5 Things to Know About Medicare

Medicare is a government insurance plan available to people over 65.  Enrolling in Medicare can be a confusing and daunting task as there are a variety of choices to make that will provide you with different benefits.

Here are 5 concepts to be aware of as you navigate the Medicare maze:

Medicare has four parts

  • Part A covers hospital visits, nursing facilities, hospice and home health care.

  • Part B is your general medical insurance that covers items such as doctor services (both in and out of the hospital), the flu shot, and emergency services like an ambulance.

  • Part C allows you to participate in Medicare Advantage Plans, which are offered by private companies. This provides all of your Part A and B and may offer extra coverage for such items as hearing, dental and vision care and may include prescription drugs.

  • Part D covers medication and prescription drugs.

Medicare is not free

Most people don’t pay a part A premium because they (or their spouse) paid Medicare taxes while working, but if you don’t qualify for premium-free Part A, you might be able to buy it.

Most people pay a standard Part B premium which in 2023 is $164.90 per month. This amount may get deducted from social security benefits if you are getting social security.  This rate is adjusted based on income, and individuals earning more than $97,000 will pay higher rates. 

Part C, on average, will cost about $28 per month. 

Part D drug plan, on average, will cost about $43 per month.

When to enroll in Medicare

You are eligible to enroll in Medicare the year you turn 65, and have a seven-month Initial Enrollment Period (IEP), which includes the three months before and after your birthday.

Use the chart below to identify your enrollment period.

When you are enrolling in Medicare, it’s important to understand what is and is not covered, and how to fill the gaps. This guide from AARP may be helpful in understanding how to choose the coverage that is right for you.

How to Enroll in Medicare

If you are already receiving Social Security benefits by the time you turn 65, you will automatically be enrolled in Medicare parts A and B. You will receive instructions on how to confirm your enrollment with Medicare before your 65th birthday.

If you are not yet receiving benefits, you’ll need to enroll in Medicare with Social Security.

Medicare Plan Changes

If you find that you want to increase your benefits, or make changes to your coverage, you can do that once a year through the Annual Enrollment period.

For 2023, that period is October 15 through December 7.

Any changes made to your Medicare plan will go into effect January 1, 2024.

In addition, there are two opportunities outside the Annual Enrollment Period when you may be able to make changes and they are (1) the Medicare Advantage Open Enrollment Period and (2) the Special Enrollment Period for qualifying life events.

For more information, contact Medicare directly at 800-633-4227 or visit Medicare.gov.  If you would like assistance, a daily money manager such as those at Everyday Money Management can help.  Give us a call at 301-801-2294 or send us a message.

Sharon Zissman