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Happy 65th Birthday, Here’s Your Medicare?

Written By: Rachel Cullor

Date: June 9, 2015

Medicare. Love it or hate it, at age 65, it becomes your only option for insurance unless you are on a plan through an employer. There are 4 parts to Medicare: Part A, Part B, Part C, and Part D. Each Part covers different benefits.

Part A: Part A is the hospital benefit. If you are already collecting social security, this is the part that the government automatically enrolls you in and usually becomes effective the first day of the month you turn 65. Certain circumstances, for example, not yet receiving social security, may require that you sign up at the social security office This Part covers things like hospital care, skilled nursing facility care, nursing home care, hospice, and home health services. It is premium free if you have paid Social Security taxes for at least 10 years.

Part B: Part B is the medical benefit. Examples of the things Part B covers are doctor visits, ambulance services, durable medical equipment, and inpatient/outpatient mental health. To get Part B, a person newly eligible for Medicare is automatically enrolled. Certain circumstances, for example, not yet receiving social security, may require that you sign up at the social security office. There is a cost associated with Part B and it is based on your income. Generally, the amount is deducted from your social security check. Parts A and B are considered Original Medicare, and benefits are provided by the government.

Part C: If you would rather have your Medicare provided by a private health insurance company, you can enroll in Part C, a Medicare Advantage plan. Medicare Advantage plans can be either HMOs or PPOs, and they are required to offer at the minimum the same benefits that Original Medicare would offer, but can have different costs, plan designs, restrictions. You may have a monthly premium that you would pay in addition to your Part B premium.

Part D: Prescriptions are covered under Part D. You can only get this Part though companies that have contracts with the government. You can get a stand-alone Part D plan to go with Original Medicare, and many Medicare Advantage plans already include prescription coverage. There is a monthly premium for the part D coverage.

When is the time to begin looking at plans?

The initial enrollment for Medicare is generally a 7-month period that includes the three months before your 65th birthday, the month that your birthday falls in, and the three month following your 65th birthday. After picking a plan, you then have an annual Medicare Enrollment in which plan changes can be made. The Annual Medicare Open Enrollment is October 15th through December 7th each year.

Our resident Medicare Specialist at American Exchange, Mary Anne Holland, can help answer questions regarding how Medicare works, explain your options and help you enroll in Medicare Advantage, Medicare Supplement plans, or Part D plans to insure that you are adequately covered to meet your needs.

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