Medicare

Are You Taking Full Advantage of Your Medicare Plan?

October 15, 2020 • By

Medicare is our country’s health insurance program for people age 65 or older, and for younger people receiving Social Security disability benefits. It helps with the cost of health care, but doesn’t cover all medical expenses or the cost of most long-term care.

You have choices for Medicare:

  • Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
  • Medicare Advantage (also known as Part C).
  • Medicare Part D (prescription drug coverage).

If you have Original Medicare, the government pays for Medicare benefits when you get them. You can add prescription drug coverage to help pay for costs that Original Medicare doesn’t cover.

Medicare Advantage Plans are offered by private companies approved by Medicare. These “all in one” alternatives to Original Medicare include Part A, Part B, and usually Part D (prescription drug coverage). Medicare Advantage Plans may have lower out-of-pocket costs than Original Medicare. They may also offer extra benefits that Original Medicare doesn’t cover — like vision, hearing, dental, and more.

How you qualify

You can enroll in a Medicare Advantage Plan, if you have Part A and Part B and reside in the plan’s service area. Please be aware there are some restrictions if you have End-Stage Renal Disease. The most common types of plans are:

Before you join a Medicare Advantage Plan:

  • Find and compare Medicare health plans in your area using Medicare’s Plan Finder.
  • Visit the plan’s website to see if you can join online.
  • You can also call Medicare at 1-800-MEDICARE (1-800-633-4227). When you call, please have your Medicare number and the date your Part A or Part B coverage started. You can find this information on your Medicare card.

When can I join, switch, or un-enroll in a Medicare Advantage Plan?

  • Initial Enrollment Period. When you first become eligible for Medicare, you can join a Medicare Advantage Plan during your Initial Enrollment Period.
  • General Enrollment Period. If you have Part A coverage and you get Part B for the first time during the General Enrollment Period, you can also join a Medicare Advantage Plan at that time. Your coverage may not start until July 1.
  • Open Enrollment Period. From October 15 – December 7 you can join, switch, or un-enroll in a Medicare Advantage Plan. Your coverage will begin on January 1 (as long as the plan gets your request by December 7).

You can learn more about Medicare, including how to apply for Medicare and get a replacement Medicare card, by reading our publication Medicare. You can also visit our website.


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About the Author

Darlynda Bogle, Assistant Deputy Commissioner

Darlynda Bogle, Assistant Deputy Commissioner

Darlynda Bogle, Assistant Deputy Commissioner

Comments

Please review our Comment Policy before leaving a comment.

  1. Rahul

    Nice blog post, very informative and thanks for upload this.

    Blogger at https://techgfworld.com/

    Reply
  2. Tin

    Does Medicare have a “special event” clause such as divorce? I’ll have Medicare in April 2021. And at the same time, I’ll be getting divorced. Thank you, Tin

    Reply
    • Vonda

      Hi Tina, thanks for using our blog to ask your question. Generally, individuals receiving Social Security benefits are automatically enrolled in Medicare Parts A and B. If you are at least 64 years and 9 months old and aren’t receiving Social Security benefits, you can apply for Medicare A and B online.

      For details on who can get Medicare, check out our Medicare brochure for the details.

      Reply
  3. Janice Porter

    MUST I have Medicare Insurance deducted from my monthly social security check? I don’t have medical issues, never been to a hospital or doctor other than to have my babies, and I don’t take meds. I have always been very healthy. Can I decide whether or not I want this deducted? Isn’t this like “Socialized Medicine” in a way?

    Reply
    • Keith

      Hi, Janice. Thanks for using our blog. If you are receiving Social Security retirement benefits, you will be automatically enrolled in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B) at age 65. However, you may refuse Medicare Part B, during your Initial Enrollment Period, if you or your spouse, actively work and have coverage under a group health plan, based on that employment. Check out our Frequently Asked Questions web page for details on how to refuse Medicare Part B. We always suggest that individuals speak to their personnel office, health benefits advisor, or health plan representative to see what’s best for them, and to prevent any penalties or delayed enrollment in the future. For more information, visit here. We hope this helps!

      Reply
  4. Alvin clinton

    How do i get a TPQY form

    Reply
  5. Gary Buck

    will medicare help with cost of caregiver or a hospital bed and patient hoist

    Reply

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