What is Medicare?

Medicare is a federally funded program coordinated through the Centers for Medical Services (CMS) and Social Security that offers health insurance to American citizens and legal residents typically over the age of 65 and also people with certain disabilities. You have two different ways to obtain your coverage.  You can go through Original Medicare (Parts A and B), which is provided through the federal government, or you can purchase a Medicare Advantage plan (Part C), which is provided by private insurance companies contracted through Medicare.

When do You Enroll?

Knowing when to enroll in Medicare is equally as important as choosing your Medicare benefits.  Specific enrollment periods were created to accommodate various life events and changes.  First, let’s identify the different enrollment period scenarios to determine which best applies to you and your situation.

Here are five key categories that guide when you enroll:

  • You’re turning 65

  • You’re working past 65

  • You have a qualifying life event or change

  • You missed your Initial Enrollment Period

  • You need a plan and prescription review

Enrollment is not automatic for everyone, and it’s important to know which enrollment period best applies to your situation.  If you miss your deadline to enroll, you risk incurring late enrollment fees, which is why it’s crucial to enroll on time.

Are You Eligible?

At age 65, you become eligible for Original Medicare if:
• You’re a U.S. citizen OR a legal permanent resident living in the U.S. for the past five years
You can also qualify for Medicare if:
• You’re younger than 65 with a qualifying disability
• You’re any age with a diagnosis of end-stage renal disease or ALS

Note: If you qualify for Original Medicare, once enrolled you’re also eligible for additional Medicare coverage options.

How Do You Enroll?

✓ For some people, enrollment in Medicare is automatic.

For most of us, however, enrollment is not automatic.  

If you aren’t among those who are already receiving social security or railroad benefits, you will need to sign up for Original Medicare yourself.  You won’t receive an official notice on how or when to do this, so it’s up to you to know when exactly you’re eligible to enroll and how to do it.   

Enroll during your Initial Enrollment Period (IEP) 

✓ Your IEP is triggered by your 65th birthday.

✓ For most, it is your first chance and ideal time to enroll in Medicare.  

✓ It is a 7-month window that begins 3 months prior to your 65th birth month, includes your birth month, and the 3 months that follow your birth month.  

✓ It provides you the opportunity to enroll penalty-free in Medicare Parts A and B, as well as a Part D prescription plan.  

What Does Medicare Cost?

Understanding your coverage costs is an important step in your Medicare education and plan selection process. 

 

It’s crucial to choose the plan that fits your budget.  At a basic level, the costs associated with Medicare plans include: premiums, deductibles and coinsurance/ copayments.

Your Annual Plan Review

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