Medicare is a federal health insurance program that provides coverage to individuals age 65 and older, as well as to some younger individuals with disabilities or end-stage renal disease. It is an important program that helps ensure that older Americans and those with certain disabilities have access to affordable healthcare.
If you are approaching 65 or are already enrolled in Medicare, it is important to understand the timeline and flow of the program. Below is a timeline and flow chart outlining everything you need to know about Medicare.
Medicare Timeline:
• Any Age: You are eligible to apply for Medicare if you are receiving Social Security disability benefits for 24 months.
• Age 65: You are eligible to enroll in Medicare if you are a U.S. citizen or permanent resident.
• 3 months before your 65th birthday: You can enroll in Medicare during this time, also known as the “initial enrollment period.”
• 3 months after your 65th birthday: If you did not enroll in Medicare during your initial enrollment period, you can still enroll during this time.
• Age 65+: You are eligible to enroll in Medicare Advantage (private insurance alternative to Original Medicare) or change your plan during the annual enrollment period (October 15-December 7).
Medicare Flow Chart:
1. Determine if you are eligible for Medicare. As mentioned above, you are typically eligible if you are age 65 or older, or if you are under 65 and have a qualifying disability.
2. Enroll in Medicare. If you are already receiving Social Security benefits when you turn 65, you will be automatically enrolled in Original Medicare. If you are not receiving Social Security benefits, you will need to manually enroll in Medicare. You can do this online at the Medicare website, by calling 1-800-MEDICARE, or by visiting a local Social Security office.
3. Decide whether to enroll in Original Medicare or Medicare Advantage. Original Medicare is the traditional fee-for-service Medicare program that includes Part A (hospital insurance) and Part B (medical insurance). Medicare Advantage is a private insurance alternative to Original Medicare that includes all of the benefits of Original Medicare and may also offer additional coverage such as prescription drugs, vision, and dental. – OR-
4. Consider enrolling in a Medicare Supplement (Medigap) plan. Medigap is a type of private insurance that helps cover out-of-pocket costs such as copays and deductibles not covered by Original Medicare. However you can not have both a supplement and a Medicare Advantage plan.
5. Enroll in a Part D prescription drug plan if needed. Part D is a separate Medicare benefit that helps cover the cost of prescription drugs. Some Medicare Advantage Plans include Part D.
6. Review and update your coverage annually. It is important to review your coverage each year to ensure that it still meets your needs. The annual enrollment period for Medicare is from October 15-December 7, during which you can make changes to your coverage.
Understanding the timeline and flow of Medicare is important for ensuring that you have the coverage you need as you age or if you have a qualifying disability. By following the steps outlined in the flow chart above, you can be confident that you have the right coverage to meet your healthcare needs.
