5 Essential Things You Need to Know About Starting Medicare Before Enrolling

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Are you approaching age sixty-five? Are you thinking about starting Medicare?

For a low cost to you, Medicare provides health insurance to older Americans who might not otherwise get covered. You can also get additional types of care through Medicare Advantage.

Yet how do you know if you’re eligible for Medicare, and when can you start coverage? What do you need to know about first time Medicare enrollment?

Let’s take a look.

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The Types of Medicare Coverage

Before you know if Medicare is right for you, you should know that there are two different types of coverage available.

Medicare Part A does not require a premium for most people. It covers services such as nursing facilities, hospice, and surgery.

Medicare Part B covers your healthcare provider’s services. It also covers the cost of medical services, as well as some preventative care. Most people pay a monthly premium of $144.60 or higher, depending upon their income.

Medicare Advantage plans usually have the same coverage as other Medicare options.

They also, however, include items that aren’t typically covered under Medicare. These include dental, vision, fitness programs. Medicare Advantage programs are approved by Medicare but offered by private companies.

In addition, Medicare Prescription plans can help you get the drug coverage you need.


Generally, you’re eligible for Medicare after you turn sixty-five or if you have a disability. 

At age 65, you can start getting Medicare without paying premiums if you get benefits from Social Security or the Railroad Retirement Board. If you’re eligible for insurance from these entities, and you aren’t receiving them yet, you still qualify for Medicare benefits. You can also get benefits or yourself or your spouse is employed by a government agency that offers Medicare.

The monthly payment for Part B is usually deducted from your Social Security, Railroad Retirement, or Civil Service Retirement paycheck. If you’re someone who doesn’t receive these checks, you will be sent a bill every three months for your Part B premium.

It is important that you start your Medicare at the right time. There can be penalties if you miss a deadline.
Keith Armbrecht
Medicare on Video

When You Can Start

You may be wondering “when can I start Medicare coverage?

Some folks will get Medicare automatically when they turn sixty-five years old. If you’re already receiving Social Security or Railroad Retirement Board benefits, you will get automatically signed up for Medicare Part A and B on the first day of the month when you turn 65.

Other folks, however, will need to sign up. You can begin registering during a seven-month enrollment period around your sixty-fifth birthday. It begins on the first day of the month that starts three months before your sixty-fifth birthday and ends three months after your birthday.

If you miss the Open Enrollment Period, you can sign up during the General Enrollment Period each year. 

How to Sign Up

You can sign up for Medicare online. You won’t need to reapply each year. You will, however, be allowed to review the types of benefits you’re receiving.

What to Do During Your First Year on Medicare

Your first year of Medicare requires a bit of extra paperwork. If you’re diligent, you could save yourself a number of extra steps later on.

For example, you’ll need to fill out a form that authorizes Medicare to speak to your spouse, family members, or friends if you’re ever unable to talk. You’ll also need to schedule your first free Medicare check-up.

It’s important to do your research and make sure that your regular physicians accept Medicare. 

If they don’t, you may need to shop around for a new doctor. Check to see if these physicians are accepting new patients. You’ll also need to check whether or not you’ll need referrals for specialists.

You’ll have to create accounts online for all Medicare parts you’re going to get benefits from. These include Parts A, B, C, D, and Medigap.

You can begin using your online accounts to keep track of your medical bills and claims. If you have questions about the details of your local coverage, you can also contact your State Health Insurance Assistance Program (SHIP.)

Understanding What You Need

Not every Medicare program is right for every recipient.

Before you decide on which Medicare programs to enroll in, make sure you take stock of what your general needs are. 

Keep in mind that there is no limit to the amount of out-of-pocket expenses you’ll pay each year with general Medicare coverage. There is, however, a yearly limit with Medicare Advantage plans. This may make them a more financially sound plan for some people.

Think about the typical costs of your doctor visits and hospital stays, and consider how much your plan will cover them. If you regularly visit a gym or need glasses, Medicare Advantage may work best for you because these services are often covered.

You’ll also want to consider your prescription drug needs and how well a Medicare prescription plan will cover them. Many Medicare Advantage Plans will cover prescription drugs. If, however, you sign up for original Medicare, you may require Plan D.

You’ll also need to think about the quality of medical care you’ll receive from doctors under different plans. If you plan to travel a lot outside of the US, you’ll need additional coverage, since Medicare usually only covers national services.

The Advantage of Starting Medicare

If you’re approaching sixty-five or have a disability, it may be time to think about starting Medicare. With a little homework, you could be getting excellent coverage and healthcare in no time.

Don’t stop learning about Medicare coverage now. For more information on Medicare supplements, contact us today.


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