Browse Frequently Asked Questions:
Medicare is health insurance for people age 65 or older, under 65 with certain disabilities,
and any age with End-State Renal Disease – ESRD (permanent kidney failure requiring dialysis or a kidney transplant).
There are different parts to Medicare coverage that eligible beneficiaries qualify to join. These different parts help cover
specific services if certain conditions are met.
Here are the different parts to the Medicare program:
Medicare Part A (Hospital Insurance)
Helps cover inpatient hospital care
Helps cover skilled nursing facility, hospice and home health care
Medicare Part B (Medical Insurance)
Helps cover doctor services, outpatient services and home health care
Helps cover some preventative services to keep up health and prevent illnesses from getting worse
Medicare Part C (Medicare Advantage Plans)
Allows Medicare benefits to be provided through a private company who is approved and contracted under Medicare
This plan includes Part A, Part B, Part D and other benefits that Medicare may not cover such as vision and dental services
May also include prescription drug coverage
Medicare Part D (Prescription Drug Coverage)
Helps cover the cost of prescription drugs
This program is run by private companies and can vary in cost and drugs that are covered.
Medicare Part D is a prescription drug coverage policy. It covers most generic and name brand drugs. Its purpose is to help people who already have high prescription drug costs as well as help with rising prescription drug costs.
There are a variety of plans available offering various costs and coverage
Everyone eligible for Medicare Part A is automatically eligible for Medicare Part D. However you must enroll in Part D three months in advance or three months after you become eligible – otherwise you will have to wait for open enrollment. Open enrollment usually takes place in the last few months of the year.
If you decide to enroll in this coverage you will be responsible for paying monthly premiums and possibly a yearly deductible. If you are considered low-income, you might be eligible for lower or no-cost plans, including Medicaid.
It is important to have prescription drug coverage even if you don’t take a lot of prescription drugs because as people get older they tend to have an increased necessity for prescription drugs. It is better to be covered should the need for prescription drugs shall arise. Keep in mind prescription drug costs are rising and you should have a plan to offset this cost.
When can you join a Medicare Part D Plan?
Enrollment starts between October 15th and December 7th – anyone can join, switch or drop a Medicare Part D plan. The change will take effect on January 1st so long as the carrier receives your request by December 7th.
When you are first eligible for Medicare – you can join Part D within the seven month period that begins three months before the month you turn 65 which includes the month you actually turn 65 and ends 3 months after the month you turn 65.
If receiving Medicare due to a disability, you can join during the seven month period that begins three months before the 25th month of disability which includes your 25th month of disability and ends 3 months after your 25th month of disability. You will be able to join 3 months before and after the month you turn 65.