For someone nearing the age of 65, it’s time to start looking into obtaining Medicare. Medicare offers healthcare coverage to those who are 65 and older (and others in some cases). It is more affordable than privatized healthcare. Furthermore, there is often additional assistance for those who may otherwise find it difficult to pay for copays, prescriptions, deductibles, or other related expenses. Of course, this is new territory and can be a little complex.
While some people will start getting Medicare automatically thanks to their employers or other connections, others have to sign up. If someone is almost 65 or recently turned 65 and isn’t yet getting Social Security, they may need to sign up through the Social Security Administration.
Some people who are younger than 65 may also qualify for Medicare, such as those who have permanent kidney failure or disabilities.
If a senior is ready to apply for Medicare, they will need to follow a few tips. At SeniorSmart, we can provide resources for the necessary information to start the application process. Sign up for our concierge membership for additional assistance.
Know When to Apply for Medicare
To start, anyone who is approaching 65 but who is not receiving Social Security benefits should apply for Medicare. There are specific times of the year when people can apply. For instance, they can enroll during:
- Initial enrollment periods, which happen when a senior first becomes eligible for Medicare
- The open enrollment period, which takes place between October 15 and December 7 each year
- The Medicare Advantage open enrollment period, which occurs between January 1 and March 31 each year
During the Medicare Advantage Open enrollment period, those who are already using Medicare Advantage plans have the opportunity to switch to an Original Medicare or different Medicare Advantage plan. A person can only change plans once during this period.
Most people first qualify for Medicare in the three months before they turn 65. It’s at that time that soon-to-be seniors may start the application process. The initial enrollment period ends three months following a senior’s 65th birthday.
What Kinds of Health Plans Are There?
Another part of Medicare that can be tricky is choosing a Medicare health plan. Private companies usually offer Medicare health plans. Medicare contracts these companies to provide both Part A (hospital insurance) and Part B (medical insurance) benefits.
The plans that may be available include:
- Demonstrations/Pilot programs
- Medicare Cost Plans
- Programs of All-Inclusive Care for the Elderly (PACE)
- Medicare Advantage Plans (MAP)
Seniors can speak with an agent with the health plan to learn more about the specific coverage and benefits available.
Can Seniors Get Help Paying for Medicare?
Yes. Since many people who are old enough to get Medicare live on set retirement benefits each month, there are options for getting assistance covering the cost of Medicare. For example, the State Medicare Savings Programs (MSP) may help some people cover their deductibles, premiums, copayments, coinsurance, and medications.
Seniors who meet specific income and resource limits may also get extra assistance with Medicare Part D coverage. This program offers prescription drug coverage. Part D is also referred to as “Extra Help” because it’s a program that helps people who use Medicaid cover coinsurance, deductibles, and premiums related to prescription drug costs.
Contact SeniorSmart for Help
At SeniorSmart, we work hard to bring you the best information about Medicare and other topics that adults may have questions about. We know that enrolling in Medicare can be difficult, which is why we have gathered this information for our readers. You can access information by signing up for our concierge membership service, which provides information about topics such as:
- Medicare benefits
- Social security benefits
- Elder law
- Senior living options
- Senior health and wellness