When you turn 65, you are eligible to enroll in Medicare. But how does this process work, and what do you need to do? Rob Wiseman explains in this video.
Here's a transcript of the video:
I am Rob Wiseman, Wiseman Insurance, and when do you need to go on Medicare? When you turn 65. Typically, people at that age go onto Medicare. Some people choose to stay on their Group Health Plan, which is okay if you're on a large group. But if you're on a small group, there can be penalties involved if you don't enroll when you're supposed to.
What If I Am Going To Continue To Work?
You don't have to, but again, there can be penalties, if you don't go onto Medicare when you're supposed to. On a large group, you don't have to. On a small group, you would be better to take Medicare.
Will I Be Signed Up For Part A & B Automatically?
If you have qualified for Part A by working 40 quarters in your life — so, basically, 10 years — and paid Medicare taxes, you will automatically receive the part A benefit. Part B, you sometimes have to sign up. Sometimes you don't. Depending on if you have retired, and you are on Social Security, it should come to you automatically before your 65th birthday. If you haven't started taking Social Security, and you're still working, you probably need to go down and sign up. Or you can go to the Social Security Administration website and sign up there.
How Do I Sign Up For Medicare?
Once you sign up for Part B, then you want to look at options to provide extra benefits. There are gaps within Medicare that can be very costly if you don't take care of them.
Who Do I Go To To Sign Up For Medicare?
To sign up for Part A and Part B, you go to the Social Security Administration, or you go to , and you can sign up there. Signing up for the health plans that cover the gaps, you can come to Wiseman Insurance — Craig Wiseman, or Robert Wiseman, we can help you here.
What Is Part A?
Part A is primarily hospital benefits. So, when you go in the hospital, there's a deductible, and then Medicare pays most of the rest of it. But there are some gaps that the Medicare plans pay extra.
What Is Part B? Do I Need Both?
Part B is the doctor's office primarily, and that is where there are large gaps in coverage if you don't have a supplemental policy. You have to have Part A and Part B in order to purchase a supplemental policy, whether it be a Medigap policy or a MedAdvantage policy.
What Is Medigap And MedAdvantage?
With a Medigap policy, you have your Part A and your Part B from Medicare. Those pay first, and then the Medigap policy covers the gaps. In addition to that, you would need a drug card — which there are penalties if you don't buy that at the appropriate time — so you would want to get that at the same time. It's not very expensive, and you can get a very good drug card.
What Doctors And Hospitals Can I Go To?
On a Medigap policy, any doctor or hospital that accepts Medicare accepts the Medigap plan, because it's just a supplemental to the other. MedAdvantage plans on the other hand — some of them are PPOs, some of them are HMOs in our area. And they cover most of the doctors in the area. But you have to be careful which plan you go with on a MedAdvantage plan, because not all of them cover all the hospitals. So, you have to know which hospital you want to go to, and that's the type of plan you want to buy.
Why Would I Want Medigap Or MedAdvantage?
That's an individual choice. A lot of it depends on your medical needs. If you have a lot of health conditions — if you're going to be going in the hospital a lot of times, or you have a history of going in the hospital a lot of times — you may be better served by purchasing a Medigap policy because it's a little bit more comprehensive. There's less cost on benefits and more cost on premium, but the benefits outweigh the premium.
What About Drugs?
Most of the MedAdvantage plans automatically include a drug card. For the Medigap plan, you have to buy a separate drug card.
Whan Can I Sign Up For Medicare?
When you turn 65, or when you lose your Group Health Coverage — particularly a large group plan.
When Can I Purchase Medigap Or MedAdvantage?
The enrollment period is based on when you initially get your Part B coverage. You have a period of time before and after your birthday — typically, your birthday or when you get your Medicare Part B plan — when you can sign up on Medigap plans. There's no underwriting, no health questions as long as you sign up when you're supposed to. On MedAdvantage plans, you can sign up at the same time periods, around your birthday. And then they have an annual election period that runs from November 7th to December 15th every year where you can stay with the plan you're on. Or, if you want to change to a different plan, you can change to a different plan.
Do I Have To Go Through Underwriting?
You only have to go through underwriting if you don't sign up when you're supposed to on a Medigap plan.
What Happens If I Want To Change Plans?
Let's say you signed up on a MedAdvantage plan. And then, a couple of years down the road, you decide, "Oh, I think I want to go back to a Medigap plan." You can do that if you're healthy. But if you have some serious health conditions, it can be very difficult to go back to a Medigap.
Thanks for watching. Please call Wiseman Insurance for your Medicare insurance needs. You can ask for Rob or Craig Wiseman at (801) 377-3060. Thank you.
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