New to Medicare? We Will Help You Make Sense Of It.

Have you recently turned 65?

Maybe that birthday is just around the corner.

This is a very important milepost on the road of your life. It is when you become eligible for Medicare, the nation’s federal health insurance program primarily for older Americans.

AmeriLife has served the senior insurance market for nearly 50 years. So if you are new to this topic, you picked the right place to begin learning about it.

What is Medicare?

In general terms, Medicare is a financial benefit Americans earn by paying a qualifying amount of taxes into the system throughout their working years.

It is also a federal entitlement program. This means by law, payments must be made to people meeting Medicare eligibility standards. (Social Security is also a government program paid for by workers via tax dollars.)

As you will see, Medicare is broad in scale and complex in nature, with varying enrollment periods, coverages, eligibility requirements and costs.

Original Medicare

This is the program’s foundation. Medicare has four parts:

• Part A – Hospital Coverage
• Part B – Medical Coverage
• Part C – Medicare Advantage Plans
• Part D – Prescription Drug Plan

While Original Medicare takes care of many health costs for beneficiaries, it is important that you understand it does not pay all of your expenses.

Part A

Also referred to as Hospital Coverage, Part A is free to people who have worked 10 years (40 quarters) or more and paid Medicare taxes.

Otherwise, you can sign up for Part A at a cost.

There are premiums, copays and coinsurance costs.

Those who collect Social Security or Railroad Retirement benefits will be automatically enrolled when you turn 65.

If you were eligible for Medicare Part A for two years but did not sign up, you will have to pay the higher premium for four years.

Usually, you do not have to pay a penalty if you meet certain conditions that allow you to sign up for Part A during a Special Enrollment Period (SEP).

Part A includes:

• Hospital inpatient
• Skilled nursing facilities
• Home health care
• Hospice

People generally receive their Medicare initial enrollment package three months before they turn 65.

Included in the package is the all-important red, white and blue Medicare benefits card.

Should you choose to accept the required Part A and the optional Part B Medical Coverage, you keep the Medicare card. If not, you return it to indicate you have declined Part B.

Part B

This is also part of Original Medicare. Part B medical coverage may be similar to the health insurance you or a loved one may have or had while working.

You can decline Part B if you are still working and have group insurance coverage. However, we strongly suggest you review Part B benefits before choosing to decline them.

It includes:

• Doctor visits
• Preventative services
• Outpatient medical and surgical services and supplies
• Lab tests
• Durable medical equipment
• Diabetic testing supplies

Part C

This refers to Medicare Advantage plans. You can enroll in a Medicare Advantage plan if you have chosen Original Medicare Parts A and B.

Private insurance companies approved by Medicare offer Medicare Advantage plans. These are required to have everything covered under Original Medicare, with the exception of hospice care.

Some MA plans offer additional benefits, such as prescription drug coverage, dental, and vision.

In addition:

• Some have a network you must use
• You may need a referral to see a specialist
• Members must continue to pay their Part B premium
• You can only join (or leave) the plan during certain periods

Part D

Medicare’s Prescription Drug Plan (PDP) program – Part D – is optional.

However, if you delay enrolling in a Medicare PDP, a late enrollment penalty may be imposed if you decide you want it later.

Criteria for joining a Prescription Drug Program are:

• Must have Part A and/or Part B coverage
• Have to live in the plan service area
• Live within the United States

Enrollment periods include:

• Initial Enrollment Period (IEP)

This is a seven-month period including the three months before you turn 65, your birthday month and the three months following your birthday.

• The Medicare Annual Election Period (AEP), which is Oct. 15 through Dec. 7 each year
• Special Election Period (SEP)

Prescription Drug Plan coverage is also available to you as a stand-alone Part D plan, which can be added to your Original Medicare coverage.

Medicare Supplement Insurance

Heard someone mention Medigap (or Med Supp)? These are other names for Medicare Supplement Insurance policies.

Private companies sell Medicare Supplement, which fills gaps in Original Medicare coverage.

Med Supp offers standardized plans. However, plan premiums vary by company, plan type, and location.

Additional features include:

• Open Enrollment Period for a Medigap plan begins the month you turn 65 and enroll in Part B
• The enrollment period is six months long
• Companies must sell you a policy within the Open Enrollment Period (OEP)
• Restrictions apply to policies sold outside of the OEP

Be sure to get the facts

There is a LOT of Medicare information available on the internet. Some sources are more reliable than others.

We suggest you start with Medicare & You 2018, the official U.S. government Medicare handbook.

It is available in hard copy, downloadable PDF format and for viewing on smartphones and other mobile devices, including eReaders such as Kindle and Nook.

The handbook contains a checklist to help you maximize your coverage. There’s also a chart depicting the two main coverage choices; a summary of what Medicare covers and what it does not cover; definitions of commonly used terms; State Health Insurance Assistance Program (SHIP) contact phone numbers; and your rights under the program.

Where to go for help

New to Medicare or in need of assistance? We recommend you either visit the Medicare website or contact the Centers for Medicare and Medicaid Services at 1-800-MEDICARE (1-800-633-4227).

Interpreters are available to provide information and answer questions in numerous languages. There is no cost.

TTY users can call 1-877-486-2048 for assistance.

Because AmeriLife has served the senior market for nearly 50 years, we have considerable experience with the Medicare program and products.

One of our representatives can sit down with you to review your options and help you make the best decision for your needs. Connect with an agent