Medicare

Are You Taking Full Advantage of Your Medicare Plan?

October 15, 2020 • By

Reading Time: 2 Minutes

Last 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:

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

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Comments

  1. Ken M.

    I am inquiring to help out a neighbor for whom English is a second language. She has recently had a severe knee injury, and it is expected to take three or more months to heal. It is not yet clear whether there will be other treatment options to address the injury. Ive seen basic eligibility information such as number of earned quarters of work and tax payments, but my question is: If her knee injury is not likely to be permanent and could reasonably be expected to heal within a time period of less than a year, would she be eligible for SSI benefits. I understand that each case is unique I am asking solely for practical guidance about whether to apply. Happy to have this service available.

  2. Charlie T.

    How do I see if I qualify for reduced part b payments?

    • Vonda

      Hi Charlie, 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.

  3. janice c.

    My husband and I are covered under a grandfather clause that covers us with no cost. My husband is retired military after 28 years. We cannot at anytime use Medicare as a source of payment of health related charges. We do still pay for Part B even though we will never use it. Is there something we are missing? we are now paying $288.00 a month for a coverage we may not use.

  4. John W.

    Is there any Dental coverage ? Thanks.

    • Vonda

      Hi John, thanks for using our blog. If you need information about Medicare Savings Programs, Medicare Advantage Plans, Medicare Prescription Drug plans, or the covered services, please call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. We hope this helps.

  5. William C.

    Two widowed people over 65 and both collecting ssn get married, will their SS Benifits be reduced because of their marriage

    • Vonda

      Hi William, thank you for the question. Widow(er)s that remarry after age 60 (age 50 if disabled), may continue to qualify for benefits on their deceased spouse’s Social Security record. If your new spouse is a Social Security beneficiary, you may want to apply for spouse’s benefits on that record. If that amount is higher, you may be entitled to the higher amount, based on both records. Generally, you must be married for one year before you can get spouse’s benefits. Please visit our Frequently Asked Questions web page to see how marriage can affect Social Security benefits. We hope this helps!

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    CAN YOU DRAW SOCIAL SECURITY BENEFITS AND DISABILITY ALSO

    • Vonda

      Hi Melvin, thanks for using our blog. We pay disability benefits through two programs: the Social Security Disability Insurance program (SSDI) and the Supplemental Security Income (SSI) program. To qualify for SSDI benefits, you must have worked long enough and recently enough in jobs covered by Social Security (usually within the last 10 years). The (SSI) program is a needs based program that gives cash assistance to disabled individuals with limited income and resources. We pay disability benefits to people who are unable to work because of a medical condition that is expected to last one year or more or to end in death. If you think you may be eligible to receive disability benefits and would like to apply, you can use our online application.

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