October 11, 2023

Your Introduction to Medicare

Here are some important questions to consider:

  1. Which is the better option for me: original Medicare or Medicare Advantage?
  2. Is it necessary for me to purchase a Medigap (Medicare Supplement) policy?
  3. Do I need prescription drug coverage?
Simple Medicare Enrollment Guide

You’ll find out about Medicare’s parts, your costs, what coverage to expect, how to enroll online and what actions to take after you sign up

What is Medicare?

Medicare is a government-funded health insurance program that enables millions of older adults and individuals with disabilities to pay for their healthcare expenses. Regardless of your income, health condition, or location, you are eligible to enroll. However, bear in mind that one size does not fit all, and making informed decisions within specific timeframes can prevent extra costs in the long run. If you receive Social Security retirement benefits, you are automatically enrolled in parts A and B of Medicare at 65. If not, you must sign up for yourself, and your initial enrollment period begins three months before your 65th birth month and ends three months after it. Not enrolling on time may result in delayed coverage and extra fines.
Medicare has 4 parts

Medicare consists of four parts: A, B, C, and D, each covering specific healthcare services such as hospitalization, medical treatments, prescription drugs, and Medicare Advantage plans.

Medicare is composed of four parts, each serving different healthcare needs:

Part A: Covers hospital costs, skilled nursing care, home health care, and hospice services after a hospital stay as an inpatient.

Part B: Helps with doctor visits, outpatient services, lab tests, medical equipment, X-rays, and certain home health care services.

Part C: Combines parts A, B, and often Part D into a comprehensive Medicare Advantage plan offered by private insurers. These plans may include additional benefits like dental and vision coverage.

Part D: Focuses on prescription drug coverage, assisting with the cost of outpatient medications through private insurance plans.

To understand each part more thoroughly, it is important to delve into their respective pros and cons.

When it comes to Medicare options, people often categorize them into two groups: Original Medicare and Medicare Advantage.

Original Medicare, a government insurance program, consists of two main parts:

Part A: Hospitalization coverage. Nearly 99 percent of Medicare beneficiaries do not pay a premium for Part A.

Part B: Doctor visits and outpatient services. Medicare beneficiaries are required to pay a monthly fee for Part B.

Private insurers offer Medicare Part C, which combines coverage from both Part A and Part B.

Medicare Part D drug coverage is typically included in Part C plans.

In addition, these plans often provide additional benefits beyond what is covered by original Medicare.

It is important to note that the premiums you pay for Parts A and B contribute towards the cost of Part C. Some Part C plans may also charge additional monthly premiums.

Navigating Medicare

Navigating Medicare can be a complex process, but having an experienced agent by your side can make it much easier to understand and make informed decisions.

When navigating your Medicare options, an initial decision you'll need to make is whether to enroll in original Medicare or opt for Medicare Advantage. This pivotal decision will then lead to other choices and considerations based on your selection.

Part D Drug Coverage:

Part D is a private health insurance option that assists in covering the cost of prescription medications.

  • It involves an additional monthly premium.
  • It is advisable to enroll in Part D when you first become eligible if you do not have prescription drug coverage that is equivalent or better than a basic Part D plan. This helps avoid higher premiums.

Medigap Insurance (Medicare Supplement):

Medigap refers to private insurers' supplementary plans that assist in paying for expenses that are not covered by Medicare.

  • It requires an additional monthly premium.
  • It is recommended to have a Medigap policy to help with out-of-pocket expenses. However, if you have retiree or Tricare military health care coverage, you may not need Medigap. It is essential to check your specific plan.
  • Purchasing a Medigap policy later on may be more challenging.

Medicare Advantage with Part D Drug Coverage:

Medicare Advantage is private health insurance that includes prescription drug coverage to help with the cost of your medications.

  • It is most commonly included as part of Medicare Advantage plans.
  • It is recommended to consider Medicare Advantage with Part D if you do not have prescription drug coverage that is equal to or better than a basic Part D plan.

Medigap Insurance:

Medigap plans cannot be used in conjunction with Medicare Advantage.

  • Medigap plans are separate from Medicare Advantage and cannot be used together.

Next, we will assist you in obtaining more information to empower you to make an informed decision.

Next, we will assist you in obtaining more information to empower you to make an informed decision.

To enroll in Medicare, follow these steps:

  1. If you are not currently receiving Social Security benefits, you can sign up for Medicare Parts A and B through the Social Security Administration (SSA) website, by calling 800-772-1213, or by visiting your local Social Security office. For assistance in making enrollment decisions, reach out to your State Health Insurance Assistance Program.
  2. If you wish to supplement your original Medicare coverage with a Medigap policy, you can compare different plans and find companies that offer coverage in your area by contacting a Lehigh Partners Senior Benefits agent. It is necessary to purchase the policy directly from the insurance company or through an authorized agent.
  3. If you need prescription drug coverage (Part D), you can compare different Part D policies and purchase coverage through a Medicare Plan Finder.
  4. If you decide to go with Medicare Advantage, explore available plans in the Plan Finder. You also have the option to purchase a policy directly from an insurance company or through an authorized agent.

Congratulations on reading your introduction to Medicare! To further expand your knowledge, we encourage you to visit more of our blog postings. There, you can find detailed information about what Medicare covers, the costs associated with Medicare Advantage or Part D plans, and strategies to reduce your expenses.

We value your feedback and would appreciate it if you could take a few minutes to contact us.

Get Help

Compare Medicare coverage options with the help of one of our agents:

Talk to us: (833) 265-9655 

Medicare brokers such as Lehigh Partners get paid by the insurance companies they represent. And you pay exactly the same rate for your insurance if you use a Medicare consultant (broker). There is no extra fee or cost for enrolling through a broker. You will never pay a fee for our help.

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