How And When To Apply For Medicare?

February 1, 2024

As we grow older, taking care of ourselves becomes increasingly important. And one crucial aspect of self-care is having the right insurance coverage to manage medical expenses. With the right insurance, we can rest easy knowing that we're covered and avoid financial stress when seeking medical attention.

If you're a senior citizen, we've got you covered! We are a leading Medicare Agency in St. Louis, we aim to help you enroll in the right Medicare plans. We understand that enrolling in Medicare can be a bit overwhelming, which is why we're here to guide you through the process.

Our team of experts will help you choose the right Medicare plan that fits your unique needs and budget. We'll provide you with all the information you need to make informed decisions about your healthcare coverage.

What is Medicare?

Medicare is a health insurance program in the United States funded by the federal government. It provides coverage for people aged 65 and above and some young individuals with disabilities or specific medical conditions.

Medicare was established in 1965 and is administered by the Centers for Medicare & Medicaid Services (CMS), which is a division of the U.S. Department of Health and Human Services. The program is designed to help people access essential healthcare services by offering a range of coverage options.

Things To Consider While Enrolling For Medicare

Medicare enrollment can be complex, but understanding the key aspects can empower you to make informed decisions about your healthcare coverage. Whether you're approaching the age of eligibility or considering a change in your plan, here's a guide to consider the things from a leading insurance company in St. Louis

Eligibility Basics

Medicare eligibility typically begins at age 65, but certain individuals may qualify earlier due to specific health conditions or disabilities. Understanding when you become eligible is crucial for planning your enrollment.

Initial Enrollment Period (IEP)

The Initial Enrollment Period is a seven-month window around your 65th birthday. It includes the three months before, the month of, and the three months after your birthday month. Enrolling during this period ensures that you don't face penalties and have coverage when you need it.

Parts of Medicare

Medicare consists of different parts, each covering specific aspects of healthcare:
Part A: Hospital Insurance
Part B: Medical Insurance
Part C: Medicare Advantage Plans
Part D: Prescription Drug Plans

Understanding the purpose of each part helps you tailor your coverage to meet your individual needs.

Medicare Advantage vs. Original Medicare

During enrollment, you'll face the choice between Original Medicare (Parts A and B) and Medicare Advantage (Part C). Original Medicare provides traditional coverage, while Medicare Advantage combines Parts A and B with additional benefits like vision plans, and dental plans, often including prescription drug coverage.

Supplemental Coverage

Medigap plans, also known as Medicare Supplement Insurance, can help fill the gaps in Original Medicare coverage. Exploring these options during enrollment can provide added financial protection against out-of-pocket expenses.

Prescription Drug Coverage

If you opt for Original Medicare, consider enrolling in a standalone Part D Prescription Drug Plan. Medicare Advantage plans often include drug coverage, but it's essential to review and compare options to ensure your medications are covered.

When Should You Apply For Medicare?

So, when it comes to enrolling for Medicare, there are periods, to enroll, to apply for medicare plan changes, and much more. We’ll walk through that so that you may understand medicare enrollment dates better!

  • Initial Enrollment Period (IEP):

    As we mentioned above, this is the 7-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

  • Annual Medicare Enrollment(AEP):

    Annual Medicare enrollment, also known as the Medicare Annual Enrollment Period (AEP), occurs each year from October 15 to December 7. During this time, you can review and make changes to their health and prescription drug plans for the upcoming year.

  • General Enrollment Period (GEP):

    If you miss your IEP, you can enroll in Medicare during the GEP, which runs from January 1 to March 31 each year. However, late enrollment may result in penalties.

  • Special Enrollment Periods (SEPs):

    There are specific circumstances, such as continuing to work beyond 65 and having employer-sponsored insurance, that may qualify you for a Special Enrollment Period.

Enrollment Options:

    • Automatic Enrollment:
      • If you're receiving Social Security benefits when you turn 65, you are usually automatically enrolled in Medicare Parts A and B. You'll receive your Medicare card in the mail three months before your 65th birthday.
  • Manual Enrollment:

    If you're not receiving Social Security benefits, you'll need to sign up for Medicare. You can do this online, by phone, or in person.

  • Online Enrollment:
      • Visit the official Social Security website at www.ssa.gov.
      • Create a “My Social Security" account if you don't already have one.
      • Follow the instructions to apply for Medicare.
  • Enrollment by Phone:
    • Contact the Social Security Administration at 1-800-772-1213 (TTY users can call 1-800-325-0778).
    • Follow the automated prompts or speak to a representative to complete the enrollment process.
    • In-Person Enrollment:
      • Visit your local Social Security office which can help you with the procedure.

Or you can reach out to a reliable medicare agency in St. Louis, that can help you with the enrollment process!

Conclusion

We believe that the above blog about Medicare will be helpful to you as you consider your options for Medicare. Jain Insurance Agency is a leading Medicare Brokers in St. Louis, and we have helped numerous individuals, families, and businesses find the right insurance solutions.

Be it Medicare, Healthcare, or Commercial we can help you choose the right insurance plan that suits you! Contact us today!