Service Details
Medicare Explained
Service Overview
Medicare 101
What is Medicare?
Medicare is a federal health insurance program that offers health insurance to American citizens and other eligible individuals based on age, disability or a qualifying medical condition. Medicare is individual insurance and doesn’t cover spouses or dependents.
Who can get Medicare?
U.S. citizens and legal residents: Legal residents must live in the U.S. for at least 5 years in a row, including the 5 years just before applying for Medicare.
You must also meet one of the following Requirements.
- Be 65 or older.
- Younger than 65 with a qualifying disability.
- Any age with a diagnosis of end-stage renal disease or ALS.
- Be disabled/receive Social Security disability income benefits for 24 Months
- Have ESRD
- Have ALS
Eligible with disability?
Your Medicare eligibility begins after 24 months of receiving Social Security disability benefits.
Medicare is not Medicaid.
Medicaid is a program that helps pay health care costs for people with limited income and resources.
Download
- Download Medicare Guide
When can I enroll?
Once you are eligible, you can begin the enrollment process! For some, automatic enrollment in Original Medicare (Part A and B) will occur. This happens when you turn 65 and receiving Social Security benefits.
It may also happen if you have a qualifying disability and have received SSDI for 24 months. In this case, you will automatically enrolled in your 25th month.
If you are not automatically enrolled, you will need to enroll yourself during the Initial Enrollment Period (IEP). This period will start three months before your 65th birthday month and end three months after your 65th birthday month.
Other enrollment periods that will be important to know about include:
MA OEP
Medicare Advantage Open Enrollment
If you’re enrolled in a Medicare Advantage plan on January 1, you can make one coverage change between January 1 and March 31. You may switch to a different Medicare Advantage plan or return to Original Medicare. If you go back to Original Medicare, you may also enroll in a Part D plan during this time.
How do you enroll?
If you are receiving Social Security or Railroad Retirement Board benefits when you become eligible you will be automatically enrolled in Medicare Parts A and B. You’ll receive your Medicare card by mail. If you’re not receiving benefits, you need to sign up for Medicare when you become eligible.
Go to socialsecurity.gov to enroll online, or call or visit your local Social Security office.
Medicare coverage options
Step one
First, you need to enroll in Original Medicare
Provided by federal government
Part A
Helps pay for hospital stays and inpatient care.
Part B
Helps pay for doctor visits and outpatient care
Step Two
Now, you can look at additional coverage options
Offered by private insurance companies
Option 1
Medicare Part D
Helps pay for prescription drugs
And, you can also add:
Medicare supplement insurance (medigap)
Helps pay some out-of-pocket costs that come with Original Medicare
Option 2
Medicare Advantage Plan (Part C)
Combines Original Medicare Part A & B coverage in one plan
Usually includes prescription drug coverage (Part D)
May offer additional benefits like vision and dental coverage
Step three
Find yourself an insurance broker
The Medicare process can be overwhelming. A licensed Medicare broker will listen to you and give you information about your coverage options that is based on your needs and preferences. Working with a trained broker can help you save time and money, ultimately helping you find the right plan..
Understanding the basics of medicare
Medicare 101- When it comes to understanding the basics of Medicare and what your choices are. Let Vance Insurance Group help you choose the health plan that meets your health care needs.
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