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Navigating Medicare: First-Timers Can Feel Overwhelmed – Here’s A Beginner’s Guide

Healthy Living 10_06
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Medicare, and its alphabet of classifications, can be a befuddling subject, especially for first-timers. With seemingly endless options and a glut of detailed information to sift through, where do you start?

Luckily, there are plain-english answers available from agencies such as the Centers for Medicare & Medicaid services and medicare.gov. These agencies both offer extensive literature and also the opportunity to ask questions - you’ll thank them profusely if you’re navigating Medicare for the first time.

If you’re approaching eligibility, here are a few basic answers to jumpstart your understanding.

Am I Eligible?
Many are eligible for Medicare for different reasons, but there are a couple of basic rules to know:

Everyone over the age of 65 is eligible for Medicare (so long as they are a U.S. citizen). If you’ve been on Social Security Disability Insurance or certain other special-case scenarios, then you may be eligible prior to age 65: but generally, 65 is the magic number. When I’m Eligible, Am I Automatically Enrolled? Most people who are receiving Social Security benefits - either through retirement or disability - are automatically enrolled in Medicare Parts A and B, which cover hospital stays and medical care. (If you’re near 65, you may likely already have received a packet in the mail.) If you’re not receiving Social Security or are not eligible, you can still sign up for Medicare, you’ll just have to do it through the Social Security Administration or filling out a form online.

When Can I Sign Up?
You can sign up for Medicare Part A (covering hospital stays) anytime after you turn 65 or are originally eligible. For Part A with a premium or Parts B and on, there are specific times you can enroll. The Initial Enrollment Period is available for seven months before and after you turn 65, and the General Enrollment Period is from Jan. 1 to Mar. 1 annually. Specific circumstances can change your enrollment period, including your spouse, disability and other factors, so make sure you reach out to a professional if you are unsure so you do not miss your timeframe.

What’s a Medicare Part C (Medicare Advantage Plan) and How Do I Qualify?
Part C coverage (Medicare Advantage) is a plan that supplements your original Medicare. It provides health insurance that might be similar to what you received when you were on a company health plan, along with desirable perks - each plan has its own. You must be enrolled in Parts A and B to qualify. To sign up, you select a plan during the open enrollment period of Oct. 15 to Dec. 7, similar to when employer health plans are selected.

Given the amount of Medicare Advantage plans, it’s important to research and ask questions to know which one is right for you. Check our first Open Enrollment section (coming Friday, Oct. 6) for more detailed information about the many Medicare Advantage plans available.

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