Within Medicare, there are various plans available. Some of which are government funded, some that are partially funded or subsidized, and others that are not funded, but available from private insurance companies. How much of the plan that is government funded and subsidized depends on your eligibility as well as the types and levels of products and services offered in any given plan.
You can start the Medicare enrollment process three months prior to turning 65. You can be eligible for Medicare at an earlier age if you have received social disability insurance for more than 24 months, if you have been diagnosed with ESRD (End Stage Renal Disease) or if you have been diagnosed with Amyotrophic Lateral Sclerosis (also known as ALS or Lou Gehrig's disease).
To describe Medicare in a nutshell, we'll separate out 3 different product and services groupings:
Original Medicare covers inpatient hospital care (Part A) and outpatient Doctor care (Part B) plus some home health care and preventive services. Part A is typically subsidized by the government while Part B is only partially subsidized and requires you to pay a monthly premium. Original Medicare Part A and Part B will not cover products and services such as:
Original Medicare covers up to 80% of doctor and hospital care. Medicare Supplement Insurance plans are products sold by private insurance companies to cover the 20% or more gap. Medigap generally covers copayments, deductibles and Foreign Travel Medical emergencies that Original Medicare does not cover. You pay a monthly rate to avoid certain copayments, coinsurance and deductibles. Medigap coverage benefits are standardized into different "Parts" of coverage, see chart below.
Medicare Advantage are privately managed plans that may cover additional services beyond the standard Medicare part A and B coverage. Typically, Medicare Advantage plans may cover extras such as prescription drugs, dental, hearing, vision, wellness programs and home health care. You can consider Medicare Advantage plans bundles of health insurance products and services, where some parts are government subsidized and others are covered by you through monthly premiums, deductibles and copays. Medicare Advantage typically uses a defined network of Doctors and service facilities Health Maintenance Organizations and Preferred Provider Organizations (HMO's and PPO's) where if you need to see a doctor outside of the given network, you may end up paying more for the services.
Medicare Advantage and Medicare Supplement Insurance plans typically require an annual commitment. There is a set time-range every year, when existing Medicare beneficiaries can switch or modify their Medicare Advantage health insurance plan, this is commonly referred to as the Annual Election Period. The Annual Election Period (AEP) runs from October 15th through December 7th every year. When you sign up for a plan during AEP, coverage will typically start January 1st of the next year.
The short answer is yes—plans change and your coverage needs are likely to change over time. We recommend that you review your coverage needs during AEP, connect with a licensed insurance agent and see if there are opportunities for you to save on your overall health costs.
Things that could change include:
You can start the Medicare enrollment process three months prior to turning 65. You can be eligible for Medicare at an earlier age if you have received social disability insurance for more than 24 months, if you have been diagnosed with ESRD (End Stage Renal Disease) or if you have been diagnosed with Amyotrophic Lateral Sclerosis (also known as ALS or Lou Gehrig's disease). Medicare Advantage and Medicare Supplement Insurance plans typically require an annual commitment. There is a set time-range every year, when existing Medicare beneficiaries can switch or modify their Medicare Advantage health insurance plan, this is commonly referred to as the Annual Election Period. The Annual Election Period (AEP) runs from October 15th through December 7th every year. When you sign up for a plan during AEP, coverage will typically start January 1st of the next year.
