefits. You are eligible for Part B if you get Part A.
To enroll in Medicare due to ESRD, visit your local Social Security office or call them at 1-800-772-1213. Remember, you must sign up for Medicare Parts A and B in order to receive ESRD coverage. It’s a good idea to apply for Part B at the same time as Part A to avoid any late penalties.
If you qualify for Medicare and have limited resources, you may also qualify for the low-income subsidy available to people who need extra help. This subsidy is intended to help individuals pay for their Medicare drug plan’s monthly premium, yearly deductible, and coinsurance/copayments. It can also limit any coverage gaps.
To qualify for extra help, you need to have limited income and limited resources available to you. This year, you might qualify if you alone make below $15,315 and have resources under $11,710. If you are married and living with your spouse (with no other dependents), you must make below $20,353 per year and have resources under $23,410.
A number of people automatically qualify for this extra help. For instance, if you have full Medicaid benefits, are receiving help from your State Medicaid program, or are receiving SSI without Medicaid, you will most likely automatically qualify for the low-income subsidy. If you do, you will receive a letter from Medicare to inform you of your status. After qualifying, you need to choose a Medicare drug plan in order to reap the benefits of your extra help. Research your available plans and select one that covers the medication you require. If you don’t select a plan, Medicare will select one for you.
Even if you don’t automatically qualify for extra help, you may be able qualify by applying. To apply, contact Social Security at 1-800-772-1213 or visit them online at www.socialsecurity.gov.
Depending on the plan you choose and the type of care you require, the costs involved in your Medicare Part B coverage can vary significantly. However, there are a few general cost categories to consider when planning for your expenses.
One of the first things to keep in mind are the premiums you will be required to pay. While Part A in the Original Medicare doesn’t typically require a montly premium, Part B does. This year, the standard premium is $96.40, although it may be higher if you make more than $82,000 per year individually or $164,000 together with your spouse. Your premium may also be 10% higher if you did not enroll in Part B when you were first eligible. In order to collect Part B benefits, you will usually also need to pay a yearly deductible before receiving any coverage. This year, the deductible is $135.
The care you require will also have an effect on your costs. Some services are denoted as “no cost” services; these are free for you. For many other services, you need to pay a coinsurance. Usually, this coinsurance is 20% of the approved Medicare amount. Sometimes, you may be required to pay a copayment, which is a set fee for a service, such as a doctor’s visit.
If you qualify for extra help, your costs may be much lower. Research your options carefully, and don’t hesitate to ask your State Health Insurance Assistance Program for help.
Medicare Part B refers to the component of Medicare that covers your medical insurance. It consists of medically-necessary services not included in your hospital insurance (Part A), like doctor’s services, outpatient care, and some preventive services. Enrolling in Part B is an important aspect of maintaining continued health and ensuring adequate coverage for a number of your health needs.
Unlike Medicare Part A, however, Part B will cost most beneficiaries a monthly premium, as well as the annual deductible. In addition to these fees, if you don’t sign up for Medicare Part B when you are first eligible, you may be required to pay a late enrollment penalty, depending on the circumstances surrounding your delayed enrollment. The late penalty is typically 10% for each year you could have been enrolled, and can be required as long as you are enrolled in Part B.
The best time to sign up for Medicare Part B is, like most parts of a Medicare plan, when you’re first eligible. If you are receiving Social Security or RRB benefits, you will automatically be enrolled the month you turn 65. If you choose not to receive Part B, you can opt out. If you don’t qualify for automatic enrollment and want to receive Part B, you will need to sign up when you are nearing your 65th birthday.
If you previously chose not to sign up (or decided to opt out) but now think you may like to enroll, you will need to take advantage of the general enrollment period. This period is from January 1 to March 31 of each year, and coverage begins on July 1. Keep in mind, however, that even if you enroll during this period, you may have to pay the late enrollment fee, unless you qualify for a special enrollment period.
In order to be exempt from this late enrollment penalty, you must qualify for the special enrollment period. If you or your spouse have a group health plan through work, you can sign up for Part B any time during that employment plan or eight months after the month the employment – or the group health plan coverage – ends. You also qualify if you didn’t enroll during your initial eligibility due to health insurance you had when volunteering in a foreign country. In most cases, if you do qualify for a special enrollment period, you will not have to pay your late enrollment penalty.
The easiest way to receive complete coverage through Medicare is to sign up as soon as you can. For more information, visit www.medicare.gov, or call Social Security at 1-800-662-1213.
Although enrolling in a Medicare prescription drug plan will ultimately save you money, there are some costs involved that you should consider before choosing your plan. Various plans will, of course, charge different amounts depending on the type of coverage you require, but all plans have similar expense categories to consider.
A monthly fee, called a premium, is charged by most drug plans. The specific amount fluctuates according to the plan you choose and does not include premiums paid for Part B of your Medicare. Some drug plans, however, do not charge a premium.
A deductible, charged yearly, is what you yourself will need to pay before your drug plan covers your medications. While some plans don’t have deductibles, the ones that do vary, depending on the plan and the medications required.
A copayment or coinsurance is what you are charged for your prescriptions on top of the deductible, paid partly by you and partly by your plan. Sometimes, your premium covers this cost, up to a specific amount.
Finally, be aware of coverage gaps, when you will be required to pay for your own costs after your plan has used the required amount for covered medication. Even when you cover your own costs, you will need to pay your plan’s monthly premium. Many plans do offer coverage while in the coverage gap, but they might charge higher premiums or limit the brand or type of drugs available to you. Catastrophic coverage can also be used if your drug costs are exceedingly high. After you’ve paid no more than a specified amount for covered drugs within a year, you will only be charged a coinsurance or copayment for you’re the rest of those prescriptions.
To avoid additional costs, apply for your drug coverage when you are first eligible. If you wait, you may be charged a permanent late-enrollment penalty when you join. Contact your intended prescription drug plan for more information.
Once you’ve decided to sign up for a Medicare prescription drug plan, you can begin to look at enrolling. Luckily, it doesn’t need to be complicated. By following a few simple steps, you can successfully enroll in the prescription drug plan that’s right for you.
The first thing you want to do, of course, is to choose a drug plan that best suits your lifestyle. Are you attached to a particular brand or would you be content using generic brands? Do you prefer low deductibles or lower copayments? Will you need additional coverage for expensive medication? Consider your costs and needs, research your choices, and make an informed decision. If you need additional information or help deciding on a plan, you can contact your State Health Insurance Assistance Program. They will be able to assist you in making a decision, free of charge. You can also call Medicare for help, at 1-800-633-4227 or visit them online at www.medicare.gov.
After you’ve chosen a plan, you will be able to enroll between November 15 and December 31 of each year. You can also join a Medicare drug plan when you first become eligible for Medicare or any time you qualify for extra help. It’s a good idea to sign up as soon as possible to avoid a late enrollment penalty. You may also be able to receive a lower monthly premium.
There are a number of ways to enroll. If you are comfortable using the Internet, you may be able to enroll online using the drug plan company’s website or, depending on the plan, Medicare’s website, at www.medicare.gov. Requesting an application from your chosen Medicare drug plan will allow you to enroll by mail or fax. You can also call your chosen drug plan or Medicare at 1-800-633-4227.
In order to finalize your decision, you will need to have some specific pieces of personal information ready, like your name, birth date, and address. You will also need to provide information from your Medicare card. You may also be asked to provide your social security number, email address, and emergency contact information, but this information isn’t usually required. After signing up and being approved, you will be sent your information and you can begin to reap the benefits from your chosen prescription drug plan.
Medicare is federally run health insurance. It is specifically designed for individuals who are at least 65 years old, as well as people who have End-Stage Renal Disease or who are under 65 with certain disabilities.
Medicare generally has 4 elements: Part A , which represents your hospital insurance, Part B, your medical insurance, Part D, prescription drug coverage plans, and Part C, Medicare Advantage Plans. Part C, of course, can include Parts A, B, and D.
If you’ve been paying into Medicare while working, you are likely eligible to be automatically enrolled in Parts A and B at age 65. In most cases, if you are automatically enrolled in Part A, you don’t need to pay a premium. Part B, however, usually does require a standard, monthly fee.
If you require prescription medication, or think you may in the future, the best time to sign up for Part D is when you are first eligible; three months before to three months after you turn 65. If you wait, you may be required pay a late enrollment penalty. Because there are a number of options in prescription drug plans, consider the available coverage and potential costs of each.
Finally, you’ll need to decide whether you want the Original Medicare Plan or a Medicare Advantage Plan, such as an HMO or PPO. Many Medicare Advantage Plans may charge extra fees but cover a number of additional benefits, such as vision and dental.
By understanding the four parts involved in Medicare, you can ensure you have the coverage you require. Your Medicare plan, through careful, informed decision making, can help you meet your healthcare needs, both now and in the future.
Medicare, the federally run health insurance exclusively for people age 65 or older, as well as people with permanent kidney failure or who are under 65 with certain disabilities, can help provide you with affordable health care both in and out of hospital. It can, if you choose, include medical insurance, hospital insurance, prescription drug coverage and, in some cases, other services such as dental and vision. The coverage you receive all depends on the choices you make when selecting your plan.
There are primarily three categories of health plans for you to consider when choosing your Medicare: Original Medicare plans, Medicare Advantage plans, and other Medicare plans. Within each category, you can select various options to further help you to customize your coverage.
In the Original Medicare Plan, you are able to receive hospital insurance and medical insurance, as well as join a prescription drug plan. You can also buy a Medical Supplement Insurance, or Megagap, policy, in order to cover some of the areas your hospital and medical insurance may miss. You will automatically be enrolled in the Original Medicare Plan, receiving hospital and medical insurance, if you receive benefits from Social Security or the RRB. You can then choose to purchase the additional coverage. While you will likely need to pay a premium for your medical insurance, a premium for the hospital insurance is not usually necessary.
In Medicare Advantage Plans, such as HMOs, you can select a privately run (Medicare approved) health plan. Like the Original Medicare Plan, these health plans cover hospital and medical insurance and provide the option of prescription drug coverage. They also offer additional coverage for services like vision and dental. They can, however, charge copayments, coinsurance, and deductibles for all parts of your coverage. Moreover, they may limit the doctors and hospitals available to you in your plan.
Other Medicare health plans are available in specific areas of the country and work in a way comparable to Medicare Advantage Plans. They include Medicare Cost Plans, demonstrations and pilot programs, and PACE. Each type of plan has a specific set of rules and, in some cases, certain stipulations for joining, so if you think you might be interested in one of these other Medicare health plans, you should contact the ones you are considering to find out more, or visit www.medicare.gov.
It’s surprising how many people who have Medicare decide not to sign up for the prescription drug coverage available to them when first eligible, making it necessary to, when they later change their minds, pay penalties for late enrollment.
Under normal circumstances, you can only join a Medicare drug plan during specific time frames. The logical time to sign up, even when it seems you may not need it, is when you first become eligible for Medicare; three months prior to turning 65 and three months immediately after. Personal health situations and thought processes change so quickly that planning ahead simply makes the most sense!
You can also apply for coverage between November 15th and December 31st each year, your coverage then beginning on January 1st. If you are receiving Medicare because of a disability, you can sign up for drug coverage three months before to three months after your 25th month of cash disability payments. Some situations, however, allow you to join a prescription drug program at other times, like if you qualify for extra help, move out of your service area, or live in an institution.
Of course, not all plans cover all medications. It’s essential that, if you do decide to sign up for coverage with Medicare, you research the various plans in order to select the one that best meets your needs.