6 Medicare Enrollment Tips

Medicare healthcare coverage is a federally funded benefit Americans can earn through a lifetime of work. Like any other medical insurance, Medicare can be complicated and confusing. Tips can go a long way when it comes to Medicare enrollment.

This article explains six points about Medicare healthcare coverage that you need to know if you’re approaching retirement age.  It explores eligibility ages and the different parts of Medicare, like Medicare Part A, B, C, and D.  As always, if you have a question beyond the scope of this piece, contact me at 1-800-617-7752.

Let’s begin with eligibility.

1. You Can Enroll in Medicare Healthcare Coverage Before Your 65th Birthday

Medicare works differently than the traditional group insurance coverage with which you’re familiar.

Per Medicare.gov, your first enrollment window is a seven-month period.  It begins three months before the month of your 65th birthday, continues through your birth month, and then lasts three months more.

For instance, if you turn 65 in January, your enrollment period includes:

• October, November, and December — the three months before January

• January — the month of your birth

• February, March, and April — three more months after your birth month

There are other times when you may choose to enroll in Medicare.  Perhaps your spouse is still working, and their group health insurance still covers you. Once your spouse is no longer providing health insurance, you can enroll in Medicare.  This is known as a Special Enrollment Period (SEP).

2. Medicare Part A is Hospital Insurance

Medicare is based on individual hospital insurance for seniors.  It covers medical bills and costs associated with a hospital visit but not most prescription drugs.

Medicare Part A covers:

• A visit to the emergency room

• Surgery and operating room costs 

• Diagnostics and tests while in the hospital

• Your care while hospitalized

You cannot list a dependent on Medicare. And since Part A is strictly hospital insurance, you may wish to purchase more coverage.

What’s Not Included in Medicare Part A?

Notably absent from Part A are medications and regular doctor visits. Furthermore, Part A will not cover vision care or prescription eyeglasses, dental care, dentures, or hearing care/hearing aids.

3. Medicare Part B Offers More Coverage

Part B is more like the traditional health insurance you’ve had in the past.  It covers things like:

• Regular doctor visits

• Preventative care, like flu shots and COVID-19 vaccinations

• Follow-up visits after a stay in the hospital

• Very few medications

Medicare Part B does not cover most prescription medications.  For that, you’ll need Part D, which is easy to remember as “D is for drugs.”  Let’s skip forward to Part D.

4. Medicare Part D is Prescription Drug Coverage

Prescription medications are more expensive than ever, and costs continue to rise yearly.  Many seniors like to add Part D coverage to their Medicare healthcare coverage.  If you have a health condition or suspect you might have one in the future, thanks to your family history or lifestyle, it makes sense to get Part D coverage.

Will you still pay a deductible for drugs with Medicare Part D? That depends on the Part D plan you choose.  Part D plans are available that offer a zero dollar (or very low) deductible for most prescriptions.  On the other hand, some Part D plans only cover drugs in specific tiers.  So, it’s important to consider your medication needs before signing up for Medicare Part D coverage.

If you have a medical condition that requires regular medications, such as hypertension or diabetes, you’ll want to weigh the costs of medicines versus the prices of various Part D plans.  Talk to an insurance agent you trust to help you with this choice.

So far, this article covered Medicare Parts A, B, and D.  Medicare Part C is different but valuable to many seniors.

If you reside in any of the 13 states: NJ, NY, PA, DE, MI, FL, TX, AL, GA, NC, SC, VA and CA click to get medicare supplement quotes. Have questions or want to enroll over the phone? Then call 1-800-617-7752 (TTY 711)*

5. Medicare Part C “Advantage Plans” Are All That And More

Medicare Part C is a more comprehensive benefits package. It includes everything in A, B, and D, plus more.  Medicare Part C, called a Medicare Advantage Plan, covers your hospital stays, regular doctor visits, and prescription drugs.

Depending on the Medicare Advantage Plan you choose, it could offer other benefits, like:

• Gym membership

• Vision care

• Hearing care

• Dental care

• Nutrition programs

• Transportation

• And more

The costs of dental care, hearing aids, and prescription eyeglasses can add up quickly as we age.  If you already wear glasses and suspect you’re experiencing hearing loss, an Advantage Plan might be the best choice.

6. On Supplemental Plans

Many seniors choose to buy a supplemental plan to pair up with Medicare.  These plans offer boosted coverage to fill in the gaps left by original Medicare, so they’re sometimes called “Medigap” plans. Plans vary from state to state.

Medicare Doesn’t Have to be Complicated; Talk to an Agent You Trust

All these different parts and benefits can be confusing if this is your first time dealing with Medicare.  Signing up for Medicare or an Advantage Plan can seem tedious and even scary.  That’s why seniors should spend some time planning their Medicare needs even before their enrollment date opens.

*Disclaimers apply. Read Disclaimer page.