What is Medicare Coverage?

MyChoice Market Medicare Coverage is here to help you navigate the choices available when you or a family member are Medicare eligible. Medicare can be confusing. It is important to understand the different pieces of Medicare:

• Part A covers inpatient care in hospitals and other skilled nursing facilities, as well as hospice, home health care and other special coverage. You generally don’t pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working.
• Part B covers doctor visits and other outpatient services. It also covers some preventive services to help maintain your health and keep certain illnesses from getting worse. You pay a monthly premium for Part B coverage. This is usually reflected as a deduction from your monthly Social Security check.

But since Parts A and B don’t cover all medical expenses, you can:

• Add Part D for prescription drug coverage, or
• Add a Medicare Supplement which may also be called a Medigap, plan, or
• Replace Medicare Parts A and B with a Medicare Advantage plan. We are here to help you review your options and shop for the types of coverage that aren’t included in Parts A and B. Given that these choices are confusing, MyChoice Market Benefits Advisors, or the MyChoice Market Medicare Coverage link can help determine which plan(s) may be best for you based upon your health care and prescription utilization. More information about Medicare is available from the Centers for Medicare & Medicaid Services (CMS) "Medicare & You" handbook.

Don't Miss Your Enrollment Window

It is critical that you enroll in your Initial Enrollment Period (IEP). The IEP is a seven-month period that starts three months before the month you turn 65, includes the month you turn 65, and then up to three months after the month you turn 65. This is when plans are guaranteed issue meaning the insurance company cannot underwrite or ask questions about your health to decide if you qualify for coverage.

• As long as you have group health insurance from an employer for which you or your spouse actively works after you turn 65, you can delay enrolling in Medicare until the employment ends or the coverage stops (whichever happens first), without incurring any late penalties.
• COBRA does not count in the example above, so you may want to consider enrolling in Medicare rather than COBRA so that you don’t incur late penalties for your Medicare plans.
• Additionally, you may be eligible for a Special Enrollment Period (SEP) allowing you to join, switch, or drop a Medicare Advantage plan. Those special circumstances include a move out of your plan’s service area or you lose your current coverage. Unlike a group plan, each family member who is Medicare-eligible can enroll in his or her own coverage to get the coverage option that best fits their unique medical and prescription needs.