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
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cheryl c.
I received a post card in the mail about getting 144.00 back from social security. Is this on the level?
V.V.
Hi Cheryl, thanks for using our blog to ask your question. If you have questions related to Medicare mailings, please call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. We hope this helps!
Laura W.
I am retired navy with tricare for lifestyles which does no longer cover dental costs or eye glasses. How can I benefet with an Advantage Plan
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carolyn
When is Medicaid going to recognize some non drug treatments such as acupuncture and chiropractors? I don’t want to take drugs!
Rosa
Nada me cubre yo vivo fuera de USA. Y aqui no tengo derecho a nada.
Rex K.
I am retired military with tricare for life which does not cover dental expenses or eye glasses. How can I benefet with an Advantage Plan
V.V.
Thank you for your service, Rex! If you are currently enrolled in Medicare Part A and Part B and have questions about Medicare Advantage Plans, please call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov or visit the TRICARE web page for more information.
Sheila M.
I don’t understand why it is that someone who’s disabled and has medicare part A and is about to turn 63 was told by the Social Security Office that they would have to wait until they turned 65 to get their part B medicare???? Could someone please help me with this matter? He is my common law husband and he decided he didn’t want part B when he got his medicare when he became disabled 4 yrs ago because he never goes to the doctor, other than the VA! Now he knows that he needs a REAL DOCTOR instead of the VA and he can’t get a supplement without having his part B! PLEASE help in this matter because he really needs his part B and the SSA doesn’t want to help, or they say that it’s the Medicare’s place to do that… They flip flop back and forth!
Thank you for any help you can give us in this matter.
Sincerely,
Sheila Mahoney
V.V.
Hi Sheila, thanks for using our blog. Enrolling in Medicare is your husband’s choice. However, because you can only sign up for Medicare Part B during designated enrollment periods, if you chose not to enroll when first eligible and later changed his mind, he may have to pay a late enrollment penalty. He qualifies for a new initial enrollment period without a penalty at age 65. We hope this helps!
Yvonne K.
I would like to know about the 144.00 i think its going to 148.00 taken out of my check. How do I apply low income to get back in check. y_kelso@aol.com….
V.V.
Hi Yvonne, thanks for using our blog. 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.
Nancy V.
Will my Medicare Part B premium increase in 2021? If so, how much?
V.V.
Hi Nancy, thanks for using our blog. Information about Medicare changes for 2021, when announced, will be available at http://www.medicare.gov.
Sharon
I’m 52 have Medicaid and receiving SSI can I get Medicare to help with doctor visits I have breast cancer and other pre conditions
V.V.
Hi Sharon, thanks for using our blog. Although Medicare is most commonly used by people age 65 or older, some younger people are eligible for Medicare, too. Those include people eligible for Social Security disability, permanent kidney failure and amyotrophic lateral sclerosis (Lou Gehrig’s disease). Check out our Frequently Asked Questions web page for additional details. We hope this is helpful!
Charles H.
I would like to know if I qualify for the Medicare Advantage plan. I’m 71 years old and receive a pension and Social security And would like to know the cost Or if its the right plan for me
V.V.
Hi Charles, thanks for using our blog. If you need information about Medicare Savings Programs, Medicare Advantage Plans, 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.