Medicare offers seniors so many ways to get healthcare coverage. From the powerful and comprehensive Medicare Advantage to the targeted Medigap and Medicare Part D plans, there are lots of different plans that can be added onto your basic Medicare plan to enhance or even replace it. Medicare enrollment is an important topic for seniors, and we want to make sure that you have all the facts.
When to Enroll
Medicare’s annual enrollment starts on October 15th. This is the time where very senior who qualifies for Medicare gets to decide if they want to sign up for a new plan, change their coverage or renew their coverage. This annual enrollment lasts all the way until December 7th.
This enrollment period comes around at the same time every year. It could change in the future, but for now, it is supposed to stay between these two dates.
Now, when you apply for a Medicare health insurance plan at this time, you have to be aware of how your preexisting medical conditions will affect your coverage, eligibility, rates and more. Annual enrollment is not the ideal time for most people to enroll in these plans. We will talk about when that time is in just a moment. However, we want you to understand that your health conditions can factor into an insurance company’s decision to deny your application. Or, they could charge you more based on what health conditions you have. You may pose a risk to the insurer, and they are evaluating that risk when they look at your application. They have to determine if it is worth it to them to take you on as an insured member or if they would be better off denying your application or even just charging you a higher than normal price.
If one insurance company turns you down, you may be able to seek out coverage from another insurer. Not all of them will have the same requirements or will factor the risks the same way.
The best time to enroll in a Medicare plan of any kind, though, is around the time when you are turning 65. There is a window of seven months there that starts three months before your 65th birthday and includes the birthday month. It ends three months after you turn 65. In this period, known as Open Enrollment, you can apply for any Medicare plan you want that you are eligible for, and you are guaranteed to get that plan. The insurance company cannot say that your application ahs been denied simply because of a preexisting health condition, for the most part. There are exceptions to this rule, such as if you have end-stage renal disease. That would disqualify you from the major Medicare plans, but then there would be other insurance options open to you at that point. You can talk to us if you want to find out more about these topics. Feel free to give us a call using the contact information on this site.
Who Can Enroll?
Let’s talk about eligibility for a second. You can qualify for Medicare once you are turning 65. You’ll need to be either a US citizen or a green card holder, but other than that, there are no strict enrollment guidelines. Most seniors qualify for Medicare. As we mentioned, some medical condition will preclude you from enrolling, but the government makes concessions for that and provides other ways for you to get medical care than through the standard Medicare plans.
Some people get to enjoy Medicare enrollment early. If you have disability or qualify for disability, then you can sign up early for Medicare plans. This is only available in some states, though.
Enrolling in Medicare and getting coverage from your Medicare plan may not go hand in hand. If you have some sort of medical insurance plan that conflicts with the Medicare plan that you are trying to sign up for, then you may be denied coverage. You might still get to enroll in the plan, but with overlapping or conflicting coverage, you will end up with two plans that are not working together, and one will have to be dropped.
If you are unsure about your eligibility, then you should call us. We can answer any questions that you may have.
Here are a few ways that Medicare peals can conflict with other kinds of healthcare plans:
Medicare Advantage will conflict with Medicare Supplements, union plans and healthcare plans. It may also overlap with trust health insurance plans and with Medicare Part D, if the Advantage plan includes Part D coverage already.
Medicare Supplements conflict in a similar way. They conflict with all Medicare Advantage plans and most employer-based or union-based plans. They are perfectly compatible with Medicare Part D, though.
A Medicare Part D plan will only conflict with Medicare Advantage if Part D benefits are included in the Advantage plan. Part D only conflicts with employer-based and union-based plans if they contain some similar drug coverage.
Medicare Plans You Should Know about
Now that you know about enrolling in a Medicare plan, let’s talk about which plans you could enroll in. You have quite a few choices, and we are just going to touch on the general plans, though each of the categories we will tell you about have multiple plans that you can choose from.
Medicare Advantage– This is the most powerful of the Medicare plans, and it will cover you for Medicare parts A and B almost entirely, taking care of nursing care, at-home medical care, hospital inpatient care, lab tests, visits to the doctor’s office and more. It also covers all emergency care and any urgently needed healthcare services that you require. Some of the Advantage plans will provide additional coverage, giving you drug plan benefits and coverage for checkups, along with wellness programs, prescription eyeglasses and hearing aids.
Medicare Supplement- There are eight basic Supplement plans for you to pick from, encompassing high and low coverage options. You can enjoy benefits for Medicare copayments and deductibles, as well as for hospice coinsurance. Nursing care costs can be covered for you, along with any blood you use for the year and even the cost of being transported out of the country for emergency medical services. If you have to go to a medical doctor who doesn’t accept Medicare, then those costs can be covered as well.
Medicare Part D- This drug plan gives you coverage for your generic drugs and name brand ones, though it covers the generic ones better. It offers coverage for tons of different medications, reducing your out-of-pocket costs.
All of these Medicare plans can be found through private insurance companies. These insurance providers get to set their own rates for the plans and choose which of the plans they want to offer. They all have to abide by Medicare’s benefits guidelines and give you the same Medicare enrollment dates and requirements. Compare their rates here on our site and see for yourself who has the best prices and who is offering the plan you want at an affordable price. We will give you up-to-date pricing info to ensure you can make an informed decision.