Medicare is health insurance provided to people age 65 and older and is divided up into four parts: Part A, Part B, Part C, and Part D. Your Part A Medicare insurance plan is your skilled nursing facility care plan. This is the card that you would present at a hospital if you are going in for surgery, for example. Your Part B, however, covers your doctor’s visits and treatment you received at outpatient facilities. It also covers durable medical equipment, such as wheelchairs and CPAP machines. People who know that they are more likely to have increased hospital stays and will need to see a specialist more often might find that their Parts A and B do not cover all of the needs they have. Medicare Part C includes Medicare Advantage plans, or Medigap plans. As the name suggests, these plans cover the gaps in coverage in Part A and B, so if you have an extended hospital stay or need to see a specialist regularly to manage your health, such as diabetes, you are not left with excessive medical bills. Medicare Part D is your prescription drug plan.

When do I become eligible for Medicare?

In order to avoid a late enrollment penalty, you will want to speak with one of our South Florida Medicare Specialists to ensure that you are enrolling at the correct time. However, here are some general guidelines to help you know when to prepare for open enrollment:

Initial Medicare Enrollment Period

The six-month timeframe, which spans from three months before your 65th birthday and three months after you turn 65, is your Initial Medicare Enrollment period. Your coverage will begin on the first of the month after you sign up for Medicare.

Medicare Open Enrollment Period 

If you miss your initial enrollment period, then you will have to wait until Medicare‘s Open Enrollment, which is from October 15 to December 7. You can also drop your Medicare plan during this time if you are offered other insurance through an employer or union.

General Medicare Enrollment Period

If you miss your Initial Medicare Enrollment Period, then you can sign up during the Medicare General Enrollment Period, which is from January 1 to March 31. Your coverage will begin on July 1.

Special Enrollment Period

You missed your Initial Medicare Enrollment Period and the General Enrollment Period, then you may have an opportunity to sign up for Medicare during a Special Enrollment Period. Circumstances that allow you to make changes to your Medicare Advantage and Medicare plans include :

  • Moving to a new area or address
  • Losing your current coverage
  • Being offered other coverage, such as through your employer or a union
  • Your plan has changed its contract with Medicare
  • If you no longer have a condition that qualifies as a special need that your Special Needs Plan served

When should I sign up for Medigap plans and a Medicare prescription drug plan?

First, it’s important to understand what Medicare Advantage Plans are. For people who know that they are going to have more medical needs due to a condition or other concerns about their health, they may be looking at their Part A and Part B plans and wondering what to do about the gaps in their coverage. They know that they are more likely to need more hospital stays or to visit specialists to manage illnesses and conditions, such as high blood pressure. What many who have chosen Medicare Advantage Plans enjoy about them is that the plans are bundled, meaning that they include your Medicare Part A hospital insurance and your Medicare Part B medical insurance, as well as your Medicare drug coverage Part D all-in-one plan. This means that instead of having multiple cards, you simply present your one Medicare Advantage Plan card wherever you need service.

That being said, the best time for you to join a Medicare Advantage Plan or Medicare Prescription Drug Plan is when you initially enroll in Medicare. This will prevent you from having to pay a lifetime Part D late enrollment penalty

South Florida Medicare Specialists

The decisions you make about your health insurance can have serious effects on your access to care, and the care you want, so we take our time getting to know you and what you want so we can offer you the best options. Call us today at 561-339-0366 to schedule your free consultation. Not all plans are available in all areas, so we serve the South Florida community by helping you choose the right plan to work within the local network.