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What You Need To Know
Medicare is a federal program that provides individuals 65 years or older healthcare coverage. Original Medicare coverage is broken into two parts—Part A and Part B—and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays while Part B covers outpatient or medical care.
Together, Part A and B cover about 80% of the typical healthcare costs seniors face. Leaving a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend coverage, lessen costs, and ultimately give beneficiaries peace of mind at all times.
How does this fit with other coverage:
Medicare Supplement (Medigap) plans work alongside your Original Medicare plan to help fill coverage gaps, such as traveling abroad and deductibles. Because it is used with your national Medicare coverage, it is also accepted at any hospital that accepts Original Medicare.
Medicare Supplement plans offer the advantage of flexibility; unlike some other senior healthcare options, you have the freedom to enroll in or change your Medicare Supplement policy at any time throughout the year. And because Medicare Supplement policies are guaranteed renewable, you cannot lose coverage if you develop a health condition or concern—meaning you’re protected year over year, no matter what.
Medicare Advantage could save you money:
Medicare Advantage plans provide at least the same benefits as Medicare Part A and Part B. Still, they may offer additional benefits that they do not, such as Prescription drug coverage, Dental coverage, Vision coverage, Wellness programs. It would help if you enrolled in Medicare Part A and Part B before enrolling in Medicare Advantage. You must live in the plan’s service area, and you generally may not have End-Stage Renal Disease (ESRD).
When to sign up for Medicare:
Most people can sign up for Medicare three months before their 65th birthday. Once you become eligible to sign up for Medicare, you have seven months (known as your Initial Enrollment Period) to enroll. If you fail to enroll in Medicare during your Initial Enrollment Period, you could end up paying more for your healthcare, unless you qualify for special enrollment.
If you’re new to Medicare:
If you’re new to Medicare and would like to enroll in a Medicare Advantage plan, you can do so anytime during your Medicare Initial Enrollment Period. Your Initial Enrollment Period begins three months before your 65th birthday includes your birthday month, and ends three months after your 65th birthday.
If you do not enroll in a Medicare Advantage plan during your initial enrollment period, you will have another chance to enroll during the Medicare Fall Open Enrollment Period, which runs from October 15 to December 7 each year.
Unlike Original Medicare, which the federal government manages, Medicare Advantage is managed by private insurers who have control over the plans they offer and how much they charge for them. Even if you enroll in Medicare Advantage, you will still have to pay a monthly Part B premium. If your Medicare Advantage plan has a premium, you are responsible for paying it on top of your Medicare Part B premium. The insurance company determines your out-of-pocket costs, including deductibles, copayment, and coinsurance, so specific out-of-pocket amounts will vary from plan to plan.
Once you’re enrolled in Original Medicare or if you have questions on that process, a licensed insurance agent at our office can help you compare Medicare Advantage plans and get you enrolled in one that works for you. Speak with a licensed agent at (208) 818-2523 to learn more about your options and enroll in a plan today.