Medicare is the national health insurance program that provides seniors 65 and older with health care coverage. Having this coverage can help you save a lot of money regarding your medical costs, but it’s important to know what each part of Medicare covers and when you can enroll to get the most out of your benefits.

But, before we discuss coverage, let’s talk about your eligibility for Medicare.

Medicare Eligibility And Enrollment

Most people will become eligible about three months before they turn 65. Anyone who gets disability benefits from Social Security for at least 24 months will also be eligible. You can also become eligible as long as you are a U.S. citizen or permanent legal resident of at least five years.

If you are younger than 65, it’s also possible to become eligible for Medicare by meeting these specific requirements:

  • You’re permanently disabled
  • You have End-Stage Renal Disease (ESRD)
  • You have Lou Gherig’s Disease, also referred to as Amyotrophic Lateral Sclerosis (ALS)

Suppose you become eligible because of your age. In that case, your Initial Enrollment Period will begin three months before your 65th birthday month. This period will then end three months after your birthday month. You can use this period to enroll in Medicare Part A and Part B. If you miss this period, you will have another chance to enroll during the General Enrollment Period, which is from January 1 to March 31. However, enrolling during the General Enrollment Period instead of your Initial Enrollment Period could cause you to pay late enrollment penalties that will be added to your monthly premiums.

Medicare Coverage

Medicare consists of multiple parts to provide you with the health coverage you need. These parts include Original Medicare, Medicare Advantage, Medicare Part D, and Medicare Supplements.

Original Medicare contains two parts: Medicare Part A and Medicare Part B. Part A will provide coverage for your inpatient hospital services, while Part B will provide coverage for your outpatient medical services. Part A will also provide coverage for skilled nursing facility care, home health care, and hospice care.

Part B will provide coverage for medically necessary services, durable medical equipment (DME), home health care, ambulance services, x-rays, lab tests, chiropractic care, and a minimal amount of prescriptions (such as anticancer or immunosuppressants).

Medicare Advantage, also known as Medicare Part C, is required to provide the same coverage as Original Medicare. You must also be enrolled in Original Medicare first before you can opt for a Medicare Advantage Plan. Some Medicare Advantage Plans may also provide extra coverage, which can include:

  • Prescription drug coverage
  • Dental coverage
  • Hearing coverage
  • Vision coverage
  • And more

Once enrolled in Original Medicare, you can also choose to enroll in a Medicare Supplement (Medigap) plan rather than opting for a Medicare Advantage Plan. Because Original Medicare doesn’t cover all medical costs, you can add on a Medicare Supplement Plan to cover out-of-pocket costs, such as coinsurance and copayments.

Then, there is Medicare Part D, which solely provides coverage for your prescription drugs. Each Part D plan has a formulary that lists the drugs that are covered. Each plan is required to cover at least two drugs from each class or category. To learn more about Part D and which plan covers the prescriptions you need, reach out to us today to help you compare your options.

We Make Medicare Easy To Understand

At Jones Insurance Group, we understand how important it is to know all the coverage options available to you. That’s why we will help you compare your options, help you enroll, and make sure you are getting the coverage you need.

Reach out to us today to learn more about your Medicare options!

We Are Committed To YOU

At Jones Insurance Group, we want to take care of your insurance needs. We get a great deal of joy and job satisfaction knowing that we are helping the people we live, work, and play with get the right type of insurance that will protect them in times of need.

That’s why we have access to a variety of insurance policies.