| Wed, Dec 28, 2011 @ 09:00 AM

Turning 65 in 2012? 3 Things You Should Know About Medicare

Posted by Medicare Made Clear

Boomers born in 1947 are among the first in their generation to become eligible for Medicare, and 2012 is their year.The official start of the post-WWII baby boom may be debatable, but those born in 1947 are surely among the first of the Boomers to be reaching Medicare eligibility. It may be time to get ready to make some choices. Here are three basic bits of information to help you get started.

1. You Have Two Ways to Get Medicare.

Original Medicare is the traditional method of receiving Medicare benefits. When you choose this method, your health care coverage is administered by the federal government. Original Medicare has two parts, Part A and Part B. Part A covers care you receive while in a hospital or a skilled nursing facility. It is premium-free for most people. Part B covers doctor visits and outpatient care. You must pay a monthly premium for Part B.

Since the 1970s, Medicare beneficiaries have had the option of choosing to receive their benefits through private insurance companies. This is now called Medicare Advantage, also known as Medicare Part C. Medicare Advantage plans are required to provide all the benefits included under Original Medicare Parts A and B. Many plans also include additional benefits, such as prescription drug coverage (Medicare Part D) and dental, vision and hearing care. Companies offering Medicare Advantage plans are approved by Medicare and contracted by the federal government.

2. You Have a Set Medicare Enrollment Window.

Your Initial Enrollment Period (IEP) begins three months before the month you turn 65, includes the month you turn 65 and ends 3 months after the month you turn 65.. If you are already receiving benefits from Social Security or the Railroard Retirement Board at this time, in most cases, you will be automatically enrolled in Original Medicare Parts A and B. Otherwise you need to contact your local Social Security office to enroll.

During your IEP, you can choose among many coverage options and combinations, depending on your needs. You can choose to:

  • Delay enrollment in Part B or Part A (if you are still receiving health care coverage through an employer, for example)
  • Keep Original Medicare Part A and Part B
  • Enroll in a Medicare Advantage plan (most, but not all, include prescription drug coverage plus additional benefits not covered by Original Medicare)
  • Enroll in a Medicare Part D prescription drug plan to add drug coverage to Original Medicare (or to a Medicare Advantage plan that doesn’t include it)
  • Enroll in a Medicare supplement insurance plan to help cover some costs and benefits not covered by Original Medicare

Don’t let your IEP pass by without making decisions and taking any necessary action. You may be charged a penalty to enroll later, unless you qualify for a Special Enrollment Period.

3. You Have Medicare Plan Choices.

When considering your Medicare choices, it’s important to think in terms of coverage and not just plans. You want to be sure that you’re comparing apples to apples. For example, you may need Original Medicare Parts A and B, plus a prescription drug plan (Part D), plus a Medicare Supplement Insurance plan (Medigap) to match the coverage that you may get with a Medicare Advantage plan that includes prescription drug coverage. Further, the coverage you get with one Medicare Advantage or prescription drug plan can vary a great deal from what you get with another.

Your coverage needs will depend on a number a factors including your:

  • Health status and health care needs
  • Prescription medications
  • Financial situation and needs
  • Health care provider preferences

Medicare Advantage and prescription drug plans are offered by private companies regionally. Coverage and costs vary. You can use the Plan Finder at Medicare.gov to see what’s available in your area. Original Medicare provides the same coverage at the same cost, no matter where you live.

For more information contact the Medicare helpline 24 hours a day, 7 days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. You can also contact UnitedHealthcare® Medicare Made Clear to learn more 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, 7 days a week.


Medicare Basics: MedicareMadeClear.com

Understanding Medicare Enrollment Periods: Medicare.gov

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