Aging is a natural process every human has to go through, but it doesn’t have to be a bad experience! There are many milestones in life, and turning 65 is just one of them. The age you can get Medicare is the stage of life is when you can finally retire and enjoy your free time with your loved ones.
Qualifying for Medicare is another milestone in life. It provides an opportunity to consider the healthcare coverage you’ll need to ensure you can stay healthy and live confidently for a long time. At 65, you can choose from various Medicare options to find the best fit for your needs and budget.
In this article, you’ll learn the basics of enrolling in Medicare, what plans are available to you, and how to choose suitable options for your future health coverage.
What is Medicare?
Medicare is a federal health insurance program for adults aged 65 or older (and certain younger people with disabilities or adults with end-stage kidney disease) designed to help them afford good health care.
Medicare covers preventive care, hospital services, and doctors’ visits without requiring you to pay anything out-of-pocket. It also covers some prescription drugs each year without cost sharing. And while there are deductibles and coinsurance, they are typically low.
Medicare comes in four parts: Parts A, B, C, and D. Parts A and B are called “Original Medicare” and are provided by the government. Parts C and D are available from insurance providers or private companies. Medicare Supplement Insurance is also available to help pay for costs not covered by Original Medicare.
Medicare Options Available for You at 65
You may be asking yourself, do I automatically get Medicare when I turn 65? The answer is yes, 65 is the age you can get Medicare, with a few exceptions. If you are disabled or have end-stage kidney failure, what age can you get on Medicare changes. Let’s cover the basics of what the Medicare program is first before we get into the details.
The Medicare program is divided into four parts and below is a general overview of how each of these parts works.
- Original Medicare – Parts A & B
- Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing care, hospice stays, and some home health services.
- Part B (Medical Insurance) covers outpatient medical care such as doctor’s visits, laboratory work and x-rays, preventative care, outpatient services, medical supplies, diagnostic tests, and certain long-term care services.
- Medicare Advantage (Part C) is an optional alternative to Original Medicare that provides all or part of the benefits of original Medicare. Medicare Advantage plans cover many services the Part A and Part B programs also provide. This can include transport for medical care, which is only available in some areas. By law, Medicare Advantage plans have to cover all of the services that Original Medicare covers, but that’s where the similarities end. Most Medicare Advantage plans include coverage for hearing, dental, and vision, options not covered by Original Medicare. Medicare Advantage plans may also include coverage for prescription drugs (Part D).
- Prescription Drug Plans (Part D) help cover the cost of prescription drugs. You might be surprised that most prescriptions aren’t covered in Parts A and B. This is where Part D comes in. Just like non-Medicare insurance plans, Medicare Part D plans have a covered prescriptions list called a formulary. Private insurance companies approved by Medicare offer these plans. They work in tandem with Original Medicare and Medicare Supplement plans. Prescription drug coverage is often included in Medicare Advantage plans.
Medicare Supplement Insurance
You can choose a Medicare Supplement Insurance policy if you already have Original Medicare Part A & Part B. A supplemental Medicare policy assists in paying for your larger and longer-term medical expenses and health gaps not covered by your current insurance.
These are plans sold by insurance providers like Blue Cross and Blue Shield of Kansas or other private insurance companies. They can be purchased in combination with Parts A, B, or D as a way to help bridge the gap in your Medicare coverage. A supplemental medical insurance plan helps pay copays, coinsurance, and deductibles. We encourage you to learn more about the Medicare Supplement plans we offer in Kansas.
How to Apply for Medicare
Medicare coverage generally begins on the first day of the month following your 65th birthday. The Medicare Open Enrollment Period starts January 1st and ends March 31st every year. The Medicare Annual Enrollment Period (AEP) is when you can change your Medicare coverage choices and runs from October 15th to December 7th. New coverage choices made during that time will go into effect on January 1st.
The best way to enroll in Medicare is by visiting the official website and applying online at www.medicare.gov. This is the easiest way to start this process. However, there are other ways to apply:
- Apply online at www.ssa.gov
- Call 1-800-MEDICARE (1-800-633-4227)
- Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778)
- Set up an appointment at your local SSA office
- Fax your enrollment forms to 1-833-914-2016
If you already have Medicare Part A, and you’re eligible to enroll in Medicare Part B through a Special Enrollment Period (SEP), complete forms CMS-40B (Application for Enrollment in Medicare) and CMS-L564 (Request for Employment Information) to do so. You can also fax these forms to 1-833-914-2016 or return them by mail to your local Social Security office. You must provide your Social Security number and birth date to apply for coverage.
You may be wondering, “do I have to sign up for Medicare at 65?” If you are already receiving Social Security benefits, you do not need to sign up as you will automatically sign you up for Parts A and B coverage at age 65. If you paid Medicare taxes while working, you might be eligible for premium-free Part A hospital insurance. If you don’t qualify, you may have to pay a monthly premium for coverage. There is a monthly premium for enrolling in Part B medical insurance.
Note: Penalties can result from not signing up for Medicare when you are eligible (at age 65.) You can avoid penalties by enrolling before the deadline. To find the deadline for Medicare enrollment this year, visit their website for more information. If your group coverage with your employer is more affordable, you can wait until after retirement to explore Medicare options. Talk to a knowledgeable Medicare expert to learn more.
How to Choose the Right Medicare Plan for You in Kansas
Let us help you simplify this process. We encourage you to call us at 1-800-432-3990 (toll-free) or (785) 291-4180 (local number) to speak to a Blue Cross and Blue Shield of Kansas representative to learn more about signing up for Medicare.
Our number one goal is to make healthcare accessible to all Kansans turning 65 and older by creating a better medical insurance experience overall. We are committed to creating trusting relationships with our members as Kansans serving Kansans. Take advantage of our expertise, support, and resources to find the Medicare insurance plan that works for you.
Contact us today to learn how to apply for Medicare in Kansas, get help aging into Medicare, and let us help you get straight to enjoying the good life!
Blue Cross and Blue Shield of Kansas is not connected with or endorsed by the U.S. Government or the Federal Medicare Program. Blue Cross and Blue Shield of Kansas, Inc. serves all counties in Kansas, except Johnson and Wyandotte. Blue Cross and Blue Shield of Kansas is an independent licensee of the Blue Cross Blue Shield Association. For costs and details of coverage, including exclusions, reductions, or limitations and the terms under which the policy may be continued in force, call or write the company at 866-842-2469 (TTY 711) or Blue Cross and Blue Shield of Kansas, 1133 SW Topeka Blvd., Topeka, KS 66629.