Part A – Your hospital coverage. With the exception of folks whose lack of employment has paid too little into the system over their lifetime, Part A is free to you. It helps cover inpatient care in hospitals, skilled nursing facility care, hospice and home health care.
Part B – Your doctor visits, preventive service, and hospital outpatient care. Part B is an optional purchase. In 2012, the most you’ll pay for this is approximately $115 each month. Those who earn $85,000 annually, or couples filing jointly who earn $170,000 together, would be assessed an additional fee.
Part C – Medicare Advantage plans. These are HMOs, PPOs or fee-for-service plans sold by private companies that replace Medicare Parts A and B, and may offer additional services and features such as vision, dental, hearing, chiropractic and podiatry care. Many include prescription drug coverage. Some, called Special Needs Plan, are especially designed to help those with diabetes or other serious conditions. They might also focus on meeting the needs of those struggling with low income.
Part D – Your prescription drug coverage. You would pay approximately $20-$60 each month depending on the plan.
Medigap policies, unlike Medicare Advantage plans which replace Parts A and B, work hand in glove with what is called Original Medicare (A and B), to help pay your out-of-pocket costs such as coinsurance, copayments and deductibles. As with Medicare Advantage, Medigap is sold by private insurance companies. Some Medigap policies offer other services Original Medicare does not.
Please note: You cannot have both a Medigap policy and a Medicare Advantage Plan.
When to apply:
This can be a little confusing; in fact, you might have more than one enrollment period for which you are eligible. Additionally, different plans might have different enrollment dates. Medicare And You, a publication of the U.S. Social Services Department, provides a lot of detail about your enrollment dates.
- You can first apply for Medicare three months before you turn 65, until three months after that birthday. If you turn 65 May 27, you can apply February 1st through August 31st.
- You can additionally apply for Medicare Advantage and / or Part D coverage during the annual election period October 15-December 7, as long as you are enrolled for Parts A and B. This applies to everyone, not just those turning 65.
- There are also three-month-long special enrollment periods. These individualized dates are based on your having special circumstances such as the onset of illness, or a move out of the coverage area of your current provider. Those who lose their low-income subsidy eligibility would be able to change (enroll or disenroll) their Medicare plans January 1-March 31.
Please note: It’s important that you not miss your enrollment period. Doing so can increase the premium you pay for the plan for the rest of your life, and /or require you to wait several months before enrolling.
We’ll talk more about the details later, and should you have questions, feel free to call, text or email me. My contact information is on the About page. You can also call 1-800-MEDICARE. Here, from the Medicare.gov site, is a list of frequently asked questions, and their answers.