GETTING STARTED WITH MEDICARE

Source: AARP.org

Medicare is a federal health insurance program for people who are 65 and over, for some younger people with disabilities, and for people with end-stage kidney disease.

medicare has:

  • Hospital insurance, called Medicare Part A, which helps pay for hospital bills
  • Medical insurance, called Medicare Part B, which helps pay for doctor bills
  • Prescription drug insurance, called Medicare Part D, which helps pay for prescription drugs

Who Can Get Medicare

Most people who are 65 and older, some younger people with disabilities and people with end-stage kidney disease can get Medicare. Call the Social Security Administration at 1-800-772-1213 if you are not certain you can get Medicare. You’ll need to provide your Social Security number and your date of birth when you call.

When You Can Get Medicare

If you are nearing 65, there is a seven-month period during which you can get Medicare. This is the case whether Medicare signs you up or if you need to sign up for Medicare yourself.

This seven month period includes:

  • the three months before your 65th birthday
  • the month of your 65th birthday
  • the three months after your 65th birthday

The best time to sign up for Medicare is during the three months before your 65th birthday.

Deciding about Medicare Prescription Drug Coverage

All people on Medicare can enroll in this voluntary drug coverage regardless of their income, health or how they pay for prescription drugs today. You will need to enroll in a Medicare-approved prescription drug plan offered through a private insurance company.

Your costs (deductible, premiums, and copayments) will vary depending on which plan you choose. You can first join for up until three months after the month your Medicare coverage started. If you do not join when you start Medicare, you may have to pay a penalty if you decide to join during a future open enrollment period (November 15-December 31 each year).

Generally if you have creditable coverage or coverage as good as Medicare’s from an employer or union, you can keep that coverage. Later, if you discontinue or lose your drug coverage, you can join a Medicare prescription drug plan without incurring a penalty.

Deciding about Medicare Supplemental Insurance

Many people with Original Medicare purchase a policy through a private insurance company that helps pay the “gaps” such as Medicare deductibles and copayments. Some of these policies provide additional services not covered by Medicare. In most states, a Medigap policy must be one of 12 standardized policies (Plans A-L), so you can compare them easily.

If you are 65 or older, when you sign up for Part B, you have six months to buy any Medicare Supplemental (Medigap) policy you choose, regardless of your health. This is called your open enrollment period. You only have this period once in your life. After this six month period, you may not be able to buy the Medigap policy you want because policies may exclude persons with certain medical conditions.

If you are 65 or older and have group health coverage from your or your spouse’s employer, you can save your open enrollment period until you need it. Get all the facts first from Medicare and your State Health Insurance Assistance Program (SHIP) before making a final decision about when to sign up for Part B.

MEDIGAP POLICIES WITH PRESCRIPTION DRUG COVERAGE

As of 2006, Medigap policies cannot offer prescription drug coverage to new enrollees. Persons wanting prescription drug coverage will need to purchase a separate prescription drug plan.

AARP Resources

Additional Resources

  • Medicare Information on who can get Medicare and how to sign up.
  • Medicare Options Compare Medicare's online tool to help you find a plan that's right for you.
  • State Health Insurance Assistance Program (SHIP) How to contact your State Health Insurance Assistance Program (SHIP), an important Medicare partner. Free one-on-one health insurance counseling to people with Medicare.
  • Social Security Administration Call the Social Security Administration at 800-772-1213 to find out if you can get Medicare. The Hearing and Speech Impaired TTY/TDD number is 800-325-0778.