Turning 65? 5 Things Every Senior Should Know About Medicare
Two free guides designed to help seniors who are turning 65 (and becoming eligible for Medicare for the first time) navigate the complexity of their health-care options are available today, thanks to Extend Health, operator of the nation’s largest private Medicare exchange and a Towers Watson company :
- Understanding Your Medicare Options – Basic explanations of the ins and outs of Medicare
- Medicare Enrollment Guide for 2013 – Specifics on enrolling in Medicare in 2013
5 Things About Medicare That Matter Most
1. When seniors are eligible to enroll in Medicare
Seniors turning 65 are eligible to enroll in original Medicare three months prior to their 65th birthday. This is the time seniors should take stock of their medical picture to determine:
- How original Medicare serves their needs
- How to bridge the gaps in what’s covered (most seniors supplement original Medicare with a private plan)
- What’s available when they turn 65 if they have coverage through their plan or their spouse's employer or another group (this is a good time to speak with them)
Seniors over 65 and already enrolled in Medicare (original and the private plans are covered below) can enroll in different plans during the 2013 Medicare Annual Open Enrollment Period, which runs from October 15–December 7, 2012.
2. What Original Medicare Covers—And What it Doesn’t
The free Extend Health guide, Understanding Your Medicare Options, offers a clear explanation of the benefits and requirements of the various parts of original Medicare, including Part A (hospital coverage) and Part B (physician and outpatient coverage). The guide also explains what original Medicare does not cover and how to fill those gaps by explaining private Medicare coverage options, including Part C—known as Medicare Advantage, Part D—prescription drug coverage, and Medigap plans.
3. What Medigap and Medicare Advantage Plans Cover
Medigap and Medicare Advantage coverage is delivered through private plans that can help bridge the gaps in what original Medicare covers. See the Extend Health guide, Understanding Your Medicare Options, for plan explanations.
4. How to Get Prescription Drug Coverage
Seniors choosing Medigap plans may also want a Part D plan to provide drug coverage. Medicare Advantage Prescription Drug (MAPD) plans already include prescription drug coverage. Seniors with Medicare Advantage cannot purchase separate Part D plans.
5. Enrollment Requirements for Original Medicare versus Medicare Advantage and Medigap Plans
Enrollment requirements for original Medicare and Medigap plans are different.
In a senior’s first enrollment period, Medigap plans are guaranteed issue, which means people over 65 cannot be denied coverage due to their health status or pre-existing conditions. After this first eligibility period, Medigap plans may cost more or coverage could be denied.
For example, if a senior chooses a Medicare Advantage plan first and then wants to switch to original Medicare in combination with a Medigap plan, it may be more expensive to enroll later.
Seniors can switch into a Medicare Advantage plan or a Medicare Part D prescription drug plan with a 5-star rating at any time during the year.
Go to the Extend Health website or click here for copies of both free Extend Health guides: Understanding Your Medicare Options and Medicare Enrollment Guide for 2013. Seniors should also refer to the CMS website.
**Seniors can call Extend Health toll-free at 1-866-322-2824 and speak with a licensed benefit advisor for a free personal consultation on how original Medicare, Medigap, and Medicare Part D plan options could best meet their medical needs.**