First Time Getting Started with Medicare
Navigating the Medicare maze can be difficult. MMAP is here to help! Let’s get started:
What is Medicare?
Medicare is the federal health insurance program for:
- People who are 65 or older;
- Certain younger people with disabilities;
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
When can I apply?
You can enroll as early as three months before your 65th birthday. The Initial Enrollment Period for Medicare is a 7month period, beginning three months before your 65th birthday and ends three months after your 65th birthday. It is important to apply for Medicare at this time to avoid a lapse in coverage and late enrollment penalties.
If you are currently working and covered under health insurance, you may delay enrolling in Medicare without penalty in most cases. It is best to contact your employer’s benefits administrator or human resource department to discuss coverage and coordination options.
How do I apply?
If you are already receiving Social Security benefits, enrollment into Medicare is typically automatic. Three months before your Medicare eligibility date, you will receive a Medicare card and Welcome packet.
All others must apply through the Social Security Administration (or Railroad Retirement Board). You can apply online at socialsecurity.gov, by phone at (800) 772-1213, or in person at your area Social Security Administration office.
What does Medicare cover?
When you enroll in Medicare, most people are enrolled in Medicare Parts A & B, which is also called Original Medicare. Because Original Medicare has costs associated with it, many people purchase additional insurance.
Part A (Hospital Insurance)
Usually no cost to you, Part A helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.
Part B (Medical Insurance)
This helps cover outpatient care, home health care, durable medical equipment, and preventive services.
Part D (Drug Coverage)
Offered by private insurance companies with premiums, this helps cover the cost of prescription drugs. You must have Part A and Part B to have Part D.
Medicare Advantage Plans (Part C)
While referred to as Medicare Part C, Medicare Advantage Plans are A&B Plans managed health care plans approved by Medicare but offered by private companies. With a Medicare Advantage Plan you will have all your Medicare Part A and B benefits, plus some plans offer additional coverage for prescription drugs, dental, vision, and hearing.
- There may be extra cost for Medicare Advantage plans since you must still pay the Medicare Part B premium.
- You may also have a monthly premium for the plan.
- Some people may qualify for a Medicare Advantage Special Needs Plan if they live in a nursing home, or have certain medical conditions
- All special needs plans provide Medicare prescription drug coverage.
MI Health Link
If you are enrolled in both Medicare and Medicaid, you may be eligible for a MI Health Link health care plan. MI Health Link plans are managed care plans that have no deductibles or copays.
- With a MI Health Link plan, you get your own Care Coordinator to answer your questions and make sure your health needs are being met.
- You will also have access to a dentist and free transportation for doctor's appointments.
- You must live in one of the eleven counties where MI Health Link plans are available to be eligible. Learn more HERE.
Medicare & You, Page 5