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Get More From Medicare

About to turn 65? Approaching retirement age? Or would you like to learn more about how original Medicare works? Whatever your situation, understanding Medicare can help you make important decisions on the kinds of health coverage that best suit your needs.

What is Medicare?

Medicare is a federal health insurance program. It’s administered by the Center for Medicare and Medicaid Services (CMS).

How to decide between traditional and Medicare Advantage coverage

Trying to decide what coverage is best for you? One of the first things you’ll need to do is consider what coverage suits your needs. Is it ‘traditional Medicare’ (Parts A and B) or Medicare Advantage (Part C)?

When you enroll in Medicare for the first time, if you do nothing, you’ll automatically be signed up for traditional Medicare.

Wondering whether you can decide to switch to another coverage option, like a Medicare Advantage plan, after your IEP? Yes you can, during the Annual Enrollment Period that runs from October 15 to December 7 every year.

About Medicare Advantage plans

All Medicare Advantage plans must include everything that traditional Medicare covers. In addition, all Medicare Advantage plans limit out-of-pocket costs and, as mentioned above, most also include Part D drug coverage. (If you choose a Medicare Advantage plan that doesn’t include Part D, and you want drug coverage, you’ll have to sign up for that coverage separately.)

Some Medicare Advantage plans charge lower copays than traditional Medicare, but may also charge an extra monthly premium. They may also require members to see healthcare providers in the plan’s network.

Sign up at the start of your initial enrollment period

Some people—including those who started to receive Social Security or other benefits before turning 65—are automatically signed up for Medicare Parts A and B. Everyone else has to enroll on their own. Make sure you sign up for Medicare coverage as soon as you’re eligible by enrolling early in your Initial Enrollment Period. This seven-month period includes: the three months before the month you turn 65; the month you turn 65; and the three months following that birthday. If you enroll during the first three months of your enrollment period, your coverage will begin sooner than if you sign up later in the enrollment period.

Sign up for Part D, even if you don’t take many drugs

Planning to enroll in a traditional Medicare plan? Or a Medicare Advantage plan that doesn’t cover prescriptions? Consider signing up for Part D (Medicare’s prescription drug plan) right from the start – even if you don’t take many medications right now. Why? If you wait, you may end up having to pay a higher premium when enrolling in Part D later.

Apply for extra help

If you have limited income and resources, you may qualify for the federal Extra Help program. It helps people cover their Medicare costs. If you’re already enrolled in Medicaid, Supplemental Security Income, or a Medicare Savings Program, you automatically qualify for Extra Help. If you’re not enrolled in those programs, you can apply by contacting the Social Security Administration or at your local Medicaid office.

Reevaluate your Medicare choices every fall

Every September or October, check whether your current plan is still the best fit for you. If a new plan better meets your needs, you can switch once the open enrollment period begins in October. Your circumstances may have changed over the course of the year. So your current plan may not be as good a fit as it used to be.

Avoid a late enrollment penalty

When signing up for traditional Medicare, most people can choose to get Part A coverage only. They can skip Part B and the monthly premium that goes along with it. If you don’t enroll in Part B when first eligible, you may have to pay a late enrollment penalty when you finally do join. There are some exceptions. For example, if you have health coverage through your or your spouse’s employer, you may be able to defer enrolling in Part B without paying a late enrollment penalty. You must have proof of creditable coverage.

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