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November 22, 2011

Turning 65 & Have Questions About Medicare?

Learn the Basics About Medicare Benefits & Insurance Options

If you're approaching your 65th birthday, you're about to join a new club: Medicare. Medicare is the federal health insurance program for U.S. citizens age 65 years and older. Along with seniors, Medicare covers people younger than 65 with qualifying medical conditions such as End Stage Renal Disease and ALS.

Many people who are new to Medicare get confused by the complexity of the program. Medicare is comprised of four major programs: Part A, Part B, Part C, and Part D. Medicare Part A and Part B are often referred to as "Original Medicare." Generally speaking, Part A covers in-patient hospitalization while Part B covers outpatient services and other medical care. Part C denotes the "Medicare Advantage" program where private insurance companies deliver Medicare Part A and Part B benefits to plan enrollees. Part D is the Medicare prescription drug benefit that provides insurance coverage for medications.

Your circumstances determine when you can enroll or change Part D plans. For seniors who already have Part D plans, the annual enrollment period (AEP) in 2012 is from October 15th through December 7th.

For those seniors turning 65, Medicare allows them to enroll in a Medicare Part D plan three prior to the month of the person's 65th birthday through three after this month. In total, that provides a senior turning 65 window of seven months in which to enroll.

Some seniors have the freedom to enroll or change plans each month. These seniors have a special enrollment period (SEP) for reasons such as:

  • Dual enrollment in Medicare and Medicaid
  • Participation in the "Extra Help" program
  • Institutionalization in a nursing home or skilled nursing facility

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Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.

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