Medicare: What You Should Know 

Medicare
Last Updated: September 2023

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Medicare is a national health insurance program for people 65 or older. You may be eligible to get Medicare earlier if you have a disability or end-stage renal disease. Each year, you can choose which way you get your health coverage (and add or switch drug coverage). It’s important to understand your coverage options and compare the different choices, so you can make an informed decision that’s right for you. The following provides a high-level summary about Medicare. For full details and interactive tools about Medicare, visit www.medicare.gov.


Click on the links below to learn about Medicare, how to sign up, and your coverage options.


Medicare: When to Enroll? 

You can only enroll in Medicare during certain times in the year:

  • Initial Enrollment Period
  • General Enrollment Period
  • Special Enrollment Period 

Initial Enrollment Period

You may initially enroll in Medicare during the 7-month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. 

If you’re close to 65, and are getting Social Security or Railroad Retirement Board benefits, you’ll automatically enroll in Medicare Part A and Part B coverage once you're eligible. Part B has a monthly premium, which you can choose to drop if you'd like.

To learn about coverage options for Medicare, scroll down to the "Which Medicare Plan Do I Choose? " section. 



EVERGREEN - Medicare Initial Enrollment Period Infosnack (1)

 

If you missed your Initial Enrollment Period (IEP) and need to enroll in Medicare, you likely will have to enroll during either a Special Enrollment Period (SEP) or the General Enrollment Period (GEP).  

General Enrollment Period

If you did not enroll in Medicare when you originally became eligible for it (or during a Special Enrollment Period), you can sign up during the General Enrollment Period (GEP). The GEP takes place January 1 through March 31 each year, with coverage starting July 1. You may face a late penalty for enrolling during the GEP instead of when you first became eligible. 

Special Enrollment Period

If you missed the Initial Enrollment Period and the General Enrollment Period, you may qualify for coverage during a Special Enrollment Period when certain life events occur.
 


Ways to Enroll 

There are a few ways to enroll in Medicare, depending on which plan you'd like to proceed with. 

For Original Medicare (Part A & Part B), you can enroll by: 

  • Applying online at Social Security

  • Calling Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.

  • Going in-person to your local Social Security office.

  • If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

Want to know what documents you'll need? Check out the Checklist for Online Medicare, Retirement, & Spouses Applications.

If you want to enroll in a Medicare Advantage Plan (Part C), enroll directly in the plan through the plan's website or at Medicare.gov.

If you want a Medicare Supplement Insurance plan (Medigap), you'll enroll directly in the plan through the plan's website. 



Open Enrollment Period

After you've enrolled in Medicare, you can make changes to your health plan during the Open Enrollment Period.

The 2024 Open Enrollment Period runs from Friday, October 15 to Tuesday, December 7, 2023. During this seven-week period, you have a chance to change and review your coverage for 2024.
 You can sign up for Original Medicare, Medicare Advantage (Part C), add prescription coverage (Part D), or add a Medicare Supplement Insurance (Medigap) plan.

Visit Medicare.gov to change your Medicare plan during the Open Enrollment Period. 

 

Medicare Advantage Open Enrollment Period

January 1 – March 31, 2024 is the Medicare Advantage Open Enrollment Period. If you’ve enrolled in a Medicare Advantage Plan during the Open Enrollment Period and change your mind, you can switch to Original Medicare (Parts A & B) or to a different Medicare Advantage Plan during this time. 
 


Which Medicare Plan Do I Choose? 

When you first enroll in Medicare, you can choose how you get your Medicare coverage. There are two options for you to pick from:

1.) Original Medicare includes Hospital (Part A) and Medical (Part B) insurance. To add drug coverage, you can add Part D. Additionally, adding a Medicare Supplement Insurance (Medigap) policy will help lower your out-of-pocket costs.

2.) Medicare Advantage (Part C) is an alternative to Original Medicare, and is purchased through private insurance companies. These plans include Part A, Part B, and usually Part D. Most plans have additional benefits— hearing, vision, dental, and more.

You can change your Medicare coverage during the Medicare Open Enrollment Period or during the Medicare Advantage Open Enrollment Period. 

Overview of Medicare Options (4)

Medicare: How do I Make a Choice? 

There are many choices when it comes to picking a Medicare plan that works for you. See below to get a high level summary of Part A, Part B, Medicare Advantage (Part C), and Part D. You'll see information such as what the plan covers, what it costs, and how to enroll. 

Know Your Medicare Parts

2024 Overview of Medicare Costs

2023 Medicare Part B costs

Skilled nursing facility care

Services & Items Not Covered by Original Medicare (Parts A & B) 

  • Long-Term Care (also known as “custodial care” and includes activities like bathing, dressing, using the bathroom, and eating)
  • Most dental care
  • Eye exams related to prescribing glasses
  • Dentures
  • Routine foot care
  • Cosmetic surgery  
  • Hearing aids and exams for fitting them
 

Recent Changes to Medicare 

  • Lower costs for prescription drugs 
    Beginning in 2024, if you have Medicare drug coverage (Part D) and your drug costs are high enough to reach the catastrophic coverage phase, you don’t have to pay a copayment or coinsurance. 
  • Lower costs for insulin and vaccines
    Your Medicare drug plan can’t charge you more than $35 for a one-month supply of each insulin product Part D covers, and you don’t have to pay a deductible for it. Check the Medicare & You 2024 Handbook to learn more. 
  • Changes to telehealth coverage
    Until the end of 2024, you can get telehealth services at any location in the U.S., including your home.  
  • Managing and treating chronic pain
    If you’ve been living with chronic pain for more than three months, Medicare will cover monthly services to treat it. 
  • Better mental health care
    Starting in 2024, Medicare will cover intensive outpatient program services provided by hospitals, community mental health centers, and more if you need mental health care.
  • COVID-19 care.
    Medicare continues to cover the COVID-19 vaccine, as well as tests and treatments. 

Check out the Medicare & You 2024 Handbook for more information. 


Get Help

  • Medicare.gov. The official government site for Medicare.
  • State Health Insurance Assistance Program (SHIP). Each state offers free virtual counseling, un-biased towards any health insurance companies. 
  • Insurance brokers. They give free advice however they may have financial incentives to get customers to sign up for these health insurance plans.
  • Fee-based consultants. These consultants have no ties to health insurance companies or health care providers, and are compensated per hour or project.
  • Ask Claire. A free Medicare resource which is un-biased and connects you with a representative from a health insurance company.
  • Medicare Plan Finder. An online tool which guides you through the process of shopping for and comparing plans.

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