Here are 10 essential things to know about Medicare
When it comes to Medicare, there’s a lot to take in. Here are answers to 10 of the most important questions about Medicare:
1. What’s the Medicare boom?
There are more than 76 million baby boomers – born from 1946 through 1964 – who have turned or will be turning 65. Nearly 10,000 people in the U.S. will become eligible for Medicare each year into 2030.
2. What’s Original Medicare?
Original Medicare is funded by the government. It includes Part A (hospitalization) and Part B (medical) coverage. Members pay monthly premiums for Part B and usually a cost for each service. Most prescriptions aren’t covered.
3. What’s Medicare Advantage?
Medicare Advantage (Part C) plans can provide additional benefits not offered by Medicare such as vision, hearing and dental. They’re offered by Medicare-approved insurers and include Medicare Part A, Medicare Part B and usually prescription drugs (Part D).
4. Who’s eligible?
You can receive Medicare when you turn 65 or when you’re younger than 65 and disabled.
5. When should I enroll?
Enroll in Medicare during one of the three months before you turn 65, the month you turn 65, or one of the three months after you turn 65.
6. What are some plan types?
- HMO – A health maintenance organization usually limits coverage to doctors who contract with the HMO. It generally won't cover out-of-network care except for urgent care and emergency visits.
- HMO-POS – A health maintenance organization with a point of service option has a more flexible network, allowing members to get care outside the HMO network in certain situations.
- PPO – Preferred provider organization plans allow you to visit any in-network health care provider that accepts Medicare without a referral.
- Medicare supplement – Often called Medigap, a supplement plan is coverage that pays some costs that Original Medicare doesn't cover, such as copayments, coinsurance and deductibles.
7. Can you get prescription coverage if your plan doesn’t cover it?
Yes, you can choose a Part D stand-alone prescription drug plan.
8. What is the AEP?
The annual enrollment period is when members can enroll in or change their Medicare Advantage plan.
9. How can I reduce costs?
Three ways to do so are:
- Stay healthy – Good health means fewer out-of-pocket expenses, such as copays and coinsurances.
- Get preventive care – Get annual exams, health screenings and immunizations.
- Use in-network providers – Choose providers that are in your network to save money.
10. Where can I get help?
Contact a Blue Cross authorized independent agent or call 888-563-3307, go to medicare.gov, or call 800-MEDICARE (800-633-4227), 24 hours a day, seven days a week for more information. TTY users, call 711.
ABOUT THE EXPERT
Shelby Weinger is the director of sales for the Retail Sales and Marketing Unit at Blue Cross Blue Shield of Michigan. She is responsible for sales strategy and execution in the individual market, including Medicare.