Medicare – A Two Step Process

Medicare Is Not A One-Size-Fits-All Process – You Do Have Choices!

Find A Plan That Is Right For You

You have choices that work best for you:

• Do you only want Original Medicare (Parts A and B)? – with a Part D stand-alone prescription drug plan?
• Would you rather have a Medicare Advantage plan (Part C) – like an HMO or PPO?
• If you prefer the Medicare Advantage plan, should it include prescription drug coverage?

Remember : It is in your best interest to consider enrolling as soon as you become eligible – this could save you higher monthly premium costs.

If you have a lower income and are eligible, there is financial help to pay for your Medicare.

Eight Things You Should Know…

1) There are two ways to get Medicare;

• Original Medicare (Parts A and B) provided by the government.
• Medicare Advantage plans (Part C) offered by private insurance companies.

2) Original Medicare does not pay for everything;

• Even though you have contributed to the costs of your Medicare by paying taxes, you will still have to pay a share of monthly premium costs and copays.

3) Medicare Supplement Insurance can help you cover out-of-pocket expenses;

• This will will help you cover costs like deductibles and copays that are not covered by Part A and Part B.

4) As a Medicare member, you are entitled to get optional prescription drug coverage (Part D);

• You can enroll in a stand alone Part D plan with your Original Medicare.
• Or, you can enroll in a Medicare Advantage plan that includes prescription drug coverage.

5) The state you reside in may offer different choices;

• Parts A and B (Original Medicare) is the same across the United States.
• Medicare Advantage (Part C) and prescription drugs (Part D) may be available only in certain counties, states or regions as they are offered by private insurance companies.
• Medicare supplement policies are available by state and offer nationwide coverage.

6) Be sure to enroll at the right time;

• The Initial Enrollment Period (IEP) is your first chance to enroll in Medicare – this is three months before your 65th birthday month, the month of your birthday, and the three months after your birthday month.
• Coverage starts on the first day of your birthday month if you enroll before the month you turn 65,
• If you enroll during your birthday month or later, coverage starts on the first day of the following month.

7) Review your plan once a year;

• You can change your plan each year during the Medicare Open Enrollment Period (OEP).
• OEP runs from October 15 to December 7.

8) Special Election Period;

• In certain cases you may be able to enroll or switch plans outside the IEP and OEP, for example, you retire and leave an employer or union health care plan; you move out of the service area of your current plan.

Important Questions About You

• Are you healthy or do you have chronic conditions?
• How much do you spend on your prescription drugs and how often do you take them?
• Who are your doctors? How do you feel about seeing new doctors?
• Besides Medicare, are you eligible for any other health care coverage? If yes, will you keep that coverage when you retire?
• How does health care impact your budget?
  • Will you need financial help to pay for your Medicare premiums?
  • How much did your health care cost in the last year?
  • Do you expect similar costs this year?
• Do you like to travel – how often and where?

(Tip : it is a good idea to write these points down – they will help with understanding Medicare choices and serve to formulate the best plan for you)