Medicare Resources

Important Topics

Budgeting for Medicare

Budgeting for Medicare

Overview of Costs Medicare consists of “Original Medicare” known as Part A and Part B, plus any Medicare insurance plans...

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COBRA & Medicare

COBRA & Medicare

COBRA coverage and Medicare are two perplexing topics on their own. And they can become even more confusing when you are...

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The Parts of Medicare

Original Medicare
Medicare Insurance Options

PART A

  • Inpatient Hospital Care
  • Skilled Nursing Services
  • Hospice Care

PART B

  • Doctor's Visits
  • Outpatient Hospital Services
  • Durable Medical Equipment
  • Physician Administered Drugs

PART C

  • An "all in one" alternative alternative to Original Medicare, offered by private companies
  • Covers the same benefits as Part A and Part B, and usually includes Part D prescription coverage
  • Plans may include additional benefits not covered by Medicare

PART D

  • Prescription Drug Coverage offered by private companies
  • Stand-alone plan option or often included with Medicare Advantage plans
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MEDIGAP

  • Supplemental insurance that helps fill "gaps" in Original Medicare (sold by private companies).
  • An alternative option to Part C
  • Can be paired with a standalone Part D prescription drug plan

"Hospital Insurance"

"Medical Insurance"

"Medicare Advantage"

"Prescription Drug Coverage"

"Medigap/Medicare Supplement"

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    What is Medicare?

    Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

    (source: https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare)

    When am I eligible for Medicare?

    You are first eligible for Medicare (typically at age 65). You have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. This begins 3 months before your 65th birthday and ends 3 months after your birth month. Your coverage can start as early as the first day of the month you turn 65, unless your birthday is on the first day of the month. In that case, it can start the first of the month prior to turning 65. Individuals with disabilities can be eligible for Medicare earlier than age 65

    Do I have to sign up for Medicare if I'm 65 and still working?

    If you are covered by an employer health plan with more than 20 employees, generally you do not have to sign up for Medicare when you turn 65. You may have the choice of either staying on your employer health plan or enrolling into Medicare. If your employer has less than 20 employees, you should enroll in Medicare when you are first eligible to avoid any late enrollment penalties. Some employer plans may be considered a “Primary Payer” by Medicare, which means the plan will pay up to the limits of coverage first. We’re here to help you understand how your employer plan works with Medicare and compare coverage details when making a decision.

    How do I sign up for Medicare?

    You can enroll in Medicare Part A and/or Medicare Part B in the following ways:

    (1) Online at www.SocialSecurity.gov

    (2) By calling Social Security at 1-800-772-1213 (TTY users 1- 800-325-0778), Monday through Friday, from 7AM to 7PM

    (3) In-person at your local Social Security office

    Can I enroll in Medicare and keep my employer plan?

    You can be enrolled in both Medicare and an employer plan. For companies with over 20 employees, the employer plan is the primary payer and Medicare is secondary. For companies under 20 employees, Medicare is the primary payer and the employer plan is secondary. While you might be eligible for premium-free Part A (Hospital Insurance), you will have to pay a premium to have Medicare Part B.

    If I am still working, can I just enroll in Part A (Hospital Insurance) and postpone enrolling in Part B (Medical Insurance)?

    Yes. Many people who are still working and covered under an employer sponsored plan elect Medicare Part A, but postpone enrolling in Part B. This is because Part B charges a monthly premium and often duplicates the employer plan coverage. If someone is enrolled in Medicare Part A and an employer plan, Medicare will pay secondary for hospitalization if the company they work for has more than 20 employees.

    Is there any reason to postpone enrolling in Part A if I'm covered under an employer plan?

    If you are enrolled in Medicare Part A, you may no longer contribute into a health savings account (HSA). Your employer can no longer contribute to an HSA on your behalf either. If you are enrolled in an HSA compatible health plan through your employer and wish to keep it in place, you should consider postponing enrollment into Part A.

    I’m ready to leave my employer’s plan and switch to Medicare. Will Original Medicare (Part A and Part B) be enough?

    Medicare has gaps in coverage and cost sharing which is why most people add on a Medicare insurance plan. These plans are offered by private insurance companies, not Medicare. There are two different types of Medicare Insurance plans and you pick one or the other:

    1) Medicare Advantage plans (also known as Part C or MA)

    2) Medicare Supplement (also known as Medigap)

    * You will continue to pay your Medicare Part B premium in addition to the premiums for the plan you select.

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