The Ultimate Guide to Medicare

The Medicare Advantage Program

The Medicare Advantage Program is Part C and is separate from the above two parts because these policies are provided to you from Medicare approved private health insurance companies. Part C plans are popular—but more expensive—because they often provide everything Parts A and B can with even more benefits. You can expect coverage for vision, dental, and hearing coverage.

Most Medicare Advantage plans, however, are restricted to certain provider networks. This means that you may have to see certain doctors or go to certain hospitals to take full advantage of your benefits. Otherwise, you may have to pay more when going outside your network. This can be inconvenient and costly, so before enrolling in Part C, before to look around where you live and work to see if you would be covered.

Medicare-Approved Private Plans

Original Medicare (Parts A and B) don’t cover most prescription medicines. This is where Part D, the Medicare-Approved private plan, comes into play to offer coverage to the prescription medicine you need.

However, there are a few things to consider:

• You’re not automatically enrolled: You need to be eligible first and may incur late enrollment penalties if you sign up after you’re first eligible.

• Enrollment in Part D is limited to certain times of the year.

• Costs & Benefits May Vary: Monthly premiums, deductibles, co-pays, and pharmacy network is provided by private insurance companies.

What is Medicare Supplement Insurance?

Often called Medigap, Medicare Supplement Insurance can help pay some of the costs original Medicare doesn’t cover, like co-payments, co-insurance, and deductibles. These policies are expressly sold by private insurance companies, meaning that just like Parts C and D, the costs and benefits you experience may vary. However, all benefits are standardized across the board.

Medigap cannot be taken alongside a Medicare Advantage Plan (Part C), and you can only apply for Medicare supplement insurance during certain times of the year.

How to Get Your Medicare Insurance

Eligibility and enrollment into Medicare can be a mixed bag. Nearly everyone can automatically qualify for Parts A and B of Medicare if they meet the below qualifications:

• Receiving retirement benefits from Social Security or the Railroad Retirement Board.

• Under 65 and have a disability.

• You have ALS or Lou Gehrig’s disease.

• You live in Puerto Rico and also get benefits from Social Security or the RRB.

You can apply for original Medicare at the same time you apply for retirement benefits through Social Security or the Railroad Retirement Board.

Past this, however, things get more complicated in the ‘initial enrollment period.’