A quick intro on Medicare: 3 things you need to know

ApexBlog - Intro to Medicare

If you’re nearing age 65, you’re almost ready to start enjoying the many benefits of Medicare. You may have heard that it can be complicated, but we see things differently. ApexHealth is here to make Medicare easy to understand – and easy to use. This is why we put together this quick intro to Medicare with 3 key things you need to know.

1. You’re eligible for Medicare at age 65

Keep an eye on the calendar! Once you’re eligible for Medicare, you have seven months to enroll – three months before you turn 65 – the month of your birthday and three months after. Here’s a handy Medicare timeline that we’ve put together to help you out:

  • Age 64 – Start doing your Medicare homework. Or if you have any questions, give ApexHealth a call and we’ll give you the simple rundown.
  • Age 64+9 months – Congratulations! You can enroll in Medicare now (three months before you turn 65). Why not do it now, and make sure you’re covered on your 65th birthday.
  • Age 65 – Happy Birthday! Sign up for Medicare now, if you haven’t already. You’re eligible to receive benefits starting on your 65th birthday. (And you’ve got three months left to act to avoid penalties.)
  • Age 65+3 months – Make sure you’re enrolled in Medicare Part B by this date. After this point, you could get penalized with a late fee. (Don’t worry about getting locked in to one plan. You get a chance to change plans every year, during the fall open enrollment period.)

Put all those great benefits to work for you at the earliest possible date and avoid penalties for enrolling late. Remember that you are only automatically enrolled in Medicare Parts A and B if you are taking Social Security benefits. If you’re not, you’ll have to sign up yourself.

2. Learn the different Medicare parts

As you unpack Medicare, you might be wondering “What’s the deal with all the parts?” Medicare includes four parts. Each part focuses on a different chunk of medical coverage. This quick rundown can help you understand each chunk and how they fit together:

Original Medicare (Parts A and B)

Part A covers hospital stays. In most cases there’s no monthly premium, but you might have to pay a deductible. Part B covers visits to doctors, specialists and urgent care centers. You pay a monthly premium that is typically deducted right from your Social Security check.

Medicare Advantage plans (Part C)

Medicare Advantage plans (Part C) include all the benefits of Original Medicare (Parts A and B), plus more comprehensive coverage, and additional benefits, such as dental, hearing and vision and extras which vary by plan such as gym memberships and OTC allowances. Also, they often include Part D prescription drug coverage. Medicare Advantage plans are offered by private health insurance companies (like ApexHealth) and have a monthly premium which varies by plan.

Medicare Prescription Drug plans (Part D)

Part D covers prescription drugs (no surprise there). Part D is sometimes included in Medicare Advantage plans. You can also buy it as stand-alone coverage. Like Medicare Advantage plans, Part D plans are offered by private health insurance companies and have a monthly premium.

Medicare Supplement plans

Also called Medigap plans, Medicare Supplement plans cover the gap left by Original Medicare. They are offered by private health insurance companies and have a monthly premium. Original Medicare pays for 80 percent of covered doctor and hospital bills and Medicare Supplement plans cover the extra 20 percent, plus the deductible. Medicare Supplement plans do not include prescription drug coverage and many of the extras offered by Medicare Advantage plans. 

3. Original Medicare leaves significant coverage gaps  

It’s also great that you get to choose the type of Medicare that suits your needs, from Original Medicare to Medicare Supplement plans to Medicare Advantage plans. Just remember that Original Medicare does leave some significant gaps in your coverage including no coverage for prescription drugs or services like routine dental and vision care. Original Medicare covers 80 percent of eligible doctor and hospital visits, leaving you to pay the remaining 20 percent.

You can purchase a Medicare Supplement plan to help cover these costs. Just keep in mind that prescription drug coverage is not included. Or you can enroll in a Medicare Advantage plan with prescription drug coverage that typically has lower premiums and also offers the convenience of having one policy, rather than juggling three different types of coverage.  

We hope that this quick intro to Medicare gave you some useful information on how Medicare works, when to sign up and more. If you have any questions, give us a call at (844) 279-0508 (TTY: 711). Our hours of operation are Monday through Friday 8 a.m. – 8 p.m. (local time) from Apr. 1 through Sept. 30 and seven days a week 8 a.m. – 8 p.m. (local time) from Oct. 1 through Mar. 31.

And check back with us for more Medicare education, health and wellness information and other ways you can make the most out of Medicare.


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