Successfully enrolling and accessing coverage through Medicare begins with a good roadmap. At LEON Health, we not only understand the ins and outs of Medicare, but we help people every day who question where and how to get started. If it seems a bit confusing, turn to us for help in understanding your coverage needs, eligibility, and costs. Our team is here to help make the process easier.
Determine If You Are Eligible for Medicare
Enrolling in Medicare is easy. If you already receive Social Security benefits, you’re automatically enrolled in Medicare. If not, first determine if you’re eligible. You can verify your Medicare eligibility with this tool from Medicare.gov.
Understand When You Should Enroll in Medicare
Some people will automatically get Medicare, but if you need to sign up, there are certain times of the year to do so. There are also certain times of the year when you can change how you get your coverage. When you are first eligible for Medicare, there is a seven-month initial enrollment period for Part A and Part B sign-up. If you’re turning 65 and are eligible for Medicare, you can sign up during the seven-month period that begins three months before the month you turn 65.
Understand the Components of the Original Medicare Plan
If you are nearing 65 and considering Medicare, keep in mind that the Original Medicare, which the federal government administers, includes Medicare Part A and Part B. Medicare Part A is also called hospital insurance. It covers inpatient hospital care.
Medicare Part B is also called medical insurance. It covers services like ambulance services, limited outpatient prescription medicine, urgent care, mental health services, and durable medical equipment — including crutches, walkers, wheelchairs, blood sugar monitors, and oxygen equipment.
Think About What Medicare Doesn’t Cover
It’s important to know that Medicare doesn’t cover every medical cost, and coverage varies by state. That’s why it’s essential always to double-check what your Medicare plan covers. Medicare.gov offers this list of services that are covered no matter where you live. In general, Medicare doesn’t cover elective surgery that isn’t considered medically necessary, eye exams for prescribing glasses, hearing aids, and most dental care.
Understand the Difference Between Medicare Advantage and Medicare Supplement
Yes, there is a difference between Medicare Advantage and Medicare Supplement plans. Medicare Advantage plans are slightly different from the Original Medicare plan. These plans, called Part C, are an alternative to the Original Medicare plan. If you participate in or are eligible for the Original Medicare plan, you can participate in a Medicare Advantage plan. These are bundled plans that give you added coverage benefits. You get hospital and medical coverage, and you may also get additional coverage such as drug coverage (Part D), dental, hearing, or vision.
If you believe you may need to fill any gaps in coverage in the Original Medicare plan, a Medigap policy can help pay some of those costs. These may include copayments, coinsurance, and deductibles. Some Medigap plans cover you if you need care outside the U.S. while traveling. Keep in mind that it does not generally cover long-term care, vision or dental care, hearing aids, glasses, or private nursing.
Are You Ready to Enroll in Medicare?
Once you’ve confirmed that you’re eligible for Medicare and have chosen a plan, you can apply through the Social Security Administration. Although Medicare is operated through the Centers for Medicare and Medicaid Services (CMS), Social Security processes enrollment applications.
You can fill out the application online or in person at a local Social Security office. The Social Security Administration will take a few weeks to process your application and mail your Medicare card.