New to Medicare? Your Options and Guidelines

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New to Medicare

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Turning 65?

If you’re turning 65 or are over 65 and new to Medicare, it’s time to start exploring your Medicare options.

 

Medicare has guidelines and time frames for enrollment. If you don’t enroll when you are first eligible, there could be late enrollment penalties. To avoid these penalties, it’s wise to contact us or Medicare four to six months before turning 65, even if you or your spouse is still working.

 

You may also be new to Medicare due to disability. Typically, there is a 24-month waiting period before you qualify for Medicare Part B.

New to Medicare

Medicare is a federal health insurance program that provides health coverage for individuals age 65 and older. It also covers certain people under age 65 with disabilities and those with End-Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig's disease).

Medicare coverage choices may include:

Original Medicare-Parts A and B 

Medicare Part A is hospital insurance. It covers care you receive when you stay in a hospital. It also covers care you get at skilled nursing facilities, home health care, and hospice care. Part A is premium-free if you or your spouse have worked and paid Social Security taxes for at least 10 years. If you have worked less than 10 years, you can still get Part A. However, you will be responsible for paying a premium.

 

Medicare Part B is medical insurance. It helps you pay for doctor visits, tests, outpatient hospital care, and other services. Part B is voluntary, which means it’s your choice to join or not. If you do choose Part B, you pay a monthly premium, and the amount depends on your annual income. Learn more about Part B premiums at medicare.gov.

Important: Original Medicare Parts A and B do not cover everything. There are deductibles for Part A and Part B. And, after you pay those deductibles, generally Medicare pays 80% of covered costs and you pay 20%.

 

Medicare Part C is Medicare Advantage (MA). MA plans are run by private companies that are approved by Medicare, like ConnectiCare. They include your Part A and Part B benefits, and many include Part D prescription drug coverage. These are called Medicare Advantage Prescription Drug plans (MAPD). Plus, many plans give you extra benefits not covered by Original Medicare, like routine care, dental, and wellness programs – often for no more than what you already pay for Part B.

 

Medicare Part D is prescription drug coverage. Medicare Part D is not offered by Medicare itself. It is offered by private companies approved by Medicare. Many Medicare Advantage plans include prescription drug coverage. They are called Medicare Advantage Prescription Drug plans (MAPD). You can also get a plan that offers Medicare Part D alone. This is called a Medicare Prescription Drug plan, or PDP.

 

Medicare Supplement plans (also known as “Medigap” coverage), help fill in the gaps to pay some of the costs for services that Original Medicare doesn’t cover, like copays, coinsurance, and deductibles. Medicare Supplement plans do not include prescription drug coverage. You need to purchase a separate Part D plan (PDP).

Compared to Original Medicare alone or with a Medicare Supplement plan, a Medicare Advantage plan can be a simpler option:

  • Convenience: All of your medical and prescription drug coverage from a single health plan.
  • Benefits: You get additional benefits not covered by Original Medicare, like routine care, dental, and wellness programs.
  • Financial protection: All plans have an annual maximum out-of-pocket limit for covered medical expenses. Amounts vary by plan.

Column I explains how you can add to your Original Medicare coverage with a Medicare Supplement plan and/or a Part D prescription drug plan.

Column II explains how you can simplify your coverage with a Medicare Advantage plan.

 

 

Column I Column II

ORIGINAL MEDICARE
PART A and PART B

MEDICARE ADVANTAGE
PLANS (PART C)

  • Medicare provides this coverage.
  • After you meet your Part A deductible and your Part B deductible, generally Medicare pays 80% of covered costs and you pay 20%.
  • You must continue to pay your Part B monthly premium.

You can add:

  • Offered by private companies, like ConnectiCare.
  • Include both Medicare Part A and Part B coverage.
  • Many plans include Part D prescription drug coverage. (These are called Medicare Advantage Prescription Drug plans).
  • May offer additional benefits beyond Original Medicare, like routine care, fitness and dental.
  • Have one monthly plan premium or, in some cases, no monthly plan premium (in addition to your Part B premium).
  • Convenience – all your medical and prescription drug benefits offered through a single health plan.

 

 

 

 

MEDICARE SUPPLEMENT PLAN (OPTIONAL)
  • Offered by private companies, like ConnectiCare.
  • Fills the gaps of cost sharing for Medicare Parts A and B.
  • Generally, does not provide more benefits than Original Medicare.
  • You pay an additional monthly premium.
You can add:
PART D PRESCRIPTION DRUG COVERAGE (OPTIONAL)
  • If you want this coverage, you must join a Medicare Part D prescription drug plan offered by a private company approved by Medicare.
  • You may need to pay an additional monthly premium.
 

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How to Enroll in Medicare

Medicare can be difficult to understand, but you don’t have to figure it out by yourself. 

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Choose the Right Health Plan

Our range of Medicare Advantage plans will give you the benefits you need at affordable prices.

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Learn More

Learn more about Medicare Advantage plan options from ConnectiCare, including plans with Part D Prescription Drug Coverage!

We're Here for You

If not currently enrolled call 877-224-8221 (TTY: 711)

From Oct. 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to Sept. 30, you can call us Monday through Friday from 8 a.m. to 8 p.m.

Medicare members call 800-224-2273 (TTY: 711)

From Oct. 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to Sept. 30, you can call us Monday through Saturday from 8 a.m. to 8 p.m.

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Last Update: 10/01/2023

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