What to Expect

New to Medicare

Medicare Part A covers inpatient care in hospitals. This includes skilled nursing facility care (not custodial or long term care), hospice care, and home health care.If you are drawing Social Security benefits and you have worked 40 quarters or 10 years you are entitled to Part A because you paid into it while you worked.


Medicare Part B covers medical expenses which include doctors services, diagnostics, medical equipment, etc. In 2020 the Part B monthly premium is $144.60 and the deductible is $198. After your deductible is met, you typically pay 20% of the medicare approved amount. You may or may not have to sign up for Part B:

  • If you are currently drawing Social Security benefits, you will be automatically enrolled in Part B when you turn 65 and will get your card in the mail prior to your birth month. You Part B premium will be subtracted from your Social Security.

  • If you are not drawing Social Security benefits, you need to sign up for Part B through your local Social Security office or go online to SSA.GOV. 

***If you are still working and have creditable coverage through your current employer or your spouses employer you may be able to delay starting your Part B. 

Enrollment Periods

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Annual Enrollment
(October 15 - December 7)

Each year during the Annual Enrollment Period (AEP) for Medicare Advantage Plans (Part C) and Prescription Drug Plans (Part D) we will discuss your current plan and any benefit changes that are happening for next year. If no switch is necessary, your plan will automatically continue for next year. If you decide to switch, your new plan will start on January 1st.

Open Enrollment
(January 1 - March 31)

If you have a Medicare Advantage Plan (Part C), you can switch to another Medicare Advantage plan in your area or dis-enroll back to Original Medicare (in which case you will probably be looking at purchasing a Medigap/Supplement policy and standalone drug plan as well)

Special Election
Period

There are several times outside of any regular enrollment periods that you can change plans. Normally some kind of  event will trigger this such as moving, qualifying for state or federal assistance (Medicaid, Extra Help, Medicare Savings Program, etc), enrolling into a plan specifically for addressing a chronic condition (diabetes or heart disease), etc.

Medicare Advantage

Simply explained, Medicare Advantage is a program Medicare recipients can choose instead of Medicare Parts A and B. Medicare Part C allows private health insurance companies to provide all of the standard benefits of Medicare Parts A and B within a managed care plan like an HMO or PPO. Medicare Advantage Plans usually provide prescription drug insurance and some may include extras such as gym memberships or vision insurance.

Below are the most common types of Medicare Advantage Plans. 

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