Medicare is the United States health insurance program. If you qualify for Medicare or are about to become eligible, you may wonder if you need to sign up or not. Suppose you have a group health plan or COBRA. In that case, you may not need to enroll right away, though you should talk to an experienced insurance agent, like the ones with Bend Medicare, to make the right decision. Medicare can help cover healthcare costs such as preventive screenings, skilled nursing facility care, and inpatient and outpatient hospital services. Understanding this coverage makes it crucial to determine when and if you should enroll.
To avoid a late enrollment penalty, it is advisable to enroll for Medicare as soon as your group health plan stops or you become eligible for Medicare.
Is Medicare Necessary?
United States citizens and legal residents become eligible for Original Medicare at age 65. However, people who receive Social Security benefits or Railroad Retirement benefits will be automatically enrolled in Medicare. If you are not automatically enrolled, you will need to sign up for Medicare as soon as you become eligible. It is essential to sign up on time as delaying enrollment may result in late enrollment penalties.
However, suppose you are still employed and have a group health plan. In that case, you may delay enrollment if your employer has 20 or more employees. This will make your group plan your primary insurance. But, you can still enroll in Medicare Part A as it is premium-free for many individuals, and it will become your secondary insurance.
Now, suppose your employer has fewer than 20 employees. In that case, you may need to enroll in Medicare during your Initial Enrollment Period, which starts three months before your 65th birthday and ends three months after, so you can avoid the late enrollment penalty. Original Medicare will serve as your primary insurance once you enroll.
Overall, it is not exactly necessary for you to enroll in Medicare if you already have creditable health coverage. However, it’s advisable to enroll once this coverage ends. Also, if you choose to delay your Medicare enrollment without having any other coverage, you would ultimately be doing yourself more harm than good if you decide to enroll in Medicare at a later time. This will cause you to pay late enrollment penalties that could have been easily avoided by enrolling in the correct enrollment period.
What Medicare Covers?
Understanding what Medicare covers is crucial in determining which plan is best for you. During the Initial Enrollment Period, you can enroll in Original Medicare, which is Part A and B. Part A is your hospital insurance, which covers inpatient services. Part B is your medical insurance, which covers outpatient services. You will need to enroll in both if you are interested in:
- Part C: Also known as Medicare Advantage, you will receive the same coverage as Original Medicare, including additional benefits like dental, vision, and hearing. You can review your Medicare coverage every fall and make changes if you feel it is necessary. You can do so during the Annual Enrollment Period (October 15 – December 7), where you can switch from Original Medicare to Medicare Advantage.
- Part D: This plan provides prescription drug coverage.
- Medicare Supplement plan: There are ten Medicare Supplements to choose from. These plans can work alongside your Original Medicare coverage and cover costs like deductibles, excess charges, coinsurance, and copayments.
At Bend Medicare, we understand how important it is to find the coverage that meets your needs best. That’s why we will walk you through each Medicare plan and help you determine what to enroll in and when you should enroll.
Reach out to us today for a free consultation.