Not sure which Medicare plan works for you? Use our easy tool to shop, compare, and enroll in plans from popular carriers.
How do you find out if you have Medicare?
Need help determining your Medicare status? Give us a call at (800) 950-0608 for live assistance.
Just the essentials...
Medicare is an entitlement for those who worked 10 years or more and paid FICA contributions
Medicare automatically enrolls disabled persons that receive RRB or SSA benefits
Most eligible persons must apply for Medicare benefits at age 65
Eligible persons can initiate Medicare coverage at age 65
Medicare and Social Security provide tools for determining eligibility and benefits
Medicare is the national health care program for older Americans. The start date for Medicare coverage is important; many other features depend on the date of enrollment. Medicare has four parts that cover hospital insurance, medical insurance, private all-in-one plans, and prescription drug benefits.
Everyone age 65 or older can get Medicare. Disabled persons can get it while under age 65. Those who paid FICA taxes for ten years can get premium-free Medicare. Medicare has private insurance plans for health, prescription drugs, and gap insurance. Comparison shopping is an excellent method for finding the best fit.
Comparison shopping is an excellent method for finding the best fit.
Need help finding the coverage you want in your location? Give us a call at (800) 950-0608 to speak to a licensed agent.
Discovering Medicare Coverage
Only a few people get Medicare without some action by them or on their behalf. These automatic referrals come from the Social Security Administration and the Railroad Retirement Board system.
Recipients under age 65 get an automatic referral for Medicare after 24 months of payments. Persons with end-stage renal disease or ALS get automatic eligibility when diagnosed. They or someone on their behalf must apply for coverage.
Timing is Important
The start times for eligibility and coverage are important dates. These dates can determine the amount of benefits one gets and the long-term costs. The start time for Part A can determine the price of Part B Medical Insurance. There is a ten percent late fee that applies for the life of coverage.
This is an also true for Part D; there may be a late fee when not taking it at the earliest time. Medigap insurance is guaranteed during the initial enrollment period, but after that, insurers can demand physical exams and delay coverage because of pre-existing conditions.
After Initial Enrollment
Those that miss the opportunities of the initial enrollment must wait for other enrollment periods. They also include special enrollment periods that come from qualifying events such as losing plan coverage because one moves to a new location.
Medicare is the agency that runs Medicare. It has many regional contractors that support the systems for payments, processing claims, and durable medical equipment. It oversees the performance of private insurance providers that sell Medicare Advantage, Medigap, and Prescription Drug plans. Medicare.gov is the ideal place to find if one has Medicare eligibility and how to get Medicare benefits.
The Centers for Medicare and Medicaid or CMS is the federal agency that has responsibility for the entire public healthcare system for Americans of all ages. CMS operates Medicare, Medicaid, the CHIP, and has partial responsibility for the Obamacare marketplace. CMS provides detailed information on Medicare, eligibility, and benefits.
The US Department of Health and Human Services oversees the CMS and has major responsibility for the Affordable Care Act and the federal and state exchanges. The Obamacare marketplace and the state exchanges provide information and assistance for determining Medicare eligibility and getting enrolled.
State and local health agencies work with Medicare and make referrals.
Get information online, by Phone, or Mail
The federal and state governments have taken a lot of steps to make information about Medicare available to everyone. The best advice for someone approaching the age of 65 is to make a study of the benefits and requirements for Medicare. Eligibility, application procedures, and timing matter; the outcomes can be better or worse depending on the actions you take. You can also get information online, call Medicare or Social Security, or write.
Meeting the Individual Mandate
The Affordable Care Act changed the health insurance industry. No longer can companies deny coverage to those that wish to buy it. The trade-off was that everyone must buy insurance and stay covered.
Those with certain forms of Medicare do not need to do anything else. They have qualified health insurance and do not need to pay the penalty. Part B Medical Insurance is the outpatient services part of Medicare. Standing alone, it does not satisfy the requirement for minimum essential coverage.
Need more coverage than Original Medicare provides? Call our hotline at (800) 950-0608 for assistance in finding a more comprehensive plan near you, or compare plans yourself online.
Medicare Satisfies the Mandate
The below-listed Parts and combinations of Medicare meet the Individual Mandate requirements for essential benefits and essential coverage. These qualified health plans have the essential health benefits, minimum value, and extensive coverage required by the Affordable Care Act.
The very useful homepage at Medicare.gov offers everyone the information needed to determine if they have Medicare eligibility and the likely level of benefits.
The Initial Enrollment Period is the seven-month period that includes the month of the 65th birthday.
The period runs from three months before the birthday month, and for three months afterward. This is the ideal time to review options and make choices for Medicare coverage.
All the options are available during this period for health, medical, prescription drug benefits, and gap insurance to pay parts not paid by Medicare.
What is Medicare?
Medicare is a combination of health insurance and healthcare services on a scale to serve the aging US population. It is an enormous system involving hundreds of $billions in payments, more than 56 million beneficiaries.
Medicare has two major choices the government-run Original Medicare and the private insurance plans in Medicare Advantage. The consumer can have access to a vast government-run network of Medicare doctors, hospitals, and specialists or choose a plan that does the work of the government-run network.
Medicare Offers Easy Enrollment
The best way to find out if one has Medicare is to apply. The main websites for Medicare and Social Security have short and simple online application pages. One can apply and get an official answer very quickly. The sites state the qualifications needed, and they process moves quickly for most applicants.
The Medicare system requires choices. One must choose the all-in-one plans of Medicare Advantage or the Original Medicare with Prescription drug and Medigap benefits added.
Comparison shopping is the ideal tool for making selections of private health, prescription drug, and gap insurance plans.