Medicare

Medicare.gov: https://www.medicare.gov/

Directory of Community Resources for Broward County Senior Citizens-Medicare Page 233

https://www.adrcbroward.org/sites/default/files/documents/October_2023_AAA_%20Resource_Directory.pdf#page=233

Medicare Interactive: https://www.medicareinteractive.org/

Medicare is a federal health insurance program primarily designed for individuals age 65 and older, as well as for younger individuals with disabilities or specific medical conditions. It is divided into different parts, each covering specific services and costs. 

Understanding the key components of Medicare is crucial for seniors to ensure that they have the appropriate coverage for their healthcare needs. 

 Part A

Hospital coverage, including inpatient stays, home health care, and some skilled nursing facility care

Part B

Medical coverage, including doctor visits, outpatient services, X-rays, lab tests, and preventive screenings

Part C

Also known as Medicare Advantage, this is an alternative way to receive Medicare benefits through private health insurance companies. Medicare Advantage plans can offer extra benefits, but they must provide the same coverage as Original Medicare.

Part D

Prescription drug coverage, which is usually included in a Medicare Advantage plan or can be obtained separately

You can be eligible for Medicare if you:

Are 65 or older and paid Medicare taxes while working for a certain amount of time (usually at least 10 years)

Are under 65 and have received Social Security Disability Insurance (SSDI) or certain Railroad Retirement Board (RRB) disability benefits for at least 24 months

Have End-Stage Renal Disease (ESRD)

When you can enroll in Medicare depends on your eligibility and circumstances:

·         Initial Enrollment Period

If you're eligible for Medicare due to your age, you can enroll during the 7-month Initial Enrollment Period (IEP) that begins 3 months before your 65th birthday and ends 3 months after. You can also enroll when you apply for Social Security if you apply 3 months before or after your 65th birthday.

·         General Enrollment Period

You can enroll during the General Enrollment Period (GEP) from January 1–March 31 each year.

·         Special Enrollment Period

You can enroll during the Special Enrollment Period (SEP) if you had group health plan coverage based on your employment. You can enroll while you're still covered by your group health plan, or when your coverage ends.

·         Automatic Enrollment

If you receive Social Security retirement benefits between age 62 and 4 months before your 65th birthday, you'll be automatically enrolled in Medicare Part A and Part B when you turn 65. Disabled individuals who have received Social Security disability benefits for 24 months are also automatically enrolled. 

You can check the status of your Medicare application through your Medicare or Social Security account. You can also call the Social Security Administration at (800) 772-1213. 

By understanding the key components of Medicare, including the different parts, eligibility requirements, coverage options, out-of-pocket costs, and enrollment periods, seniors can make informed decisions about their healthcare coverage. It is important for seniors to evaluate their healthcare needs and compare Medicare plans to find the best fit for their individual circumstances. Seeking guidance from healthcare providers, insurance counselors, or Medicare resources can also help seniors navigate the complexities of Medicare and ensure they have comprehensive coverage for their medical needs.