Understanding Your Medicare Options

Understanding Your Medicare Options

Annual Enrollment Period

Back Annual Enrollment Period Medicare Annual Enrollment Period You must have Medicare before you can enroll in a Medicare Advantage Plan or Drug plan (Part D). Outside Open Enrollment (October 15 – December 7) you can enroll only during specific times, like your Initial Enrollment Period or a Special Enrollment Period. Outside Open Enrollment (October 15 – December 7) you can enroll in a Medicare Advantage Plan or drug plan, or make changes to coverage you already have only during these specific times: Initial Enrollment Period (New to Medicare) You can join a Medicare Advantage Plan or drug plan during the 7-month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. Special Enrollment Period You may be able to join, switch, or drop your Medicare Advantage Plan and drug coverage when certain events happen in your life (like if you move or you lose other insurance coverage). Rules about when you can make changes and the type of changes you can make are different for each Special Enrollment Period. Learn more about the circumstances that qualify you for a Special Enrollment Period. Medicare Advantage Open Enrollment Period January 1 – March 31 each year, you can make these changes: If you’re in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage). You can drop your Medicare Advantage Plan and return to Original Medicare. You’ll also be able to join a drug plan. Note: If you enrolled in a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare. General Enrollment Period If you didn’t enroll in a plan during your Initial Enrollment Period, and you don’t qualify for a Special Enrollment Period, you can enroll in a Medicare Advantage Plan or drug plan January 1 – March 31 each year. Your coverage won’t start until July 1 of that year and you may have to pay a higher Hospital (Part A) and/or Medical (Part B) premium for late enrollment. See the Medicare & You” handbook for more information about these Enrollment Periods. https://www.medicare.gov/plan-compare/#/questions?year=2021&lang=en  A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Understanding Your Medicare Options

What is Not Covered

Back What is Not Covered What’s not covered by Part A & Part B? Medicare doesn’t cover everything. Some of the items and services Medicare doesn’t cover include: Long-Term Care(also called custodial care) See What is Long Term Care Long Term Care on this website? Most dental care Eye exams related to prescribing glasses Dentures Cosmetic surgery Acupuncture Hearing aids and exams for fitting them Routine foot care A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Understanding Your Medicare Options

Part B How Does it Work?

Back Part B How Does it Work? Medicare Part B How much does Part B coverage cost?  The standard Part B premium amount in 2023 is $164.90. Most people pay the standard Part B premium amount every month.  If your modified adjusted gross income is above a certain amount (in 2023: $97,000 if you file individually or $194,000 if you’re married and file jointly), you may pay an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium. To determine if you’ll pay the IRMAA, Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago.  Visit Medicare.gov to learn more about IRMAA.  Visit Medicare.gov later this fall for 2024 amounts Note: You may also pay an extra amount for your Medicare drug coverage (Part D) premium if your modified adjusted gross income is above a certain amount. Go to page 82 of your Medicare & You Guide  Part B covers things like: Clinical research Ambulance services Durable medical equipment (DME) Mental health Inpatient Outpatient Partial hospitalization Getting a second opinion before surgery Limited outpatient prescription drugs   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Understanding Your Medicare Options

Part A – How Does it Work?

Back Part A – How Does it Work? Your Medicare Costs If you buy Part A, you’ll pay a premium of either $278 or up to $506 each month in 2023 depending on how long you or your spouse worked and paid Medicare taxes. If you need help paying your Part A premium, go to pages 91–92.  If you have questions about paying for Part A, visit Medicare.gov or call 1-800-MEDICARE.  In most cases, if you choose to buy Part A, you must also have Part B and pay monthly premiums for both. If you choose NOT to buy Part A, you can still buy Part B if you’re eligible. Visit Medicare.gov later this fall for 2024 amounts What’s the Part A late enrollment penalty? If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, your monthly premium may go up 10%. You’ll have to pay the higher premium for twice the number of years you could have had Part A but didn’t sign up. For example, if you were eligible for Part A for 2 years but didn’t sign up, you’ll have to pay a 10% higher premium for 4 years A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Understanding Your Medicare Options

What are the Parts of Medicare?

Back What are the Parts of Medicare? What are the parts of Medicare? Part A (Hospital Insurance) Helps cover: • Inpatient care in hospitals • Skilled nursing facility care • Hospice care • Home health care Go to pages 25–29.  Part B (Medical Insurance) Helps cover: • Services from doctors and other health care providers • Outpatient care • Home health care • Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment) • Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits) Go to pages 29–55.  Part C (Medicare Advantage Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. Part D (Drug coverage) Helps cover the cost of prescription drugs (including many recommended shots or vaccines). Plans that offer Medicare drug coverage (Part D) are run by private insurance companies that follow rules set by Medicare.   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Understanding Your Medicare Options

Welcome Medicare & You

Back Welcome Medicare & You Welcome If you have Medicare drug coverage (Part D) and your drug costs are high enough to reach the catastrophic coverage phase, you don’t have to pay a copayment or coinsurance. Extra Help—a program that helps cover your Part D drug costs—will expand to cover more drug costs for certain people with limited resources and income.  Go to pages 83 and 92. Coinsurance amounts for some Part B-covered drugs may be less if a prescription drug’s price increased higher than the rate of inflation. Go to page 40. Lower costs for insulin and vaccines  Your Medicare drug plan can’t charge you more than $35 for a one-month supply of each insulin product Part D covers, and you don’t have to pay a deductible for it. Go to page 88. If you take insulin through a traditional pump that’s covered under Medicare’s durable medical equipment benefit, that insulin is covered under Medicare Part B.  You won’t pay more than $35 for a month’s supply and the Medicare deductible no longer applies. Go to pages 39 and 88. Recommended adult vaccines are also now available at no cost to you. Go to page 50. Changes to telehealth coverage  You can still get telehealth services at any location in the U.S., including your home, until the end of 2024. After that, you must be in an office or medical facility located in a rural area to get most telehealth services. There are some exceptions, like for mental health services. Go to page 51. Managing and treating chronic pain Medicare now covers monthly services to treat chronic pain if you’ve been living with it for more than 3 months. Go to page 34. Better mental health care  Starting January 1, 2024, Medicare will cover intensive outpatient program services provided by hospitals, community mental health centers, and other locations if you need mental health care. Go to pages 46–47. More times to sign up for Medicare If you recently lost (or will soon lose) Medicaid, you may be able to sign up for Medicare or change your current Medicare coverage.  There are other special situations that allow you to sign up for Medicare. Go to page 18. COVID-19 care Medicare continues to cover the COVID-19 vaccine, and several tests and treatments to keep you and others safe. Go to page 37. A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.


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