If you are over the age of 40 and live in the United States, you know generally what Medicare is. Therefore, in this section, I won’t repeat all the good things you can read about on the government’s official Medicare site. What I will do is point out a few areas from publicly available government sites that I think you should be aware of – and remember, with government programs being some of the most complicated creations in the world, you know I will miss a few things but here we go!
Who qualifies for Medicare?
“Medicare is a Health Insurance Program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease “
Medicare has two basic parts:
Part A = Hospitalization: which you don’t typically pay for
Part B = Medical Insurance: covers such things as doctor visits & diagnostic tests and you typically pay for this, often as a deduction from your social security check. Cost for existing Medicare recipients is $96.40/month but higher for others.
There are also these optional “parts:”
Part C = these are Medicare Advantage Plans which are private health insurance company plans contracted with and approved by Medicare which combines Part A, B, and also typically a drug plan (Part D).
Part D = the prescription drug plans offered by approved private insurers which can be a stand alone plan or part of a Medicare Advantage plan.
“Medigap”Policies = typically, if one enrolls in Parts A & B, and gets a Part D plan without using a Medicare Advantage plan, there will be “gaps” in coverage. Medigap policies can be purchased from private insurers to cover those gaps.
When Do I (You) Sign Up for Medicare?
This depends if you were receiving social security benefits before turning 65. If you are in this posiition, Medicare will send you an enrollment packet 3 months before you turn 65 and enroll you automatically in Parts A & B (you must opt out of B in this circumstance if you don’t want it).
If you are not receiving social security before age 65, then you need to go to the social security office or call social security and enroll for your free Part A Medicare between 3 months before to 6 months after your 65th birthday – if you wait longer, you will be penalized by delayed entry into Part A. Part B can also be applied for up to 3 months before you turn 65 – if you are still working, you may not need to sign up for Part B since your work plan covers those services. Most employers will make you sign up for A because it saves them money! You can apply for Part D 3 months before to 3 months after turning age 65.
Note: If you are working or your spouse is working, you can wait to sign up for part B. If you and your spouse are not working, you could be penalized both in delayed enrollment and higher premiums. Also, if you are not receiving social security but enroll in Medicare, Medicare will bil you direct quarterly.
Medicare sends out Medicare Summary Notices (MSN) which shows all the services that were billed to Medicare which Medicare paid for.
And as mentioned above, bills for those not receiving social security, are sent out quarterly to Medicare enrollees.
Other services available to help with costs:
- Medicare Service Programs
- Extra Help Low Income Subsidy
- State Pharmaceutical Assistance Program
- Pharmaceutical Assistance Program
To contact Medicare: 1 (800) Medicare or 1-800-633-4227
To contact Social Security: 1-800-772-1213
If you’d like more local advice, feel free to call our office – 781-393-0021 or send us a Quick Contact. We have a team of professionals that can help with your situation.
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