mymedicarebenefits.com

INITIAL ENROLLMENT (Turning 65)


          YOU MAY ENROLL IN A MEDICARE SUPPLEMENT OR MEDICARE ADVANTAGE PLAN

                     3 MONTHS BEFORE THE MONTH OF YOUR BIRTHDAY

                       THE MONTH OF YOUR BIRTHDAY

                      3 MONTHS AFTER THE MONTH OF YOUR BIRTHDAY (7 MONTH PERIOD)


Your Medicare coverage will begin on the first of the month of your birthday. You can delay enrollment in PART B, if you are insured through an employer group plan or other creditable coverage.

Choosing a Medicare plan does not have to be difficult. We have been helping people for over 20 years.

Congress created Social Security in1965.

Choosing the right Medicare coverage can be overwhelming. That is why it is important to discuss your Medicare needs with a professional who can explain your options, and help you to make an informed decision.

   * This website is not associated or endorsed by the Social Security Administration, the Centers for Medicare and Medicaid Services, or the Department of Health and Human Services.

MEDICARE ENROLLMENT PERIODS

* Medicare Supplement Plans are not the same as Medicare Advantage Plans. Medicare Advantage plans are managed by private insurance companies, while Medicare Supplements are plans that work with Original Medicare. Original Medicare is managed by the Federal Government.

Medicare Supplements

                                                          

  Help to pay for expenses that are not covered under Original Medicare

  • Original Medicare does not pay for all the costs associated with Medicare healthcare coverage. A Medicare Supplement is a health insurance policy sold by a private insurance company to help cover some or most of the costs not paid by Medicare.


 

Things to consider when choosing a Medicare Advantage Plan:


  • Is my Primary Care Doctor in the Network?
  • Are ALL of My Medical Specialists in the Network?
  • Is My Local Hospital in my Network?
  • Are ALL of my Prescription Drugs Covered?
  • Do I Need Referrals?
  • Does My Plan have Deductibles?
  • Will My Plan Cover Me When I Travel?
  • What Additional Benefits Does My Plan Offer?

ANNUAL ENROLLMENT PERIOD  (Medicare Advantage Plans)


     OCTOBER 1ST - 14TH                                 PRE ENROLLMENT      (NEXT YEAR'S PLANS BENEFITS PUBLISHED)

     OCTOBER 15TH - DECEMBER 7TH            ANNUAL ENROLLMENT PERIOD (AEP)

     JANUARY 1ST - MARCH 31ST                    MEDICARE ADVANTAGE OPEN ENROLLMENT PERIOD (OEP)

     APRIL 1ST - DECEMBER 31ST                   LOCK-IN PERIOD UNLESS QUALIFIED FOR AN S.E.P.


                    SPECIAL ENROLLMENT PERIOD (SEP)-  An individual may be able to change their Medicare Advantage plan under special circumstances such as:


                                     Loss of Current Coverage

                                     Move out of the plan's service area

                                     Eligible for extra benefits through Medicaid or Low Income Supplement

                                     Reside in a Skilled Nursing Facility or Long Term Care facility

                                     Qualify for a Chronic Care Plan

                                     5 Star Plan available in the service area

                                     Error by Federal Employee or Insurance Agent



* YOU CAN CHANGE YOUR MEDICARE SUPPLEMENT ANYTIME DURING THE YEAR.

What is medicare ?

 

   Medicare began in 1965, and is a health program for:

  • Individuals age 65 or older
  • Individuals under age 65 with certain disabilities
  • Individuals of all ages with End-Stage Renal Disease

                                                                                                                                            

Original Medicare  (1965)

                                                                                                   

  Original Medicare consists of Part A & Part B

  • Part A Hospital Insurance: Covers care in hospitals and skilled nursing homes. It does not cover custodial or long-term care.

​​         Most Medicare enrollees pay $0. monthly premium for Part A coverage

  • Part B Medical Insurance: Helps cover doctors' services and out-patient care.

​        Most Medicare enrollees pay$164.90 monthly premium for Part B                    coverage. 

                                                  

mEDICARE ADVANTAGE PLANS  (1997)

                                             

   Medicare Part C comprises the Medicare Advantages Plans

  • Medicare Advantage Plans are Medicare health plans offered through and managed by private insurance companies. These plans consist of HMO's, PPO's, and PFFS.
  • Medicare Advantage Plans are a 1- year contract between Medicare and 

        the private insurance companies. Plan benefits and premiums may

        change annually.

                                                                                                 

PRESCRIPTION DRUG PLANS (2006)


  Medicare Part D is Prescription Drug Coverage

  • Prescription drug coverage is mandatory for Medicare beneficiaries. Individuals not having "Creditable" coverage may incur a penalty for non compliance. Many Medicare Advantage Plans include Part D prescription drug coverage. Medicare members who wish to remain on Original Medical, may be required to purchase a Stand-Alone Prescription Drug Plan.