Medicare Basics You Need To Know Before You Enroll

By Author: William Richards
Total Articles: 366
Comment this article

What many people don’t realize is that even though the Centers for Medicare and Medicaid Services (CMS) oversee Medicare insurance, Social Security makes the final decision on your eligibility and enrollment status.

“You don’t need to be collecting Social Security benefits to be covered by Medicare,” suggests Alan Weinstock, insurance broker at MedicareSupplementPlans.com. “However, it does determine when and how you enroll in Medicare.”

Medicare Parts A, B, C and D

There are four parts to Medicare. Medicare Part A (hospital insurance) also known as Original Medicare helps cover your inpatient care in hospitals, critical access hospitals, and skilled nursing facilities. Medicare Part B (medical insurance) helps cover your doctors' services, outpatient hospital care and some other medical services that Part A does not cover.

Medicare Part C (Medicare Advantage) is also known as Medicare Advantage and Medicare Part D is the Medicare prescription drug coverage plan.

Receiving Medicare Part A and Part B Benefits

If you are not receiving retirement benefits from Social Security ...
... or the Railroad Retirement Board, and you want Medicare Part B to begin at age 65, you must apply for Medicare during the three-month period before you turn 65. If you apply the month you turn age 65 or later, your Medicare Part B start date will be delayed.

If you are already drawing Social Security before the age of 65 you will be automatically enrolled in Medicare Part A and Part B. Your Medicare card will be sent to you approximately three months before you turn 65.

You don't have to pay for Medicare Part A if you have worked for at least 10 years in Medicare-covered employment. The cost for Medicare Part B for new enrollees is currently $115.40. This monthly premium is deducted from your Social Security, Railroad Retirement or Civil Service Retirement check. If you don't get any of these payments, Medicare will send you a bill for your Part B premium every 3 months.

When you sign up for Medicare Part B, you automatically begin your Medigap (Medicare Supplement Insurance) open enrollment period. Once your Medigap open enrollment period begins, it can't be changed or restarted.

Medicare Plus Medigap Insurance and Medicare Advantage

“Knowing whether to choose original Medicare and supplement your coverage with a Medigap policy or to select a Medicare Advantage Plan means identifying your needs and what each plan offers,” notes Alan.

Medicare Advantage Plans (known as Medicare Part C) are run by private insurance companies that must follow rules set by Medicare. With this plan you get Part A and Part B coverage rolled into one, but actual costs for services vary by plan. Drug coverage is generally available through your Medicare Advantage Plan as well.

On the other hand Medicare supplement insurance plan (Medigap) is health insurance sold by private insurance companies to fill the "gaps" between what the original Medicare plan covers and what the beneficiary will have to end up paying. Medigap policies help pay some of the health care costs that the original Medicare plan does not cover.

All in all it is important to take your time to you choose the best Medicare plan for you. Whether you decide on Medicare with a supplemental Medigap policy or choose a Medicare Advantage Plan, don’t make a snap decision. Consider your options by getting the facts from the Center for Medicare and Medicaid Services or the experts at MedicareSupplementPlans.com.

Medigap insurance can give what the original Medicare Supplement cannot and this is a very effective advantage of the Medigap insurance California.