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Medicare & You 

Are you or someone you know turning 65 or becoming Medicare-eligible? Do you have questions about when and how to enroll? Medicare is the federal health insurance program for:

  • People who are 65 or older
  • Certain younger people with disabilities
  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

There are no income requirements to be eligible. Eligible persons are U.S. citizens or resident who has lived in the U.S. for five years.  

 

You should begin looking into Medicare and understanding the coverage at least three months before your 65th birthday or the month you will become eligible.

 

There are two ways to get your Medicare A and B benefits, either through Original Medicare or through a Medicare private plan. It is important to understand how your choice can affect the health care you receive.

 

 

Why Is An Annual Open Enrollment Review Important?

Each year, insurance companies can make changes that impact your coverage and what you pay for it. With Part D Prescription Drug coverage in particular, a change could mean the difference between paying a few bucks for a prescription and shelling out hundreds each month. For example, your insurance company could drop a drug you take from its formulary — a list of drugs covered in the plan and how the plan covers them — or move it to a different tier. 

But often, people will switch to a different Part D Prescription Drug plan thinking they’ll save money because its premium is lower. The cost of one month’s worth of one drug that’s not on your plan’s formulary could exceed an entire year’s worth of your monthly premiums. This is a common mistake, but the plans with the lowest premiums are not always the better financial choice.

 

Understanding Medicare Special Enrollment Periods

Medicare offers Special Enrollment Periods (SEPs) to provide flexibility for individuals who experience specific life events. Unlike the General Enrollment Period, which occurs annually, SEPs allow you to enroll in or make changes to your Medicare coverage outside of the usual enrollment windows. Here are some key situations that qualify for a Special Enrollment Period:

1. Change in Employment

  • If you or your spouse are still working and have health insurance through an employer, you can enroll in Medicare Part B without a late penalty when this coverage ends.

2. Moving to a New Location

  • If you move to a new area that isn’t in your current plan’s service area, you can switch to a new Medicare Advantage Plan or Part D plan that covers your new location.

3. Changes in Your Medicaid or Extra Help Eligibility

  • If you gain or lose eligibility for Medicaid or Extra Help (a program to assist with Medicare Part D costs), you qualify for a SEP to make changes to your Medicare coverage.

4. Leaving Incarceration

  • If you’re released from prison, you have a SEP to enroll in Medicare.

5. Losing Other Creditable Drug Coverage

  • If you lose your drug coverage that is at least as good as Medicare’s standard prescription drug coverage, you can use a SEP to enroll in a Part D plan.

6. Enrollment in or Disenrollment from a Medicare Advantage Plan

  • Certain circumstances, such as your Medicare Advantage Plan leaving your area, allow you to switch back to Original Medicare or join a different Medicare Advantage Plan.

How to Use Your SEP

If you qualify for a SEP, contact Medicare or your Medicare plan provider to understand your options and ensure timely enrollment. This can help you avoid gaps in coverage and potential late enrollment penalties.

 

Make it easier! How do I get started?  Medicare Questionnaire

"We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options." 

Enjoy your life!

Exercise Tips for Successful Aging

You can age successfully. The more active, healthy, and fit you are now, the better you will feel as you age. Daily exercise is important for your physical and mental health. Many counties have Senior Centers offering classes to encourage healthy living. Exercise helps you think better and improves your mood. Exercises to explore as you age include:

Walking

Swimming

Cycling

Resistance training

Strength training

Flexibility and balance exercises.


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