Are you approaching retirement and wondering about what your healthcare options may be? You probably understand that Medicare is a government-run health insurance program, but you may still be confused about what it will do for you. Our insurance experts can help you understand Medicare and how it works with private insurance companies to offer you valuable health coverage in retirement.
What Are My Medicare Plan Options?
MEDICARE
PART A
Inpatient/Hospital Coverage
Partial Coverage for Hospital and Skilled Nursing Facility, including:
- Inpatient Surgery
- Inpatient Care
- Hospice Care
- Home Health Care (Limited)
MEDICARE
PART B
Outpatient/Wellness Coverage
Partial Coverage for Professional Medical Services, including:
- Doctor Visits
- Outpatient Surgery
- Diagnostic Tests
- Outpatient Treatment
- Durable Medical Equipment
- Preventative Services
MEDICARE
PART C
Private Insurance
Provides benefits like or better than Part A & B and limits out-of-pocket expense. Services include:
- Professional Medical Services
- Inpatient Hospital
- Preventative Services
- Drug Coverage (Optional)
- Dental (Optional)
- Vision (Optional)
Must have Parts A & B to enroll
MEDICARE
PART D
Prescription
Coverage
Stand-alone Coverage for Prescribed Medication. Benefits can include:
- Copays Based On Formulary Tier of Medication
- Possible Deductible
- Several In-network Pharmacies
Must Have Part A or B to Enroll
MEDIGAP
Supplement
Insurance
A Medigap policy is a private health insurance policy that covers some of the gaps in Medicare coverage, such as deductibles and coinsurances. Medigap plans have no provider network restrictions and can be used to cover services at any doctor or facility in the U.S. that participates with Medicare billing. Some Medigap plans provide benefits that Medicare doesn’t offer, like coverage out of the country. You must be enrolled in Medicare A and B to be eligible to enroll in a Medigap plan. Medigap plans can be used with original Medicare and Part D plans but cannot be combined with a Medicare Part C plan.
Have Questions About Medicare?
When Can I Enroll in Medicare Parts C & D?
Initial
Enrollment Period
You become eligible 3 months before your 65th birthday and are able to enroll until 3 months after your 65th birthday.
Annual
Election
Period
The annual enrollment period is from October 15th through December 7th of each year and is the period you are eligible to make changes to your Medicare plans and switch between original Medicare and Medicare Advantage plans.
Open
Enrollment
Period
The period between January 1st and March 31st where if a person is enrolled in a Medicare Advantage plan they have a one-time election to drop their plan and switch to another plan or return to original Medicare coverage.
Special
Enrollment Periods
Special Enrollment Periods can occur outside of other enrollment periods and are triggered by life events, such as the loss of employer coverage or a change of address to a different county.
* See Medicare.gov for more information on eligibility and enrollment guidelines. Additional enrollment guidelines may apply based on an individual’s unique circumstances.
Contact Us
Evolution Retirement Solutions, LLC
Anthony Hinds-Fritz, CFP®, ChFC®
920 Spencer Street
Syracuse, NY 13204
(315) 450-5014Syracuse, NY 13204
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