Medicare is the federal health insurance program for:

• People who are 65 or older
• Certain younger people with disabilities
• People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

There are 3 times you can sign up for Medicare:

1. Initial Enrollment Period—If you’re eligible for Medicare when you turn 65, you can sign up during your Initial Enrollment Period. This is a 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.
   • You can sign up for free Medicare Part A (Hospital Insurance) (if you’re eligible) any time after your Initial Enrollment Period starts. Your Part A coverage will start 6 months back from the date you apply for Medicare (or Social Security/RRB benefits), but no earlier than the first month you were eligible for Medicare.
   • You can only sign up for Part A (if you have to buy it) and/or Medicare Part B (Medical Insurance) during the times listed below.
   • Important: In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty for as long as you have Part B and could have a gap in your health coverage.

2. Special Enrollment Period—Once your Initial Enrollment Period ends, you may have a chance to sign up for Part A (if you have to buy it) and Part B during a Special Enrollment Period, but only if you meet certain requirements. If you’re covered under a group health plan based on current employment, you have a Special Enrollment Period to sign up for Part A and/or Part B at any time as long as you or your spouse (or family member if you’re disabled) is working, and you’re covered by a group health plan through the employer or union based on that work.

1. 1. Section 2—Signing up for Part A and Part B 13 If you enroll during a Special Enrollment Period, your Medicare coverage typically begins the month after Social Security gets your completed request. Usually you don’t pay a Part B late enrollment penalty if you sign up during a Special Enrollment Period.
   2. Note: COBRA and retiree health plans aren’t considered coverage based on current employment. You’re not eligible for a Special Enrollment Period when that coverage ends. This Special Enrollment Period also doesn’t apply if you have one of these:
      • • End-Stage Renal Disease (ESRD)
        • Veterans Affairs and Individual Health Insurance Marketplace coverage
2. General Enrollment Period — If you don’t sign up for Part A (if you have to buy it) and/or Part B when you’re first eligible, and you don’t qualify for a Special Enrollment Period, you may have to wait until the Medicare General Enrollment Period (from January–March 31) to enroll and coverage will start July 1 of that year. In most cases, you’ll have to pay a late enrollment penalty for as long as you have Part B if you sign up during the General Enrollment Period.

Costs
Costs in Original Medicare
There’s no limit on how much you pay out-of-pocket per year unless you have supplemental coverage.

Costs in Medicare Advantage
Plans have a yearly limit on your out-of-pocket costs. If you join a Medicare Advantage Plan, once you reach a certain limit, you’ll pay nothing for covered services for the rest of the year. This option may be more cost effective for you.

Coverage

Coverage in Original Medicare
Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care settings. Services are either covered under Part A or Part B.

Coverage in Medicare Advantage
Plans must cover all of the services that Original Medicare covers. Some plans offer benefits that Original Medicare doesn’t cover like vision, hearing, or dental.

Your Other Coverage

If you have other types of health or prescription drug coverage, make sure you understand how that coverage works with Medicare. If you have employment-related coverage, or get your health care from an Indian Health or Tribal Health Program, talk to your benefits administrator or insurer before making any changes.

Supplemental coverage in Original Medicare
You can add a Medigap policy to help pay your out-of-pocket costs in Original Medicare, like your deductible and coinsurance.

Supplemental coverage in Medicare Advantage
It may be more cost effective for you to join a Medicare Advantage Plan because your cost sharing is lower (or included). And, many Medicare Advantage plans offer vision, hearing, and dental. You can’t use (and can’t be sold) a Medigap policy if you’re in a Medicare Advantage Plan.

Prescription Drugs

Prescription drug coverage in Original Medicare
You’ll need to join a Medicare Drug Plan (Part D) to get drug coverage.

Prescription drug coverage in Medicare Advantage
Most Medicare Advantage Plans include drug coverage. If yours doesn’t, you may be able to join a separate Part D plan.

Doctor and Hospital Choice

Doctor and hospital choice in Original Medicare
You can go to any doctor that accepts Medicare.

Doctor and hospital choice in Medicare Advantage
You may need to use health care providers who participate in the plan’s network. If so, find out how close the network’s doctor or pharmacies are to your home. Some plans offer out-of-network coverage.

Quality of care

Are you satisfied with your medical care? The quality of care and services offered by plans and other health care providers can vary. How have Medicare and other people with Medicare rated your health and drug plan’s care and services? Get help comparing plans and providers.

Travel

Travel coverage in Original Medicare
Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy supplemental insurance that offers travel coverage.

Travel coverage in Medicare Advantage
Plans usually don’t cover care you get outside of the U.S.

You probably have more questions regarding the best Medicare coverage for you.

The best thing for you to do right now, reach out to Ben Bauman and explore all of your personalized Medicare options.

Call Ben at: 763.241.7900 or Email Ben