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Question to Ask When I’m New to Medicare

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If you’re new to Medicare, congratulations! It’s great that you have an opportunity for Medicare coverage, but which type of coverage is right for you? Let’s run through some Medicare questions to get you thinking about it.

What type of Medicare coverage do I get automatically?

Many people don’t even have to enroll in Original Medicare (Part A and Part B). You might be enrolled automatically. Generally you’re automatically enrolled in Part A and Part B if you’re getting Social Security benefits when you become eligible for Medicare.

So, if you’re new to Medicare and are one of those who’s automatically enrolled, why would you have to decide about coverage? That’s what these Medicare questions are for – explain your options so you can decide. Some people want benefits beyond what Part A and Part B provide.

Medicare questions: how’s my health?

If you’re new to Medicare and are in good health, you might feel that you don’t need anything beyond Medicare Part A and Part B.

But you might want to think about whether you’d like some of the extra benefits that come with some Medicare Advantage plans (described below).

What if you’re not in good health, or you tend to have a lot of doctor visits? Are you likely to be hospitalized – for example, if you have a chronic or serious health condition?

If you have a lot of doctor visits or hospital stays, you may be wise to buy a Medicare Supplement insurance plan. These plans work alongside your Medicare Part A and art B coverage, and may help pay Part A and Part B copayments, coinsurance, and deductibles. Learn more about Medicare Supplement insurance.

Medicare questions: what extra benefits do I want?

Medicare Advantage plans deliver your Medicare Part A and Part B benefits. But many Medicare Advantage plans go beyond Original Medicare. They’re offered by private, Medicare-approved insurance companies.

Most Medicare Advantage plans include prescription drug coverage, so if you were looking for that benefit, that’s something to consider.

Medicare Advantage plans can also offer other coverage not delivered by Medicare Part A and Part B. Here are just a few benefits these plans may offer:

  • Routine dental care
  • Routine vision care
  • Acupuncture
  • Fitness programs
  • Counseling services for mental health
  • Enhanced disease management (if you’re eligible)

Please note that different Medicare Advantage plans may offer different benefits beyond Part A and Part B- and some plans might not include extra benefits at all. Be sure to shop around so you can sign up for the plan that works best for you.

To compare plans right now, just enter your zip code on this page to get started – find the box, enter your zip, and click to display a list of plans serving your area.

You still have to pay your Medicare Part B premium when you have a Medicare Advantage plan, along with any premium the plan may charge.

Medicare questions: will I need prescription drug coverage?

You also might want to consider health history – your own and your family’s. Here’s why: if you ever need prescription drugs to treat a health condition, Medicare Part A and Part B may not cover those prescriptions. Original Medicare only covers certain drugs in limited situations – not usually medications you take at home. And if you don’t sign up for Medicare prescription drug coverage when you’re first eligible for Medicare, you could face a late enrollment penalty if you decide to enroll later.

Medicare questions: do I have to change doctors?

One Medicare question some people new to Medicare may have is, “Now that I have Medicare, can I keep the doctor I’ve been seeing for years?”

If you want Medicare to cover your doctor visits, your doctor has to accept Medicare assignment. That means she or he agrees to accept the Medicare-approved amount and not bill you extra.

Many doctors accept Medicare assignment, so chances are you won’t have to worry. In fact, Kaiser Family Foundation reported that more than 90% of primary care doctors accept Medicare. Just ask your doctor’s office if they accept Medicare assignment.

But here’s a Medicare question that may be worth asking, especially if you are new to Medicare. If you sign up for a Medicare Advantage plan, can you keep your doctor?

The answer is “it depends.” Some Medicare Advantage plans have provider networks. Depending on the kind of Medicare Advantage plan, some require you to see in-network doctors, or charge you more to see providers outside the plan’s network.

If you buy a Medicare Supplement insurance plan, in most cases you can see any doctor who takes Medicare assignment.  One type of Medicare Supplement insurance plan, called Medicare SELECT, might require you to see a doctor in the plan network.

Medicare questions: what if I’m still covered by an employer’s plan?

Maybe you’re still working when you become eligible for Medicare, or maybe you’re covered under your spouse’s plan. What coverage you want is up to you, but you might want to do some research.

  • First, figure out if you’re entitled to Medicare Part A (hospital insurance) without paying a monthly premium. Most people are. If you’ve worked at least 10 years while paying Medicare taxes, you won’t need to pay the Part A premium. So, even if you have employer- or union-based health insurance, you might want to still sign up for Part A.
  • Most people pay a monthly premium for Medicare Part B (medical insurance). So, if you’re still covered by a health plan when you turn 65 or qualify for Medicare by disability, you might want to delay enrollment in Part B. If you do delay enrollment, be aware that there’s a Part B late enrollment penalty. You may be able to avoid the penalty by signing up for Part B during a special enrollment period when your other coverage ends.
  • Ask your health plan administrator how your health insurance works with Medicare. That conversation might help you decide whether to delay enrollment in Medicare Part B, whether to sign up for Medicare prescription drug coverage, and how to plan your coverage.

If you still have Medicare questions, you can compare various Medicare plan options right now. It all starts with typing your zip code right here on this page, in the box. Then you can click the tab to display which type of coverage you’re interested in (such as Medicare prescription drug plans or Medicare Supplement insurance plans). Read each plan’s details to see what plan might work best for you.

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