Medicare is our country’s health insurance program for people age 65 or older. People younger than age 65 with certain disabilities, or permanent kidney failure, or amyotrophic lateral sclerosis (Lou Gehrig’s disease), can also qualify for Medicare. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care. We take the time to answer Medicare questions to help you understand Medicare Coverage.
To Qualify you must have both Medicare Parts A and B. Also, you need to live in the plan’s service area. Note: If you have end-stage renal disease (ESRD), you can only join a Medicare Advantage plan in certain situations.
The first two parts are the government programs A for hospital care and B for medical care (you pay a premium). The third part is the private medical plans C Medicare Advantage. The fourth part is the private drug plans D prescription drugs. Both C and D are available at additional cost through a private insurer.
Medicare Advantages is provided by private insurance companies, such as Aetna and others. MA is approved by the Centers for Medicare and Medicaid Services. It combines Medicare Part A, Part B, and Part D into one MAPD plan (some MA plans do not include Part D).
MA plans are sometimes called Part C plans. They include everything that original Medicare covers and can add things such as prescription drug coverage, fitness and more. These programs are offered by private companies that are approved by Medicare. These are not Medigap plans (Medicare Supplement plans).
The Annual Enrollment Period is October 15 to December 7. Initial Enrollment Period varies. It begins three months before you turn 65 and ends three months after you turn 65. Special Enrollment Period varies. You can join or switch your plan if you move out of plan’s service area, you have Medicaid or you qualify for extra help. Medicare Advantage Disenrollment Period is January 1 to February 14. If you are in a Medicare Advantage plan, you can leave your plan and switch to original Medicare.
You can join a Medicare Advantage plan such as an HMO, HMO-POS or PPO if one is available in your area.
Yes, there is. The late enrollment penalty fee may be added to your Part D premium if you do not have creditable prescription drug coverage. It may apply if you do not have creditable coverage when your initial enrollment period is over. Also, if there is a 63 day period in a row when you do not have Part D or other creditable prescription drug coverage.