6For those of you who are turning 65 years old in 2019, congratulations on beginning your Medicare journey! This journey may feel at first like it’s full of twists and turns, making it easy to lose your way. Because Medicare has several moving parts, here’s a breakdown to the basics you should know when you are new to Medicare.
How and When to Enroll in Medicare
Medicare gives each new Medicare beneficiary a seven-month window to initially enroll in Medicare. This window is called your Initial Enrollment Period for Medicare, or IEP. Your IEP will always begin three months prior to the month in which you turn 65. Then it will end three months after your birthday month. You’ll use this period to enroll in Medicare Part A and Part B and Part D (if you need drug coverage).
There are three ways you can enroll in Medicare. The first, most convenient way is online. Simply go to Medicare’s website and fill out the online application. The second way you can apply for Medicare is in person at the Social Security office. Make an appointment ahead of time to avoid long wait times. The third way to apply is by calling the Social Security office and requesting an application over the phone.
It’s important to note that if you are already taking out Social Security benefits, you will be auto-enrolled into Medicare and your documents will be mailed to you shortly before you turn 65.
Two Main Routes for Supplemental Coverage
A popular misconception among some new Medicare beneficiaries is that Medicare will pay 100% of everything. However, this is untrue. Medicare has cost-sharing amounts just like every other type of health insurance.
That’s why Medicare allows for additional coverage to help supplement your Original Medicare coverage. The first type of plan is Medigap. Also known as Medicare Supplement plans, Medigap plans help you with your out-of-pocket expenses. For example, Medigap Plan G covers all of your cost-sharing expenses except the Part B annual deductible. If you enroll within 6 months of your Part B effective date, there is no underwriting or health questions to obtain Medigap coverage.
The second type of supplemental coverage you can get is Medicare Advantage, or Part C. Medicare Advantage plans are similar to network plans like those you have had through your former employers. There are set copays and deductibles just like with Medicare, but they are specific to the plan.
Medicare Advantage plans usually include extra benefits such as a built-in Part D drug plan. Beginning in 2019, these plans can also include benefits like transportation to medical appointments, meal delivery, and even some custodial home healthcare.
Medicare’s drug coverage is known as Part D. Ultimately, Part D is voluntary. However, you can be penalized if you do not enroll during your initial enrollment period. You can either enroll in a stand-alone Part D drug plan or you can have one through a Medicare Advantage plan. In years past, Part D plans had a coverage gap that could be expensive if you have multiple brand-name medications. Fortunately, the Bipartisan Budget Act passed in 2018 eliminates the coverage gap for brand-name medications starting in January 2019.
Annual Election Period
Each year, Medicare has the Annual Election Period (AEP) in the fall from October 15th through December 7th. This period is an opportunity to review your Medicare Advantage plan or your Part D drug plan and change your plan if you wish. During the AEP, you can switch Medicare Advantage plans or switch Part D drug plans. You can also switch from a Medicare Advantage plan to a stand-alone Part D drug plan, and vice versa.
Knowing these basics will help you to enroll on time, avoid late penalties and select the right supplemental coverage for you. To learn more, visit Medicare’s website or contact a Medicare insurance broker who can guide you through your options.
Danielle Kunkle is a founding partner of Boomer Benefits, a family-owned agency specializing in Medicare-related insurance products. They have just launched a free Medicare mini course; to learn more visit https://boomerbenefits.com/