At CareLink, we know finding a health care plan can be confusing. Getting enrolled in Medicare and understanding the various supplemental plans offered can be hard to navigate. We have a team of trained staff offering free Part D plan reviews throughout the open enrollment period to help alleviate the stress and confusion many can have when choosing the right policy.
How Do I Enroll for Medicare?
Some people are automatically enrolled for Medicare Part A and Part B coverage, while others will need to enroll during the Initial Enrollment Period that takes place over a seven month period around the time of your 65th birthday. Your Initial Enrollment Period, or IEP, begins three months before you turn 65 and ends three months after your birthday month. If you are automatically enrolled in Medicare, you will receive a Medicare card shortly before your 65th birthday. If you are not automatically enrolled for Medicare, you’ll need to register shortly before or after your 65th birthday to avoid having to pay late enrollment penalties and to avoid a waiting period for coverage to begin. You can register for Medicare in one of the following ways:
- Online at www.SocialSecuity.gov
- Over the phone by calling 1-800-772-1213 on weekdays from 7am-7pm
- In person at your local Social Security Administration office
WHO IS AUTOMATICALLY ENROLLED FOR MEDICARE?
Those currently receiving retirement benefits from Social Security as well as those who receive benefits from the Railroad Retirement Board are automatically enrolled in Medicare Part A and Part B. You are also automatically enrolled for Medicare if you are under the age of 65 and currently receiving disability benefits. Benefits begin on the first day of the month that you turn 65, but if your birthday falls on the first of the month, benefits will begin on the month preceding your birthday.
What is Medicare?
There’s a lot of information to sift through regarding Medicare plans. Whether you’re preparing to enroll in Medicare for the first time or you’re interested in learning more about changing your existing plan or adding a Medigap plan, here’s what you need to know about Medicare’s four core components – Parts A, B, C, and D.
Part A (Hospital Insurance)
Medicare Part A is intended to cover the cost of inpatient hospital care and includes coverage for a variety of services, including:
- Semi-Private Rooms
- Meals and Nutrition
- Treatments and Medications
- Nursing Services
Medicare Part A is offered for anyone over the age of 65, and others under the age of 65 with certain medical conditions, including anyone with end-stage renal failure or ALS, which is also commonly referred to as Lou Gehrig’s disease. Part A is also available to cover the expenses incurred from in-patient care provided at long-term treatment facilities, including:
- Mental Health Facilities
- Nursing Homes
- Hospice Care
- Home Health Care Services
Part B (Medical Insurance)
While Medicare Part A covers the cost of inpatient hospital care, Part B covers the cost of outpatient care. This includes medically-necessary services used to treat chronic and acute symptoms and illnesses, including:
- Doctor’s Office Visits
- Lab Work
- Outpatient Procedures
- Medically-Necessary Equipment
- Diabetic Testing Supplies
- Blood Pressure Monitors
Typically, Medicare Part B does not cover 100 percent of the costs of treatments or supplies until a deductible is met. Once the deductible is reached, Medicare typically covers 80 percent of the cost of doctor visits, outpatient procedures and treatments, medically-necessary supplies, and other items.
Part C (Medicare Advantage)
Medicare Part C, more commonly referred to as Medicare Advantage plans, provides Medicare Parts A and B through a Medicare-approved, private insurance company. Many Medicare Advantage plans also offer prescription drug coverage similar to Medicare Part D, and some even offer other benefits not provided by Medicare, such as dental insurance.
MEDICARE COVERAGE OPTIONS BY STATE
To learn more about the available Medicare plans offered in your area, visit the official Medicare website to view more information regarding Medicare coverage options and plans by state.
Part D (Prescription Drug Coverage)
Medicare Part D, also known as the Medicare prescription drug benefit, provides optional coverage for prescription drug costs. Even if you are already enrolled through Medicare, you will not be automatically enrolled for Part D Prescription Drug Coverage. If you’re eligible for Plan D benefits, you’ll need to enroll for Part D to add this option to your original Medicare coverage. Without Medicare Plan D coverage, you’ll have to pay for prescription drugs out-of-pocket unless you have other private insurance that covers the cost.
AM I ELIGIBLE FOR PRESCRIPTION DRUG COVERAGE THROUGH MEDICARE PART D?
Those who are already enrolled in Medicare Part A or Part B who live in the service area of a Medicare Part D prescription drug plan are eligible for Part D prescription drug coverage. If you are enrolled in a Medicare Advantage plan, your plan may or may not cover prescription drug costs. If your Medicare Advantage plan does not cover prescription drug costs and you would like to enroll for Medicare Part D, you must also be enrolled in Medicare Part A and Part B.
WHEN CAN I ENROLL IN MEDICARE PART D? WHEN IS MY INITIAL ENROLLMENT PERIOD?
You’re first eligible to enroll in Medicare Part D when your Initial Enrollment Period, or IEP, for Medicare opens. Your Initial Enrollment Period is a seven-month window beginning three months before you turn 65 and ending three months after your birthday month. It’s best to enroll in Medicare Part D when you first enroll in Medicare, since waiting until after you are 65 to enroll may require you to pay a late enrollment fee or wait for a period before your benefits begin.
MEDICARE PART D OPEN ENROLLMENT
If you didn’t sign up for Medicare Part D at the time of your initial enrollment with Medicare, you are still able to apply for Part D coverage during the Medicare Part D open enrollment period beginning on October 15 and ending on December 7.
WHAT PRESCRIPTIONS DOES MEDICARE PART D COVER?
The type of prescriptions and the amount of coverage provided will vary depending on the type of medications you use, whether you take generic or brand-name medications, and other factors. Because Medicare Part D only covers a certain amount of prescriptions drug costs, it’s best to create a plan for prescription drug care. There are a few ways to work with your doctor and pharmacy to help cut prescription drug costs, which allows you a much higher chance of seeing all of your medication costs being covered. Some steps you can take to lower prescription drug costs include:
- Asking your doctor to prescribe generic and over-the-counter medications rather than costly brand-name medications
- Ask your plan provider or supplemental insurance about mail-in prescription programs
- Ask your doctor to prescribe 60- or 90-day supplies that can cut the costs of copayments and prescription costs over time
- Use your Medicare plan’s in-network pharmacies
- Use your Medicare plan insurance card
CareLink Can Help
Have questions about how to optimize the amount of prescription drug coverage you can receive with or without Medicare Part D? CareLink offers free prescription drug counseling services for Medicare recipients in Central Arkansas. Learn more about CareLink services or sign up to speak with a representative who can provide more information on Medicare Part D coverage.
How Do I Change My Medicare Plan?
If you’re already enrolled in Medicare but want to add another plan to your coverage package, you can do so during the Annual Election Period that takes place between October 15 and December 7. During this time, you can switch between plans or add supplements you’re not currently receiving, meaning you can:
- Enroll for Medicare Part C, or a Medicare Advantage Plan, with prescription drug coverage
- Enroll for Medicare Part D prescription drug coverage
- Disenroll from any Medicare plan
- Switch from one Medicare plan to another (including prescription drug plans)
If you’ve recently moved to a new state where a different type of coverage is offered, or if you’ve recently become eligible for a new type of plan, you’ll want to take advantage of the Annual Enrollment Period to find the best plan for your needs. To speak with a professional who can help you determine which plans you are eligible for and which you can enroll in to begin receiving coverage, schedule an appointment today.
Medicare Enrollment and Coverage Updates for 2022
There are a few updates for 2022 Medicare coverage.
1. Part B Deductible
Newly eligible Medicare beneficiaries will no longer have coverage over the Part B deductible. This rule was set in place in hopes of preventing individuals from over-utilizing the health care system. For those who already are receiving the Medigap plan C or F, the deductible will be fully covered, without charge. However, individuals who do not have a Medigap plan that covers the plan B deductible will have to pay out-of-pocket. Those who already have plans C and F will be able to continue utilizing those plans. However, newly eligible Medicare beneficiaries will no longer be able to use those plans after 2021.
2. Prescription Drug Coverage Gap
The gap in prescription drug coverage will be fully closed beginning in 2022. Those enrolled in Medicare will only be responsible for paying up to 25% of their drugs until they reach the maximum coverage. Part D deductible max in 2022 will be $435.