It's important to have a Medicare Supplement Insurance plan
Don't get caught short. The original Medicare program is designed to provide health benefits, but it doesn't cover the total cost of health care, or leaves gaps in coverage such as deductibles and coinsurance, like for hospitalization, doctor visits and other medical services.
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Every year Medicare updates materials to inform you on the latest benefits, changes and topics.
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What is Medicare?
Medicare is a federal health insurance program that provides benefits to eligible people who are aged 65 and older, certain younger people who have a qualifying disability or illness, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Medicare is administered by the Centers for Medicare & Medicaid Services (CMS). People are enrolled in Medicare through the Social Security Administration and they also collect Medicare premiums.
What does Centers for Medicare & Medicaid Services (CMS) do?
The federal agency that runs the Medicare, Medicaid, and Children's Health Insurance Programs, and the federally facilitated Marketplace.
When can I enroll in Original Medicare?
There are several times when you can enroll in Medicare. The first time when you can sign up for Medicare is called the Initial Enrollment Period (IEP). You may join Medicare Parts A, B, C and D during this time. Your coverage will start no sooner than your birthday month.
Here’s how it works - You have a seven month Initial Enrollment Period:
three months before your 65th birthday, the month of your birthday and three months after your birthday.
Am I automatically enrolled in Original Medicare?
You are automatically enrolled in Original Medicare Part A and/or Part B, if you are turning 65 years old and already getting Social Security or Railroad Retirement Benefits (RRB) benefits or will start collecting retirement at age 65.
You will need to sign up for Medicare Part B at the time that you apply for retirement benefits, and Medicare Part A enrollment occurs automatically if you are eligible for Social Security retirement.
- Do I need to sign up for Medicare?
If you aren't receiving Social Security or RRB benefits when you turn 65, you will have to sign up for Medicare A and/or Part B during your Initial Enrollment Period (IEP).
- Do I have to pay for Medicare Part A and/or Part B?
Most people don’t pay a premium for Part A, if they have paid Medicare taxes and worked at least 40 quarters (10 years). Medicare Part B has a monthly premium. People that are still covered under an employer group plan or different plan may choose to delay enrollment in Part B.
- When does Medicare coverage begin?
If you sign up for Medicare Part A and/or Part B during your initial enrollment, the start of your coverage will depend on which month of IEP you signed up. As an example, if you sign up one to three months before you turn 65 years old, then your Medicare coverage starts generally the month you turn 65 years old.
What is a Medicare Benefit period?
This is the way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you're admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven't gotten any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There's no limit to the number of benefit periods.
What is a Medicare deductible?
The amount you must pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay.
What is a Medicare Coinsurance?
An amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance is usually a percentage (for example, 20%).
What is a Medicare Supplement Insurance (Medigap)?
It's also referred to as a Medigap policy, as it fill "gaps" in Original Medicare coverage. It can help pay some of the Medicare approved health care costs that Original Medicare doesn't cover (deductibles, coinsurance and copayments). Medicare Supplement Insurance policies are purchased through private insurance companies.
When can I buy Medicare Supplement Insurance?
The best time to buy a Medigap policy is when you're first eligible. If you apply for Medigap coverage after your open enrollment period, the insurance company will have you to through their medical underwriting requirements. There isn’t a guarantee you will be approved, unless your eligibility is based on a special situation.
Do Medicare Supplement policies (Medigap) cover everything?
No. Medigap policies don’t cover costs that are not approved by Medicare. Medigap does not generally don't cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.