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What Is Medicare?
Medicare is a federal health insurance program provided to anyone age 65 and older, and to people under 65 with certain disabilities or conditions. First established in 1965, Medicare has expanded into four distinct parts, two of which are offered through private insurers.
"Original Medicare"
Hospital Insurance
“Premium free” for most people and includes:
- Inpatient hospital
- Skilled nursing care
- Hospice care
- Home healthcare
Medical Insurance
Includes outpatient services like:
- Doctor visits
- Lab tests and X-rays
- Outpatient hospital care
- Durable medical equipment
Private Plan Medicare
Medicare Advantage
Offered by private insurance companies like Zing Health:
- Combines Medicare Parts A, B, C, and can include D
- Covers additional services like dental, vision, and hearing
- Monthly plan premium could be as low as $0
Prescription Drug Plan
Private companies provide Medicare Part D coverage:
- Can be purchased as a standalone plan
- Or purchased as part of a Medicare Advantage Prescription Drug Plan (MAPD)
Who Can Enroll?
You can enroll in a Medicare plan if:
- You are about to, or have recently, turned 65
- You are under the age of 65 with certain disabilities
- At any age, you have End-Stage Renal Disease (sometimes called ESRD) or myotrophic Lateral Sclerosis (ALS), also called Lou Gehrig's Disease
When to Enroll
There are certain times when you can join a Medicare Advantage and/or Medicare Prescription Drug Plan or make changes to your Medicare coverage. These are called “enrollment periods.”
Let's take a closer look at the enrollment periods below:
Initial Coverage Election Period (ICEP)
Most people first become eligible to sign up three months before their 65th birthday month.
The Initial Coverage Election Period lasts until three months after their 65th birthday month.
Annual Election Period (AEP)
The Annual Election Period starts on October 15 and ends on December 7 every year. During this period, you can...
- Enroll in a Medicare Advantage plan from Original Medicare.
- Enroll from one Medicare Advantage plan to another.
- Enroll in Original Medicare from a Medicare Advantage plan.
When you make changes to your coverage during this time, they take effect January 1 of the following year.
Medicare Advantage Open Enrollment Period (MA OEP)
Medicare Advantage's Open Enrollment Period starts January 1 and ends March 31 of every year. During this period, you can...
- Enroll from one Medicare Advantage plan to another.
- Enroll from a Medicare Advantage plan to Original Medicare (but not from Original Medicare to a Medicare Advantage plan).
When you make changes to your coverage during this time, they take the first day of the following month.
Special Election Period (SEP)
An SEP which enables you to join, switch, or drop a Medicare Advantage plan in certain situations such as...
- You move.
- You are or become eligible for Medicaid.
- You qualify for Extra Help with Medicare prescription drug costs.
- You move to an institution, like a skilled nursing facility or long-term care hospital.
We can help you understand your options and choose a plan that's right for you.
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