As you near age 65, you may have heard of the federal health insurance program known as Medicare. This program is for people 65 or older, younger people with disabilities, and people with end-stage renal disease (ESRD).
Medicare has four parts, each providing different types of coverage:
It’s important to understand that not all services are covered under Medicare. There may be out-of-pocket costs such as deductibles, copayments, and coinsurance. Fortunately, if you have Original Medicare, you can enroll in a Medicare Supplement (Medigap) plan to provide coverage for some, if not all, of the costs not covered.
Here is a breakdown of the coverage you can expect to see with each Medigap plan:
*The 2023 out-of-pocket spending limit for Plans K and L are $6,940 and $3,470.
If you’re new to Medicare, it’s recommended that you enroll during the Initial Enrollment Period, which is a seven-month period that begins three months before your 65th birthday and ends three months after your birthday. If you miss this window, you may have to pay a penalty or wait until the next enrollment period.
Enrollment periods that are useful for beneficiaries to know include:
The GEP begins January 1 and ends March 31 of every year. You can enroll in Medicare during the GEP if you missed your IEP. However, you may have to pay late enrollment penalties if you enroll during this period.
The GEP begins January 1 and ends March 31 of every year. You can enroll in Medicare during the GEP if you missed your IEP. However, you may have to pay late enrollment penalties if you enroll during this period.
You can avoid late enrollment penalties if your qualify for a SEP. This period grants you the chance to delay your Medicare enrollment if you’ve experienced certain circumstances.
This 6-month period becomes available when you are 65 and your Part B coverage is effective. This period allows you to buy a Medigap plan without the worry of being denied coverage.
This period begins January 1 and ends March 31 of every year. If you have a Medicare Advantage plan, you can use this period to switch to a new plan or go back to Original Medicare. You can only switch plans once during this time.
AEP begins October 15 and ends December 7 of every year. If you are enrolled in Medicare, you can use this time to review your plan and make changes if necessary. Any and all changes will become effective on January 1 of the following year.
This period starts three months before your 65th birthday and ends three months after. This period marks your eligibility for Medicare. It is recommended you enroll during this period as soon as possible to avoid any coverage gaps.
The GEP begins January 1 and ends March 31 of every year. You can enroll in Medicare during the GEP if you missed your IEP. However, you may have to pay late enrollment penalties if you enroll during this period.
You can avoid late enrollment penalties if your qualify for a SEP. This period grants you the chance to delay your Medicare enrollment if you’ve experienced certain circumstances.
This 6-month period becomes available when you are 65 and your Part B coverage is effective. This period allows you to buy a Medigap plan without the worry of being denied coverage.
This period begins January 1 and ends March 31 of every year. If you have a Medicare Advantage plan, you can use this period to switch to a new plan or go back to Original Medicare. You can only switch plans once during this time.
AEP begins October 15 and ends December 7 of every year. If you are enrolled in Medicare, you can use this time to review your plan and make changes if necessary. Any and all changes will become effective on January 1 of the following year.
If you do not enroll in Medicare when you first become eligible or you don’t qualify for a Special Enrollment Period, you will have to pay a late enrollment penalty. Here’s how they work:
If you find yourself having difficulty keeping up with your Medicare costs, there are solutions available. Here are some of your options:
These programs help you pay your premiums, copayments, coinsurance, and copayments. The four programs include:
If you have limited income and resources, you may qualify for the Extra Help Program, which helps you pay for your Medicare Part D premiums, coinsurance, deductibles, and other related costs. You also won’t have to pay a Part D late enrollment penalty. You will receive Extra Help benefits automatically if you:
This is a joint federal and state program designed to help cover medical costs for those who meet their state’s limited income and resources requirements. If you currently have Medicare and qualify for Medicaid, Medicaid may help pay for:
Speak with the Medicare experts at Planned Coverage to help you understand your options and find the best plan for your needs. Don’t wait until it’s too late to enroll, take action today and secure the healthcare coverage you deserve through Medicare!
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