MEDICARE

A Simple Guide to Understanding Medicare

Open Enrollment 10/15 - 12/7

What is Medicare? Medicare is a federal health insurance program for people aged 65 or older, certain younger individuals with disabilities, and those with End-Stage Renal Disease. It helps cover medical costs but doesn’t pay for everything, so understanding your options is key!

Types of Medicare Coverage:

  1. Medicare Part A (Hospital Insurance)

    Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare.

  2. Medicare Part B (Medical Insurance)

    Covers doctor visits, outpatient care, preventive services, and medical supplies like lab tests and wheelchairs.

  3. Medicare Part C (Medicare Advantage Plans)

    These are all-in-one plans offered by private companies that combine Part A, Part B, and usually Part D. These plans often include extra benefits like vision, dental, or wellness programs.

  4. Medicare Part D (Prescription Drug Coverage)

    Helps cover the cost of prescription drugs. Part D plans are offered by private insurance companies and can be added to Original Medicare (Parts A and B).

What is Medicare Supplement Insurance (Medigap)?

Medigap policies are sold by private companies and help pay for costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. You need to have Medicare Parts A and B to get a Medigap plan.

Enrollment Periods:

- Initial Enrollment Period (IEP): Starts 3 months before you turn 65 and lasts for 7 months.

- General Enrollment Period (GEP): Runs from January 1 to March 31 each year if you missed your initial enrollment.

- Special Enrollment Period (SEP): You may qualify for this period based on specific life events, like losing your employer's insurance.

Frequently Asked Questions:

- Do I need all parts of Medicare?

No, you can choose which parts you want based on your healthcare needs. However, having more parts means more comprehensive coverage.

- What happens if I don’t sign up for Medicare on time?

You may face penalties if you don’t enroll when you’re first eligible, especially for Part B and Part D.

- Can I change my Medicare plan?

Yes! Every year during the Annual Enrollment Period (Oct 15 - Dec 7), you can change your plan if your needs or preferences change.

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Gerry Ruffino Insurance

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Austin, TX, USA