How to Make the Most of Medicare
Plan Ahead
It’s never too early to get informed. Most people will be eligible for Medicare when they turn 65, but you can sign up 3 months before your birthday. You also may be able to sign up earlier if you have a disability. Medicare has lots of different parts, and you’ll have many choices to make. The more you know ahead of time, the easier it’ll be to make the best and most cost-savvy choices about Medicare coverage when the time comes.
Sign Up on Time
Medicare.gov offers a series of questions to help you figure out when to sign up. Most people can sign up for Parts A and B, covering hospital and medical insurance, 3 months before turning 65 and up to 3 months after. If you don’t sign up when you’re first eligible, you’ll have to wait. You may also need to pay extra in monthly penalties. The longer you hold off, the more it will cost you.
If You Have Insurance From a Job
If you still have health insurance through your job or your spouse’s, you may decide to wait to sign up for Medicare until after you turn 65. Most people don’t pay a premium for Part A, so you could go ahead with that portion when you turn 65. But you can likely hold off on Part B. As long as you enroll within 8 months after you or your spouse stops working, you won’t pay a penalty for signing up late.
Don’t Miss Your Welcome Visit
Medicare Part B, which covers medical insurance, offers a free “Welcome to Medicare” preventive care visit within your first year of coverage. If your doctor or another qualified provider accepts, you’ll pay nothing for the visit. But you may have out-of-pocket costs if your doctor recommends other services. It’s a good chance to review your medical history and plan for preventive services and any other health needs.
Consider Your Unique Needs and Costs
Should you stick with Original Medicare? Or would a Medicare Advantage plan make more sense? You’ll have lots of choices to make. You also need to sign up for a Part D plan unless you choose a Medicare Advantage plan with drug coverage. You can search for Medicare Advantage plans and Part D plans available where you live on Medicare.gov. Be sure to explore all your coverage options – and carefully consider your preferences, needs, and costs – before making a final decision. Don’t assume that what’s best for someone else is best for you.
Review Each Year
Your needs might change over time, and so will the plans available to you and their costs. Mark your calendar each year to assess them and review your coverage options. You’ll need to make changes – join, switch, or drop a plan – during the open enrollment period each year from Oct. 15 to Dec. 7. If you already enrolled in a Medicare Advantage plan, you’ll have another open enrollment period yearly from Jan. 1 to March 31. During this time, you do a one-time switch to another plan or back to Original Medicare. If you move or lose other insurance coverage, you may be able to make changes at other times.
Get Help With Costs
If you’re worried about Medicare costs, look into programs that might offer you some relief. Your State Medical Assistance (Medicaid) program may offer help outside of Medicaid. You may be able to get help paying for your Part A and B premiums, prescription drugs, and other costs. Find out what you’re eligible for based on your income and resources.
Know Who’s in Your Network
If you have Original Medicare, you can go to any doctor or hospital that takes it. You won’t normally need a referral. But if you’ve chosen a Medicare Advantage plan, you’ll need to know which doctors and other providers are in your network and service area. You also may need referrals to see a specialist. When you’re choosing a plan, check to see that your preferred doctors are on the list.
Know What’s Covered
Avoid surprises by making sure you know what your plan covers and what it doesn’t. Part A generally covers hospital care, skilled nursing, nursing home care, hospice, and home health. Part B covers medically necessary and preventive services, including ambulances, medical equipment, and mental health care. Part D covers prescription drugs. You can search for specific tests, items, and services to check coverage on Medicare.gov.
Mind the Gap
If you have Original Medicare and have needs that aren’t covered, look into Medicare supplemental insurance, also known as Medigap. You can buy this extra insurance from a private company to help cover your costs. Consider choosing a Medigap policy within 6 months of signing up for Medicare. If you wait, you may not be able to get a policy or it might cost you more. If you have a Medicare Advantage plan, you can’t buy a Medigap plan.
Make an Online Account
By setting up a secure online account, you’ll have access to your Medicare information 24/7. Your online account can help you compare health and drug plans where you live. You’ll see your Medicare claims faster and can print a copy of your Medicare card. You’ll have easy access to a list of preventive services you can get, and more.
Ask Questions
If you’re unsure about something and can’t find what you need online, reach out for help. You can talk to a Medicare representative any time of day, with the exception of certain holidays. Just pick up the phone and dial 800-MEDICARE (800-633-4227) or start a live chat through your online account. You can also get help through a Medicare State Health Insurance Assistance Program (SHIP). SHIPs are paid for by the federal government and offer free, unbiased advice to answer your Medicare questions. You can find your local SHIP at shiphelp.org.
Get Help From Someone You Trust
If you could use more help with your Medicare choices, claims, and billing, ask someone you trust – a spouse, family member, caregiver, or friend – for help. You’ll need to give Medicare written permission to share any and all of your information with them. Complete and mail in the authorization form or log into your online account to set it up.
Show Sources
Photo Credit: Ridofranz / Getty Images
SOURCES:
Medicare.gov: “Basics,” “Your Medicare Coverage Options,” “Sign up/change plans,” “What Medicare covers,” “Contact Medicare,” “5 Tips for Using Medicare.”