Medicare is federally-provided health care for individuals 65 and older, individuals who may be under 65 but have been receiving Social Security Disability Insurance (SSDI) for a certain amount of time, or who are under 65 and have End-Stage Renal Disease (ESRD).
Original Medicare offers hospital and medical coverage with an option to add prescription drug coverage. With Original Medicare, you also have the opportunity to add supplemental coverage.
Medicare Advantage plans combine hospital and medical coverage (parts A and B) and usually prescription drug coverage, often with additional benefits such as vision, hearing, or dental. Some of these packages may also come with lower out-of-pocket expenses than Original Medicare.
Original Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care settings. You also have the option to join a separate plan for prescription drug coverage. You may also get Medicare Supplement Insurance (Medigap) coverage for additional needs.
Medicare Advantage is required to cover all the services that Original Medicare covers and typically includes prescription drug coverage. Some Medicare Advantage plans will also offer extra benefits that Original Medicare doesn’t include, such as vision, dental, and hearing. Some Medicare Advantage plans also come with lower out-of-pocket expenses.
Medicare plans are unique to the individual. There is not a one size fits all, in most cases your unique list of prescription drugs will be the determining factor.
Call (661) 212-9171 for a one-on-one confidential personalized evaluation.
Turning the age of 65 is when most people would qualify for Medicare. To be eligible typically a person would have 40 quarters/worked appx 10 years and paid into Medicare through a payroll deduction.
There are some cases based on a disability that allow for those individuals to enroll with Medicare earlier.
There can be additional circumstances, please feel free to call for more details.
The first step is to determine if you are ready to activate Medicare A&B.
If you are still working and have an employer sponsored plan, you could hold off. This is usually a financial decision. You could continue to work and activate Medicare and get some great Medicare Insurance coverage, or you could hold off on your activation and stay with your employer Health plan if your costs are low, and the benefits are better. The employer must have 20+ employees for this to work without a penalty. Give me a call and I can help you in the analysis and comparison.
Initial Enrollment Period – Activate Medicare A&B 3-months before your 65th birthday month. The month of your Bday, and up to 3-months after allowed and no penalty would be imposed.
Annual Enrollment Period – Oct 15th – Dec 7th
This is when you can review, and make a change to your current plan and it will take effect January of the upcoming year.
Special Enrollment Period – These can be unique dates like coming off an employer plan any given month.
OEP The Medicare Advantage Open Enrollment Period - This is from January 1 through March 31 each year. During this time, MA-eligible beneficiaries will be able to change their MA Plan or elect Original Medicare and coverage under Part D. Changes are effective the first of the following month.