New to Medicare

If you are new to Medicare, then there are certain things to know about Medicare eligibility, enrollment, and costs.

What is Medicare?

Medicare is a federal health insurance program designed to help qualified individuals with certain medical costs. To qualify for Medicare, you must be aged 65 or older or meet the alternative eligibility requirements.

Medicare is divided into various parts: Original Medicare (Medicare Part A and Part B), Part C, Part D, and Medigap. Each part covers different medical services.

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Medicare Eligibility

There are some eligibility requirements you must meet to qualify for Medicare. First, Medicare is only open to individuals aged 65 or older. Under certain conditions, people under age 65 may be able to register for Medicare. Those who meet the eligibility requirements will become eligible for Medicare three months before their 65th birthday up until three months after turning 65. This is known as the Initial Enrollment Period.

If you qualify for Medicare, it is advisable to register during this period to avoid the late enrollment penalty. You can enroll for Medicare while under 65 if you fall under specific categories. People who have received Social Security disability benefits for 24 months automatically qualify for Medicare on the 25th month. Also, people who have End-Stage Renal Disease or Amyotrophic Lateral Sclerosis automatically qualify for Medicare.

There are other general requirements that apply to Medicare enrollees, such as being a U.S. citizen or a permanent legal resident for at least five years.

Enrollment

If you meet Medicare’s eligibility requirements, the next step is to register during the enrollment periods. There are different enrollment periods for Medicare, each with different purposes. The first enrollment period is the Initial Enrollment Period, which was previously mentioned above. The Initial Enrollment Period is meant for new Medicare enrollees to enroll in Original Medicare. It starts three months before you turn 65 and ends three months after you turn 65.

The next enrollment period is the General Enrollment Period. The General Enrollment period starts on January 1 and ends on March 31. If you missed the Initial Enrollment Period, you could enroll during the General Enrollment Period, but you may face late enrollment penalties.

There are other enrollment periods such as the Annual Enrollment Period, Special Enrollment Period, and the Medigap Open Enrollment Period. During the Annual Enrollment Period, you can switch to Medicare Advantage, enroll for Part D, or drop a plan.

The Special Enrollment Period allows enrollees to choose or enroll for a new plan under special circumstances.

The Medigap Open Enrollment Period allows enrollees to enroll in a Medigap Plan after turning 65 and enrolled in Original Medicare. They have six months to choose a plan and will not be denied coverage.

What Does Medicare Cover?

Medicare covers various types of medical services. Part A covers inpatient care, hospice care, skilled nursing facility care, and other services. Medicare Part B covers outpatient hospital services such as durable medical equipment, ambulance services, preventive screenings, and other outpatient services.

Part D offers prescription drug coverage, while Part C covers the same benefits as Original Medicare and some extra benefits. Medicare Supplement plans cover the out-of-pocket costs left from Original Medicare.

For more information about Medicare and other insurance plans in Nebraska, contact us at 800-560-9373.

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