YOUR MEDICARE OPTIONS
Step 1Decide how you want to get your coverage
- Hospital stays
- Skilled nursing facility
- Hospice care
- Some home health care
Once you turn 65, you’re automatically enrolled in Medicare Part A. Most people don’t have to pay a premium for Part A because they, or their spouse, paid Medicare taxes while working.
- Medical service
- Outpatient care
- Medical items
Medicare pays: 80% of approved charges
Beneficiary Pays: about 20% of approved charges
Part B is optional because you have to pay a monthly premium and satisfy a deductible before Medicare will pay benefits.
Medicare Advantage Plan
Medicare Advantage Plan
- Combines Part A and Part B in one plan
- Often also include Part D (prescription drug coverage)
These plans are part of the government’s Medicare program, but are offered and managed through private insurers and may offer plan extras not found in Original Medicare. You must be enrolled in Medicare Parts A and B to join.
Step 2Decide if you need to add drug coverage
Prescription Drug Coverage
- Help lower prescription drug cost
- All plans must offer at least a standard level of coverage set by Medicare
- Some Medicare Advantage plans offer built-in prescription drug coverage
Part D plans are part of the government’s Medicare program, but they’re offered and managed through approved private insurers.
Step 3Decide if you need to add supplemental coverage
Medicare Supplement Insurance
- Helps pay costs (copays, coinsurance and deductibles) that Original Medicare doesn’t cover
- Only works with Original Medicare
- Medicare Supplement insurance cannot be used with Medicare Advantage plans, but can be used with Prescription Drug plans
A Medicare Supplement policy (also known as a Medigap policy) is private health insurance that supplements Original Medicare. It helps pay about 20% of the Medicare expenses that Original Medicare doesn't cover.
Learn more about Medicare Supplement Insurance Plans
When Can You Apply?
The best time to buy a Medicare Supplement policy is during your Open Enrollment Period. This period lasts for 6 months and begins on the first day of the month in which you’re both 65 or older and enrolled in Medicare Part B. Some states have additional Open Enrollment Periods. You can apply for a Medicare Supplement policy throughout the year.*
Unlike Original Medicare and Medicare Advantage Plans which have a designated enrollment period each year, Medicare Supplement Insurance can be purchased at any time.
*You may be subject to underwriting restrictions, medical questions and possibly denied acceptance by the company when applying outside your Open Enrollment Period.
In Colorado, Delaware, Georgia, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Missouri, Mississippi, Montana, New Hampshire, Oregon, Pennsylvania, South Dakota, Tennessee and Vermont, all Medicare Supplement plans are available to persons eligible for Medicare because of disability.