What is Medicare?

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Medicare is the federal health insurance program for everyone who is 65 or older or those under 65 with certain disabilities. With Original Medicare, there are two Parts that provide different coverage — Medicare Part A and Part B.

Part A covers:

Inpatient care in a hospital — When you’re admitted to the hospital as an inpatient after an official doctor’s order, which says you need inpatient hospital care to treat your illness or injury.
Skilled nursing facility care
Hospice care
Home health care

Part B covers:

Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

However, it only covers 80% of these services. Without a Medicare insurance plan, you are on the hook for 20% coinsurance/copayment plans.

Q: DOES MEDICARE HAVE A DEDUCTIBLE?

A: YES.

Both parts have deductibles. Part A’s deductible, the inpatient hospital deductible that beneficiaries will pay when admitted to the hospital, will be $1,408 in 2020. Part B’s deductible, the one you pay for medically necessary services or supplies, is $198 in 2020. There are insurance plans, called Medicare Supplements that can cover some or all of your deductibles depending on your eligibility.

MEDICARE DOES NOT COVER PRESCRIPTION DRUGS

If you stick with Part A and B, you will have to pay out-of-pocket for your prescription medicine.

To get coverage, you will either have to purchase a standalone Part D plan or a Medicare Advantage plan that incorporates a Part D plan in it from a Medicare insurance company.

MEDICARE ENROLLMENT PERIODS

Whether you’re approaching your 65th birthday, looking for the annual election period, or otherwise wondering about Medicare enrollment periods, we have nearly all of them listed here.

We’ll detail what you can do during these periods and when they are.

INITIAL ENROLLMENT PERIOD

The first time you become eligible for Medicare is known as your initial enrollment period.

If you’re becoming eligible due to age, your initial enrollment period begins three months before the month of your 65th birthday and ends three months after your 65th birthday month.

This happens with one exception: if your birthday is on the first of the month. This will cause your enrollment period to begin one month early. For example: if your birthday is November 1, your enrollment period will begin July 1 and your Medicare will begin one month early as well — October 1.

During your initial enrollment period, you can enroll in Original Medicare (Part A and B), Medicare Advantage plan, a Medicare Supplement, or Medicare Part D.

In fact, this is the best time to get a supplement or Part D plan.

You can get a Medicare Supplement during your initial enrollment period with no health questions asked.

Also, signing up for a Part D plan during IEP helps you to avoid any late enrollment penalties.

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