People are tempted to think that Medicare is solely a government-run insurance program, but it has grown since its inception to include both publicly funded and private plans offered by major insurers.
Since Americans’ health care needs are so diverse, they need the benefit of flexibility when it comes to selecting, enrolling in and managing their Medicare options. It can sometimes feel confusing, but in the end, you’ll find Medicare one of the most essential benefits you’ll ever receive.
Vozza Insurance Agency offers customizable health insurance options to all Michigan residents. For more information, or to request your free quote on coverage, call or text us at (231) 938-6200, or toll free at (800) 668 – 5910.
Who Does Medicare Cover?
In the 1960’s the U.S. government began the Medicare program to address the fact that senior citizens often do not have access to private health insurance options after their retirement from the workforce. Coupled with the significant cost burden of medical care, seniors usually face a critical need for the benefits of medical insurance, and Medicare was designed to help meet this need.
Most Americans become eligible for Medicare upon reaching their 65th birthday, though some individuals with qualifying disabilities or end-stage renal disease (ESRD) qualify for benefits earlier. Once you enroll in benefits, you will be able to remain enrolled in the Medicare program for the rest of your life, provided you continue to renew and pay for any requisite benefits.
How Does Medicare Work?
The Medicare program is very expansive. However, it is based on a core set of taxpayer-funded benefits known as Original Medicare. Original Medicare offers two types of coverage:
- Medicare Part A: This coverage pays for hospital services. It might pay for inpatient hospitalizations, surgeries, IV treatments and similar care.
- Medicare Part B: For your everyday health care needs, you will need Part B coverage. This part of Original Medicare pays for regular checkups, lab services, X-rays, vaccinations and other outpatient costs.
However, within the private health insurance marketplace, there are numerous supplementary Medicare Insurance plans that are designed to enhance Original Medicare. These include:
- Medicare Advantage (Medicare Part C):Advantage plans must offer all the benefits of Part A & Part B coverage (with limited exceptions). However, they take your coverage a step further by offering expanded benefits like prescription drug coverage, dental insurance and vision care.
- Medicare Prescription Drug Coverage (Medicare Part D): Original Medicare participants who do not have Medicare Advantage can buy Part D coverage to get their prescription drug insurance. Part D plans offer various drug formularies, premiums and pharmacy networks.
- Medicare Supplemental Insurance (Medigap Insurance): Medicare supplements are private plans designed to cover outstanding costs not insured by Original Medicare, such as copayments, deductibles, coinsurance and the costs of out-of-network care.
If you choose to enroll in a Medicare Insurance plan, you must meet eligibility requirements, and you will remain enrolled in Original Medicare despite receiving benefits from a private plan.
To learn more about your eligibility for private coverage, speak to one of our agents.
When Can I Get Medicare Insurance?
You usually become eligible for Original Medicare around your 65th birthday, and as you approach that landmark date, you will enter your Initial Enrollment Period (IEP). This is a seven-month period that:
- Begins the first day of the month three months before the month of your birthday. If your birthday is in October, then your IEP begins July 1.
- Ends the last day of the month three months after your IEP. If your birthday is in October, then then your IEP ends the following Jan. 31.
Most people enroll in their private Medicare insurance during their IEP. However, there is also the Medicare Insurance Annual Enrollment Period, which occurs annually from Oct. 15 – Dec. 7.
At this time, Medicare recipients can:
- Change from Original Medicare to a Medicare Advantage Plan.
- Change from a Medicare Advantage Plan back to Original Medicare.
- Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
- Switch from a Medicare Advantage Plan that does not offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
- Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that does not offer drug coverage.
- Join a Medicare drug plan.
- Switch from one Medicare drug plan to another Medicare drug plan.
- Drop your Medicare drug coverage completely.
For more information about other enrollment requirements, speak to one of our agents.
What Will Medicare Insurance Cost?
Private Medicare plans are entirely separate from Original Medicare, so you will have to pay a separate premium for these plans. All plans offer different pricing structures and premiums.
Our agents are available to discuss your Medicare Insurance options and the potential costs. Call the number above to be connected with one of our Medicare experts now.
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.