Medicare: How it Works

Enrollment for Medicare should be done three months prior to your sixty-fifth (65) birthday. Failure to sign up for Medicare at sixty-five may impose a late penalty.

Medicare is health insurance for people 65 or older, or people under 65 with certain disabilities.

When you first enroll in Medicare, you’ll have the Original Medicare unless you make another choice. Here are different ways you can get your Medicare coverage.

You can choose to stay in Original Medicare. If you want prescription drug coverage, you’ll need to join a Medicare Prescription Drug Plan, which is Part D. When you don’t join a Medicare drug plan when you are first eligible and don’t have other drug coverage, you may be imposed a late enrollment penalty if you choose to join later.

- OR - You can choose to join a Medicare Advantage Plan such as a HMO or PPO if it’s available in your area. The Medicare may include Medicare prescription drug coverage. In this instance, you must take the drug coverage that comes with the Medicare health plan if offered. Some types of plans don’t offer drug coverage, then, you may be able to join a Medicare Prescription Drug Plan.

Learn as much about the types of coverage as you can. Visit Medicare Plan Finder at Medicare.gov/find-a-plan. Compare coverage, benefits costs for a plan that meets your needs. Call 1-800-MEDICARE (1-800-633-4227).

You can also call Social Security for questions regarding Medicare and premiums. Following are the different Parts of Medicare.

Medicare Part A

(Hospital Insurance)

- Inpatient care in hospitals and Skilled nursing facility care;

- Hospice care and Home health care.

Medicare Part B

(Medical Insurance)

- Service from doctors & other health care providers;

- Outpatient care and Home health care;

- Durable medical equipment & Preventive services.

Medicare Part C

(Medicare Advantage)

- Includes all benefits and services covered under Part A and Part B;

- Usually includes Medicare prescription drug coverage (Part D) as part of the plan; Run by Medicare-approved private insurance companies that follow rules set by Medicare;

- May include extra benefits and services for an extra cost.

Medicare Part D

(Medicare prescription drug coverage)

- Helps cover the cost of prescription drugs, run by Medicare-approved private insurance companies that follow rules set by Medicare;

- May help lower your prescription drug costs and help protect against higher costs in the future.

*If you have your own health plan, (i.e. NALC – CIGNA) check your prescription costs. Part “D” may not be necessary.

Also, you may drop or add part “D” at anytime, but there is a cost.

When choosing your coverage, you should consider: convenience, cost, coverage, doctor and hospital choice, prescription drugs, quality of care, travel,