If you are new to Medicare, there are several questions you should consider while approaching or within your Initial Enrollment Period (IEP) or a Special Enrollment Period (SEP). Use this guide to consider your options when preparing to enroll in Medicare or after you have already enrolled.
What are the basics? Medicare is a complex program and can sometimes be confusing. The best place to start when you are new to Medicare is by familiarizing yourself with the differences between it and the health insurance you have now. Learn what makes a person Medicare-eligible, the different parts of Medicare insurance and what those parts cover, the times to enroll in Medicare (typically enrollment begins October 15th and runs through December), and how putting off enrollment can result in penalties. These initial steps will help smooth the transition from your current insurance to Medicare once you are eligible.
What are your coverage options? Everyone has different healthcare needs, meaning the coverage that is right for your friends or family may not be right for you. Will you enroll in Original Medicare, or would you prefer a Medicare Advantage Plan that may limit your provider networks or have different costs – but that offers additional coverage? If you have current employer insurance, you may decide not to enroll in Medicare until you have retired. If you are already retired, you might find that Original Medicare plus retiree insurance works better for you than Original Medicare plus a Medigap (or vice versa). Find out the full range of your coverage options at Medicare.gov.
Should you enroll in Part D? While you should make sure you enroll in Part D prescription drug coverage when you become Medicare-eligible (assuming you do not have other creditable drug coverage), there are many Part D options for you to explore. Keep in mind, too, that sometimes retiree insurance offers prescription drug coverage that is as good as or better than Medicare Part D. If that is the case, you might decide not to take Part D because you are already covered. Finally, if you have difficulty affording your drug costs, you may want to consider applying for programs that can help you pay these costs.
Are you eligible for programs that help lower Medicare costs? There are several programs for those with lower incomes which help pay for Medicare-related costs, such as premiums and co-pays. Some of these programs are federal, while others are state-specific. You will need to find out whether you meet the eligibility requirements.
What resources exist to help you navigate Medicare? Medicare is a beneficial program, and a variety of trusted sources can help you navigate your rights and options. A few are listed below:
- 1-800-MEDICARE
- Social Security Administration (https://www.ssa.gov/)
- State Health Insurance Assistance Program (SHIP) (https://www.shiptacenter.org/)
- Medicare Rights Center (https://www.medicarerights.org/)
As your financial services professional with the First Financial Investment & Retirement Center, I can help you with the planning of your long-term care options.
To learn more about Medicare, watch the short video below. You can also schedule an appointment with me and we’ll go through it together, or visit Medicare.gov for more information.
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