Turning 65? What to Know Before Choosing Medicare Coverage
Turning 65 is an important milestone-and it often comes with plenty of questions about Medicare.
When should you enroll? What do Parts A, B, C and D cover? Should you choose Original Medicare or Medicare Advantage? What happens if you continue working?
The best place to begin is with education. Understanding the basics before making a decision can help you approach Medicare with greater confidence.
Know Your Enrollment Period
For most people, the Initial Enrollment Period is a seven month window:
The three months before your 65th birthday month
Your birthday month
The three months after your birthday month
The timing of your enrollment can affect when coverage begins. Late enrollment penalties or delayed coverage may apply in certain situations, so it is important to understand which enrollment period applies to you.
Understand the Parts of Medicare
Medicare has four main parts:
Part A - Hospital Insurance
Helps cover inpatient hospital care, skilled nursing facility care, hospice care and certain home healthcare services.
Part B - Medical Insurance (Doctors Services)
Helps cover doctor visits, specialists, outpatient care, preventive services, laboratory work and other medically necessary services.
Part C - Medicare Advantage
An alternative way to receive your Part A and Part B benefits through a private insurance company approved by Medicare. Many plans also include Part D prescription drug coverage.
Part D - Prescription Drug Coverage
Helps cover prescription medications. Part D coverage is available through private insurance companies approved by Medicare.
Original Medicare or Medicare Advantage?
One of the biggest decisions is how you want to receive your Medicare coverage.
With Original Medicare, you received Part A and Part B directly through Medicare. You may also choose a stand-alone Part D prescription drug plan and a Medicare Supplement plan to help with certain eligible costs that Original Medicare leaves behind.
A Medicare Advantage plan, also known as Part C, provides your Part A and Part B benefits through a private insurance company. Plans may use provider networks, often include prescription coverage, and may offer additional benefits depending on the plan.
Neither path is automatically right for everyone. Your decision should be based on your individual needs - not a television commercial or someone else’s plan.
Check Your Doctors and Prescriptions
Before choosing coverage, consider:
Your doctors and specialists
Your preferred hospitals and healthcare providers
Your prescriptions, dosages and frequency
Your preferred pharmacy
Your travel habits
Your healthcare needs and priorities
Provider networks, prescription formularies, benefits and costs can differ between plans and may change from year to year.
Look Beyond the Monthly Premium
A low or even zero-dollar plan premium does not necessarily mean there will be no healthcare expenses.
Consider the complete financial picture, including:
Monthly premiums
Deductibles
Copayments
Coinsurance
Prescription costs
Maximum out of pocket limits, when applicable
The goal is to understand how the coverage works - not simply choose based on the premium.
Working Past 65?
If you plan to continue working after age 65, do not automatically assume that you should enroll in Medicare or delay enrollment.
Employer size, active employee coverage, prescription coverage and coverage for your spouse or dependents can all affect your decision.
Ask whether your prescription coverage is considered creditable for Medicare Part D and keep any creditable coverage notices you receive. Review your specific employer coverage before making an enrollment decision.
Prepare Before You Decide
Before enrolling, gather:
Your Medicare card, if you already have one
Current health insurance information
A complete prescription list
The names of your doctors and preferred providers
Employer or retiree coverage information
Your Medicare questions and concerns
A little preparation can help you make the most of a personal Medicare review.
Attend a Free Medicare Education Workshop
The Guffey Group is offering free education workshops designed to explain Medicare in plain English.
Collinsville Library
September 14 and October 5
11 am -12:30 pm
Glen Carbon Library
August 27, September 17 and October 8
11 am- 12:30 pm
There is no pressure and no sales presentation-just clear Medicare education you can use.
For more information or to schedule a personal Medicare review, call
618-593-6558 or visit
theguffeygroup.net
Diane Guffey Newell
The Guffey Group
Education You Can Trust. Guidance You Can Count On.]
Protecting what matters most.
The Guffey Group is not connected with or endorsed by the U.S. goverenment or the federal Medicare program. This is a solicitation for insurance. A licensed insurance agent may contact you.