By Wiley Long
President
MediGap Advisors

Final Newsletter
5 Most Important Things to Remember Now That You’re Almost 65

Newsletter Issue #12

Hello again, and welcome to the final installment of our series of newsletters aimed at helping you get ready for the changes to your health insurance coverage when you turn 65. I’m Wiley Long, President of Medigap Advisors and author of The Medicare Playbook. I hope these missives have proven helpful as you navigate the often confusing waters of Medicare, prescription drug plans, supplemental coverage, and Medicare Advantage plans.

If you still have questions, remember that you can always contact your Personal Benefits Manager at any time.

1. You have some important deadlines coming up.

Unless you’ve been receiving Social Security payments prior to your 65th birthday you have a seven month Initial Enrollment Period (IEP) to sign up for Medicare. This starts on the first of the month, three months prior to the month of your 65th birthday, and ends on the last day of the month three months after your birthday. My birthday is in June, so my IEP begins on March 1 and ends on September 30.

This means you can (and should) sign up for Medicare before your 65th birthday.

The 7 month IEP also applies to Medicare Advantage plans and Part D prescription drug plans as well.

If you have not already signed up for a Medicare supplement plan, you have six months from the day you turn 65 to enroll. During this time you do not need an initial medical exam to qualify.

2. What are the important differences between having Medicare and a Medicare Supplement plan versus a Medicare Advantage plan?

Whether to stay with Original Medicare and buy a Medicare Supplement plan or to enroll in a Medicare Advantage plan alone is without a doubt the biggest decision you have to make about your senior health coverage. Here’s a rundown of the key differences:

Medicare Supplement plans give you coverage when you travel out of the country, and Medicare Advantage plans do not.
You’ll pay a premium for a Medicare Supplement plan, while the premiums for Medicare Advantage plans are nothing or typically very low.
Medicare Supplement plans cover excess Part B charges, and Medicare Advantage plans do not.
When you purchase a Medicare Supplement plan, you get coverage for an additional 365 inpatient hospital days (during your lifetime).
Medicare Advantage plans make use of existing provider networks and typically provide no coverage for out-of-network providers. Medicare Supplement plans allow you to see any provider you wish.
Medicare Supplement plans cover your Part B deductible, and some cover Part B as well.
Your can initially apply for a Medicare Supplement plan for six months, starting the month you turn 65. Once you turn 65 you only have three more months to enroll in a Medicare Advantage plan.
Outside of your initial enrollment period, you can apply for a Medicare Supplement plan at any time throughout the year. You can only apply for Medicare Advantage plans during the Annual Enrollment Period (October 15 – December 7 and January 1 – March 31).

Perhaps the most important point to remember is how the two options are the same: They both cap your out-of-pocket expenses, and having Medicare alone will not do this.

3. How will you pay for your prescriptions?

Big point about Medicare: it does not cover the cost of prescription drugs. You’ll need to purchase a Part D prescription drug plan in order to take care of what can be substantial costs associated with drugs your doctor prescribes. Many Medicare Advantage plans include Part D prescription drug coverage, so in those cases you don’t need additional coverage for these charges.

4. Missing the initial enrollment period can cost you for the rest of your life.

You really, really don’t want to miss the deadline for signing up for coverage. Ideally, you should sign up while you’re still 64, to ensure that there’s no lapse in coverage between your pre-65 coverage and Medicare.

And remember that you may have to pay higher premiums for Part B (medical insurance) coverage if you sign up after your initial enrollment period. You could pay a 10% penalty by signing up late, and this will likely be a cost that you’ll continue paying for the rest of your life!

5. Need to refer back to information in previous newsletters?

Medicare is an enormous topic, and hopefully, these newsletters have imparted some information you can use. Remember, your Personal Benefits Manager will be with you every step of the way to help. Don’t hesitate to call on him or her.

Perhaps this summary has sparked some questions in your mind about things you might have learned in previous newsletters. If so, here’s a list of links to get you back to those newsletters, and hopefully answer your questions.