You are coming up on an important “milestone” birthday. And while turning 65 can be a great time to reflect on your life’s accomplishments … it’s also a time to make sure you are prepared for what’s ahead.
As you know, Medicare is our country’s health insurance program for people aged 65 or older. Medicare is designed to help with your health care costs, but it will not cover all your medical expenses.
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B covers certain doctor’s services, outpatient care, medical supplies, and preventative care.
Part D provides outpatient drug coverage. Part D is not provided directly by the government, but through private insurance companies.
If you are planning to enroll in Medicare and switching from private health insurance, there are some very important dates to keep in mind.
Your Medicare Initial Enrollment Period
You can sign up for Medicare during a seven-month period, beginning three months before the month you turn 65 and ending three months after the month you turn 65.
Your Medicare Supplement Open Enrollment Period
Your Medicare Supplement Open Enrollment Period lasts six months and begins the first day of the month in which you are both 65 or older and enrolled in Medicare Part B.
Your Part D Open Enrollment
Your Part D (Prescription Drug) Open Enrollment begins three months prior to your Medicare Eligibility (four months prior to your Medicare Eligibility for 1st of the month birthdays).
Medicare Part B is designed to cover only 80% of your medical costs. The remaining 20% is your financial responsibility. Understanding the coverage options available to you is important. Here are a few key facts to keep in mind:
Medicare Supplement Insurance, also known as Medigap, is private health insurance designed to pay those costs not covered by Medicare—copayments, coinsurance and deductibles. You have a six-month Medicare Supplement Open Enrollment Period that begins the month you turn 65 and are enrolled in Medicare Part B. During this time, all insurance carriers offering Medicare supplement insurance plans waive medical underwriting. If you apply for coverage outside of your Medicare Supplement Open Enrollment Period, your coverage may be denied or issued based on your health history. There are, however, some guaranteed issue Medicare supplement plans in the market.
Medicare Part D is prescription drug coverage. Original Medicare generally will not cover your prescription drugs. Your initial Enrollment Period for Part D starts three months before you turn 65 and continues for 7 months. The annual Open Enrollment Period for Medicare prescription drug coverage is October 15–December 7. During this time, you may join a Medicare Prescription Drug Plan or switch from one Medicare drug plan to another Medicare drug plan.
Medicare Advantage offers you a way to secure the Part A and Part B benefits of Original Medicare through a private insurance company. A Medicare Advantage Plan must cover the same benefits that Medicare Part A and B do, except for Hospice Care which is still covered by Medicare Part A. You have a seven-month Medicare Advantage Initial Enrollment Period that begins three months prior to your 65th birthday.
Selecting the right insurance products can be confusing. Browse lists of products for physicians at different points in your medical career, or talk to an Insurance Specialist for more specific guidance and assistance.
Our work is unique; our insurance plans should reflect that. The only plans sponsored by the American Medical Association (AMA), we tap into the power of over one million physicians to offer you competitive rates and benefits from top insurance companies.
You have important decisions to make in the coming months and AMA Insurance is here to assist you in any way we can.