Are You Taking Full Advantage of Your Medicare Plan?
Reading Time: 2 MinutesLast Updated: July 19, 2021
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:
- Health Maintenance Organization (HMO) Plans.
- Preferred Provider Organization (PPO) Plans.
- Private Fee-for-Service (PFFS) Plans.
- Special Needs Plans (SNPs).
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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Tags: Medicare
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Darlynda Bogle, Assistant Deputy Commissioner
Darlynda Bogle, Assistant Deputy Commissioner
Comments
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Jackie
Why is there no mention here of Medicare Supplements (Medigap plans) here? Those are a great option for people as well, at initial sign-up for Medicare.
Pamela S.
I am 64 yrs and 2 months old. When should I apply for medicare or will I automatically enrolled st 65 yrs?
V.V.
Hi Pamela, thank you for using our blog. 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. We hope this is helpful!
Pamela S.
I am getting my retirement social security benefits & I understand I will automatically enrolled ib Medicare parts A &B however how do I know the cost & is it taken out of my social security check?
V.V.
Hi Pamela, thank you for using our blog. Generally, individuals receiving Social Security benefits are automatically enrolled in Medicare Parts A and B. The Centers for Medicare & Medicaid Services manages Medicare. After you are enrolled they will send you a Welcome to Medicare packet in the mail with your Medicare card. You will also receive the Medicare & You handbook, with important information about your Medicare coverage choices. We hope this helps!
Ànn C.
Why Medicaid help some and some have to fight with have to pay for medicine and paying co-payment when going to the doctor.
V.V.
Hi Ann. If you currently have Medicare, you may want to apply for Extra Help with Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $5,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia. In addition to the Extra Help, you may be able to get help from your State with other Medicare costs under the Medicare Savings Programs. By completing the Extra Help application, you will start your application process for a Medicare Savings Program. We will send information to your State who will contact you to help you apply for a Medicare Savings Program unless you tell us not to when you complete the application.
If you need information about Medicare Savings Programs, Medicare Prescription Drug plans or how to enroll in a plan, call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. You also can request information about how to contact your State Health Insurance Counseling and Assistance Program (SHIP). The SHIP offers help with your Medicare questions. We hope this helps.
Keith
Greetings,
This past February my wife and I turned 65 and we started Medicare A & B, plus Medicare Supplement Standard policies with WPS. We will continue both policies in 2021. Also, do we need to take any action to continue Medicare parts A & B?
We did not sign up for D and will not again for 2021, but sign up for an approved plan via the state of Wis.
Regards,
Keith
V.V.
Hi Keith, thanks for using our blog. If you and your wife are enrolled in both Medicare Part A and Part B, it sounds like you’re all set with that. However, if you have any questions or need information about Medicare Savings Programs, Medicare Prescription Drug plans or how to enroll in a plan, call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. You also can request information about how to contact your State Health Insurance Counseling and Assistance Program (SHIP). The SHIP offers help with your Medicare questions. We hope this helps.
dmk@email.arizona.edu
can i sign up NOW to start to receive my standard SS retirement for age 67, which i will be of this age on December 15th.
V.V.
Hi there. Our system is set up to take applications four months in advance, and when you’re ready, you can apply for your retirement benefits online. If you need further assistance, call us at 1-800-772-1213 or you can contact your local Social Security office. Please look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.
James M.
Will Medicare pay for a “Shingles” shot?
V.V.
Hi James, thanks for using our blog. For information about what Medicare does and does not cover, please call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. Thanks!
Hector R.
Iam 62 on november 2020 will recive my payment, do i qualify for medical plan before 65
V.V.
Hi Hector, thanks for using our blog. Medicare is most commonly used by people age 65 or older. Some younger people are eligible for Medicare, too. Those include people with disabilities, permanent kidney failure and amyotrophic lateral sclerosis (Lou Gehrig’s disease). We hope this helps!
Henry L.
I have medicare and tricare for life. Does the tricare for life take care of the extra benefits?
V.V.
Hi Henry, thanks for using our blog. For information on Tricare, please visit the Tricare web page. Thanks!
Salena
Social Security has Deducted Medicare from all my monthly payments. Kept the money and then called to cancel Medicare for non payment. FACT lies in the paymemt history. Now I’m out of insurance.
Then once I start complaining I mysteriously receive a month refund. Still no Insurance. Help would be greatly appreciated
V.V.
For your security, Salena, we do not have access to private information in this venue. We ask that members in our Blog community work with our offices with specific questions. You can call us at 1-800-772-1213 for assistance or you can contact your local Social Security office. Please look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.
Akshita S.
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