Medicare 101: What is Medigap?

Your beginner’s guide to Medicare Supplemental Coverage.

Medicare Supplement

(Medigap)

What is it?

Medicare Supplement plans, sometimes called Medigap plans, are private insurance policies that you can add to your existing Original Medicare plan (Parts A and B). They can help cover the “gap” in healthcare costs that Original Medicare doesn’t cover, hence the nickname “Medigap”.  Sometimes, insurance companies may also add extra perks to their Medigap plans!

What does it cover?

Medigap helps pay for some costs not covered by Original Medicare, such as:

  • Copayments
  • Coinsurance
  • Deductibles

All you have to pay is a monthly premium, anywhere from $64/month to $461/month depending on the Medicare Supplement plan type and area. And unlike other Medicare plans, there are no network restrictions!

Who is eligible?

You may be eligible for a Medicare Supplement plan if you meet the following criteria:

  1. You qualify for both Medicare Part A and Part B
  2. You live in an area where your insurance provider offers Medicare Supplement plans

 

Remember: if you need extra help deciding which plan you should enroll in, you can always talk to a licensed Medicare agent for free, with no commitment required on your part. Just call 833-716-0673 today for help.

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Medicare 101: What is Medicare Advantage?

Your beginner’s guide to Part C.

Medicare Part C

(Medicare Advantage)

What is it?

Unlike Medicare Parts A and B (“Original Medicare”), which are provided through federal and state government agencies, Medicare Part C is a private health insurance plan offered by insurance companies. 

By law, all Medicare Part C plans have to provide at least as much coverage as Original Medicare, but most private insurance companies offer extra health and wellness benefits in addition to the standard coverage. 

What does it cover?

Everything the Medicare Parts A and B covers plus extras, which may include:

  • Prescription drugs (Medicare Part D)
  • Vision care
  • Dental care
  • Heart attack or cancer treatment
  • Long-term care
  • Hospital indemnity
  • Health and wellness programs
  • Gym memberships

Who is eligible?

To enroll in a Medicare Advantage plan, you must first be eligible for both Medicare Part A and Part B. Typically this means you need to be at least 65 years old or have a Medicare-covered disability or disease. 

In addition, since Medicare Part C plans are offered through private insurance companies, this usually means you will have to meet your insurance provider’s enrollment requirements, too. 

Remember: if you need extra help deciding which plan you should enroll in, you can always talk to a licensed Medicare agent for free, with no commitment required on your part. Just call 833-716-0673 today for help.

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Medicare 101: When can I enroll in Medicare?

Your beginner’s guide to Medicare Enrollment Periods.

Medicare enrollment periods

Annual Enrollment Period (AEP)

Also known as the Open Enrollment Period (OEP), Annual Enrollment begins October 15 and ends December 7 each year. This is the time of year when you can enroll in new Medicare plans, make changes to your current Medicare elections, or cancel your plans. Any changes you make during Annual Enrollment will officially start January 1 the following year.

If you like your current plan and don’t need to make any changes, then you don’t have to do anything. You will be re-enrolled in your plan automatically.

Initial Enrollment Period (IEP)

Your Initial Enrollment Period (IEP) is the time period when you first become eligible for Medicare.

Your Initial Enrollment Period lasts seven months. It starts three months before the month of your 65th birthday and ends three months after that same month. So, for example, if your birthday is on September 15, your Initial Enrollment Period goes from June 1 to December 31.

Now here’s where it gets a little tricky. If your birthday falls on the first day of the month, then Medicare counts the previous month as your month of birth. In other words, if your birthday falls on September 1, your Initial Enrollment Period starts May 1 and ends November 30.

General Enrollment Period (GEP)

If for some reason you miss your Initial Enrollment Period (IEP), you can enroll in Medicare policies during what’s called the General Enrollment Period or GEP. GEP runs from January 1 to March 31 each year. Keep in mind, however, that if you miss your IEP and need to sign up during GEP, you may have to pay a late fee.

Special Enrollment Periods (SEPs)

Under certain circumstances, you can enroll in Medicare plans or make changes to your existing plan at a time other than the above-mentioned enrollment periods. For example, if you’ve moved out of your current plan’s area of coverage. This is what’s known as a Special Enrollment Period or SEP.

See this list of special circumstances that qualify for a Special Enrollment Period.

 

Your Medicare enrollment checklist

Enrolling for your first time? You may be wondering what all you need to do. Lucky for you, we’ve put together this easy-to-follow checklist. Remember: if you have questions or need extra help, you can always call 833-716-0673 to speak with a licensed Medicare agent.

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Medicare 101: What is Medicare?

Your ultimate beginner’s guide

What is Medicare, anyway?

Simply put, Medicare is a federally funded health insurance program. Though it was originally designed to help people 65 and older gain access to essential health care services, Medicare is now also available to younger people who have certain diseases and disabilities. 

To help you get the health care you need at a more affordable rate, Medicare is divided into different “parts,” each covering a different set of health services, supplies, and expenses. Depending on your location and circumstances, the rules surrounding who can enroll in which plan and when may vary quite a bit. 

Don’t sweat it, though. We’ll cover each of these topics as we go. 

Who is eligible for Medicare?

People ages 65 and older

If you’re 65 years old or older and a US citizen who’s been living in the country for at least five years, chances are you’re already eligible to enroll in Medicare. You may even qualify for what’s called “premium-free” Medicare Part A if you meet the following requirements:

  • You or your spouse have worked and paid Medicare taxes for at least 10 years before enrolling in Medicare
  • You or your spouse are eligible to receive Social Security or Railroad Retirement Board (RRB) benefits

Or …

  • You or your spouse worked in a job that was covered by Medicare

People younger than 65

If you’re under the age of 65, a US citizen, and have a Medicare-covered disease or disability, you can also enroll in Medicare. However, the requirements are slightly different. Here are some of them:

  • If you have a disability, you must apply for and receive Social Security benefits for 24 consecutive months before you can enroll in Medicare
  • If you have end-stage renal disease (also called ESRD or catastrophic kidney failure), you can enroll in Medicare plans after a kidney transplant or three months after you start your regular course of kidney dialysis
  • If you have amyotrophic lateral sclerosis (also called ALS or Lou Gehrig’s disease), you can enroll in Medicare as soon as you start receiving Social Security benefits

Medicare plans: which one is right for you?

As mentioned earlier, Medicare is split into a few different “parts,” otherwise known as plans. Each part of Medicare offers its own unique range of benefits, as well as costs and requirements for enrollment. But which Medicare plan is right for you? Click on a plan below to read a brief overview to get a better idea.

Remember: if you need extra help deciding which plan you should enroll in, you can always talk to a licensed Medicare agent for free, with no commitment required on your part. Just call 833-716-0673 today for help.

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