10 key things you should know about Medicare – Residents of Redlands, Yucaipa, Banning, Beaumont
There are two ways to get Original Medicare (Part A and Part B).
ChooseOriginal Medicare on its own, with the option to add Medicare Part D prescription drug coverage and/or Medicare Supplement Insurance (Medigap) for more complete coverage. Or choose a MedicareAdvantage (Medicare Part C) plan that bundles Original Medicare with extra benefits and may include prescription drug coverage in one plan. Once you’ve made this decision, it’s time to compare plans and pricing, and make a selection that meets your needs.
Medicare Prescription Drug coverage is available.
Original Medicare doesn’t include prescription drug coverage. That’s where Medicare Part D comes in. You can add Medicare Part D prescription drug coverage as a standalone plan or, depending on where you live, choose a Medicare Advantage plan that includes prescription drug coverage.
Important: If you don’t sign up for a plan with Part D prescription drug coverage as soon as you become eligible for Medicare, you may pay a penalty on your premium unless you qualify for an exception or have other creditable coverage.
You’ll pay a share of the cost of Medicare.
Medicare helps you get the health care you need, but you’ll still be expected to pay a share of the cost. You’ve already contributed to Medicare by paying taxes while you worked. Now that you’re starting to use your Medicare benefits, you’ll pay for a share of the care you receive through monthly premiums, co-pays or coinsurance.
Your share of the Medicare costs may be larger than you expect.
There are some expenses Original Medicare doesn’t cover. Many people who choose Original Medicare add extra coverage, a Medicare Supplement Insurance plan, to help fill in those gaps. Another alternative is to choose a Medicare Advantage plan, which can also help with some of these expenses.
Where you live makes a difference.
Original Medicare is the same across the United States. But other parts of Medicare (Medicare Advantage and Medicare Part D) are offered by private insurance companies and may be available only in specific counties, states or regions, and not in others—although you may also find Medicare Advantage and Medicare Part D plans that offer nationwide coverage. Medicare Supplement Insurance plans are offered by private insurance companies. These plans may offer nationwide coverage and are available by state.
Original Medicare doesn’t cover all your expenses.
You’ll find that each part of Medicare has things it doesn’t cover. Find more coverage information on the Understanding Medicare page.
Start by looking at the health insurance coverage you have now.
Considering your or your loved one’s current health coverage can help you decide what you want in a Medicare plan. For example, if you have group coverage from your current job, or retiree insurance from a former employer, you’ll want to see how this coverage works with Medicare. Ask your benefits administrator for advice on next steps based on your individual situation.
Timing matters when you’re choosing Medicare coverage
Your Medicare Initial Enrollment Period (IEP) begins three months before your 65th birth month or when you become eligible for Original Medicare due to disability. If you wait until after your IEP to join, you may find you’ll pay more and have fewer choices.
It’s a good idea to review your health care needs once a year.
Once you choose your Medicare coverage, you’re not locked into that choice. You’ll have the chance to change your choices during the Annual Enrollment Period (AEP) (October 15 through December 7) each year. That’s why it makes sense to check your coverage every year to see if it still fits your needs.
Don’t be afraid to ask for help with Medicare.
There’s help available for everyone making Medicare choices. And there are financial assistance programs to help with the cost of Medicare for people with limited income and assets. Choosing your Medicare plan is an important decision. Asking an expert will help you know that you’ve made the right one.
Medicare Made Clear