To be eligible for Medicare insurance typically you would be age 65 or older and you or your spouse has worked for at least 10 years accruing credits and paying Medicare taxes; or you may be under age 65 and been on Social Security disability for 24 months.
Part A—Hospital Benefits
Part A Hospital benefits are available to you at no premium if you have accrued the required number of credits. If not, you will be charged a monthly premium for Part A.
Part B—Outpatient Services
Part B is outpatient services (i.e., doctor office visits, therapy, lab work, x-rays, MRIs, etc.). There is a premium for Part B which is based on the adjusted gross income filed with your income tax return. Generally, Social Security looks back at the tax return filed two years ago to determine your Part B premium. It can be adjusted up or down each year based on each year’s Medicare Part B premium rates, as well as the individual’s adjusted gross income two years ago.
Part C—Medicare Advantage
If you have Medicare Part A and B and you elect to be on a Medicare Advantage plan which provides both your medical care and drug benefits, you then are on a Part C plan. You haven’t lost your Medicare A and B; it is because you have Part A and B that you are eligible to sign up for a Medicare Advantage plan.
Part D—Prescription Drug Benefits
You must be enrolled in Medicare Part A and/or Part B to enroll in a Medicare drug benefit (Part D).
Enrollment
People who decide to keep working may be able to defer signing up for Part B at age 65 without penalty if they have health care coverage through their employer; Medicare would be their secondary insurer. However, if their prescription drug benefit under the employer plan did not have verbiage that stated that their prescription drug coverage was creditable or comparable to a Medicare prescription drug plan, they would incur a penalty for each month they were on non-creditable coverage and would carry that penalty in perpetuity.
When you become eligible for Medicare, there is an initial eligibility period to select either a Medicare supplement and stand-alone drug plan or a Medicare Advantage plan.
Each year for beneficiaries currently enrolled onto Medicare insurance plans there is a Medicare Annual Enrollment period (October 15 thru December 7) during which you review the changes in coverages offered and decide what coverage you would like to have in effect as of January 1st of the following year. The ONLY change that can be made at the beginning of the year (January 1st thru February 14) is for individuals on Medicare Advantage plans who want to opt out onto Medicare-only and a stand-alone drug plan. Other enrollment periods are available for individuals who are newly eligible to Medicare, recently relocated into the area, lost their employer retirement health plan, fulfill a special chronic needs classification or their financial status has changed (i.e., low income subsidy for drug coverage or have become Medicare/Medi-Cal).
How Do I Choose A Medicare Option?
Selection is based on an individual’s specific needs. I can assist you with reviewing the various benefit plans options available to help you understand the different coverages available and to enable you to make a selection that you feel will fit your needs.
Medicare has neither reviewed nor endorsed this information. By contacting Barbara Hogan Insurance Services Inc. (OH44806) you will be directed to a licensed insurance agent.
