In health care, the magic number is 65.
Most people who live in America are eligible for Medicare, a federal health insurance program, when they turn 65, as long as they have a Social Security number and have paid into Social Security. It’s also available for younger people with disabilities or other chronic diseases.
Many people do not know the fine print of Medicare, which can lead to overspending on health care or penalties in the future.
Most receive tons of mail because every insurance company will send somebody who is Medicare-eligible mailouts. Over the years, they don’t open them and throw them away. Under (Centers for Medicare and Medicaid Services) guidelines, agents are not allowed to solicit clients, so it’s hard to reach people and why many people don’t know about Medicare options.
Medicare fall open enrollment is Oct. 15-Dec. 7 annually. But figuring out the best plan for you, and possibly your spouse, should be done months in advance, Montoya said.
That “window of opportunity” is three months before and three months after the month a person turns 65. Medicare benefits can begin the month a person turns 65.
A delayed registration could result in a penalty down the line with certain parts of Medicare, including medication-related Part D.
MEDICARE PARTS AT A GLANCE
Medicare includes four parts, each of which cover a specific aspect of health care.
Part A covers hospital care, skilled nursing facility care, nursing home care, hospital and home health services. Part A typically does not require a monthly premium, but there is a yearly deductible, according to Medicare.gov.
Part B covers medically necessary and preventive services, like office visits, ambulance services, durable medical equipment, mental health services and hospitalization and clinical research, according to the website.
Currently, the Part B premium is $134 a month.
Part C is a private insurance option, which is where Montoya’s services come in. This part’s plans are offered through private insurance companies and approved by the Centers for Medicare and Medicaid Services. These also are called Medicare Advantage or Medicare Health plans.
Recipients must be enrolled in parts A or B before enrolling in a Part C plan.
Part C helps cover costs not covered by parts A and B. Medicare recipients are not required to enroll in Part C.
Finally, Part D is Medicare’s drug prescription plan. It’s optional to those enrolled in Original Medicare and Medicare Advantage plans, and it’s also offered by private insurance companies and approved by Centers for Medicare and Medicaid Services.
The drug plan involves a monthly premium and deductible and includes co-payments for drugs, according to Medicare.gov.
Contact us at 859-312-9646 if you would like further help with your Medicare Options.