Medicare 65+&
People with Disabilities
Senior Health Insurance Options
If you are about to turn 65 or become eligible for Medicare, you may be curious about the different health insurance options available to seniors. Luckily, there are many ways to supplement Original Medicare.
Medicare Advantage Plans (Part C)
Medicare Advantage Plans, also known as “MA Plans” or “Part C,” are offered by private, Medicare-approved companies. These plans include:
- Preferred Provider Organizations (PPO)
- Special Needs Plans (SNP)
- Private Fee-for-Service Plans (PFFS)
- Medicare Medical Savings Account Plans (MSA)
- Health Maintenance Organizations (HMO)
Prescription Drug Plans (Part D)
A Medicare Prescription Drug Plan Part D is a plan that helps you with the cost of prescription drugs, vaccines, biological products, and some supplies that are not covered by Medicare Part A and Part B.
Even if you don’t need any prescriptions right now, it’s a good idea to consider getting a Prescription Drug Plan to avoid a penalty from the government and to be prepared for future prescription needs.
All Medicare plans must provide coverage for a wide variety of prescription drugs that are commonly used by Medicare beneficiaries, including most drugs in certain protected classes. Each plan has its own formulary, which is a list of covered drugs. Medicare drug coverage categorizes drugs into different tiers on their formularies, with each tier having a different cost.
How to Choose Your Senior Health Insurance Plan
When making important decisions about Medicare Advantage and Medicare supplemental plans, there are several factors to consider. For those who are new to Medicare, the most common considerations include:
Determining Your Coverage Needs
You must evaluate your current health status and any pre-existing conditions. Next, determine what medical services you anticipate needing in the future. It's also important to consider your budget and how much you can afford to pay for coverage. There are various plans available, including Original Medicare, Medicare Advantage, and prescription drug coverage plans. Each plan has unique benefits and drawbacks, so it's essential to research and compare them before making a decision.
Premiums and out-of-pocket costs
Out-of-pocket costs, refer to the expenses that you have to pay out of your own pocket when receiving medical care. These can include deductibles, copayments, and coinsurance. It is important to note that some health insurance plans may have lower premiums but higher out-of-pocket costs, while others may have higher premiums but lower out-of-pocket costs. It's important to understand the balance between premiums and out-of-pocket costs in order to choose the right health insurance plan for your needs.
Access to your preferred providers
There are several options available to Medicare beneficiaries. One option is to enroll in a Medicare Advantage plan, which may offer a provider network that includes the doctors and hospitals you prefer. Another option is to enroll in Original Medicare and use a Medigap plan to supplement your coverage. With a Medigap plan, you can see any provider that accepts Medicare, giving you greater flexibility in choosing your healthcare providers.
Speaking with trusted advisors
If you are considering your Medicare options, it can be helpful to speak with someone who is knowledgeable about the process. This could be a close friend, family member, or plan representative who has experience with the different options available. It's also important to do your own research and compare your options to ensure that you are able to access healthcare providers who are best suited to your needs.
Enrollment
To enroll in Medicare, you can start the process three months before your 65th birthday. It’s important to complete your enrollment no later than three months after your birthday, during what’s called the Initial Enrollment Period. You have several options to enroll, including visiting the Social Security website, heading to your local Social Security office, or calling 800-772-1213. Enrolling during this time ensures that you’ll start receiving your benefits as soon as you’re eligible and avoid penalty fees.
If you miss the Initial Enrollment Period, you can still sign up during the General Enrollment Period, which takes place every year from January 1 to March 31. You may also qualify for a Special Enrollment Period under certain circumstances.
If you’re already receiving Railroad Retirement or Social Security benefits and you’re turning 65, you may be automatically enrolled in the program. If so, you’ll receive your Medicare card in the mail three months before your 65th birthday or once you’ve been on disability for 25 months.
Do you have questions about Medicare plans?
We understand that choosing a Senior Health Insurance plan can be overwhelming due to the numerous options and carriers available. However, we are here to make the process quick and easy for you by helping you find the right plan that fits your specific needs.
With over 25 years of experience, we have been serving the Medicare-eligible population in California. As a free-service brokerage that specializes in Senior Health Insurance, our primary goal is to assist you in comprehending your Medicare options and addressing any inquiries you may have.
For live support, call 1-619-925-8000
Medicare Eligibility and Requirements
Generally, you’re eligible for Medicare when:
- You’re 65 years old or older.
- You are not 65 but have a qualifying disability or End-Stage Renal disease.
- You or your spouse have worked for ten (10) years for an employer
- You have worked for 10 years and paid taxes for 40 quarters
- You’re a citizen or permanent United States resident.
