Medicare 101

Your guide to understanding Medicare.
Hero border 1

Adobestock 137773804

Understanding Medicare

Medicare can be overwhelming, but it doesn't have to be! AssureSource's Medicare 101 is an educational resource designed to demystify the basics of Medicare. Here, you'll find an overview of Medicare and each of its parts, as well as information about eligibility and the enrollment process. Medicare 101 is a great starting point to learning about and understanding Medicare. For more personalized advice and assistance with decision making, work with an AssureSource agent to learn about your coverage options, available benefits, and more. Take our quick and easy survey to get started on your Medicare journey!

Pick a topic to get started

The Basics

What Is Medicare?
Medicare is a federal health insurance program primarily for adults aged 65 and older. It also covers certain younger individuals with disabilities and those with end-stage renal disease.

The Different Parts of Medicare (A, B, C, and D)
Imagine Medicare as a toolbox with different tools for different situations. Here's a breakdown of the key parts:

Part A (Hospital Insurance): This tool covers things like hospital stays, skilled nursing care (think rehab after a surgery), and hospice care. Most people get Part A for free if they paid taxes while working. You might still have some costs depending on the service.

Part B (Medical Insurance): This tool helps pay for doctor visits, checkups, and some treatments. It usually has a monthly fee taken out of your Social Security check. You'll typically pay a portion (usually 20%) of the bill for covered services.

Part C (Medicare Advantage Plans): This is an alternative to Original Medicare (Parts A and B) that is offered by private insurance companies – with approval from Medicare. It covers everything Parts A and B do and often includes extras like prescription drugs, dental care, or gym memberships. These plans can have different costs depending on the plan you choose.

Part D (Prescription Drug Coverage): This tool helps pay for your medications. It's offered by Medicare-approved private insurance companies, too. You'll likely pay a monthly fee, might have a deductible (amount you pay before insurance kicks in), and may still have a co-pay (fixed amount) or coinsurance (percentage) for each medication.

Remember: this is a simplified explanation, and there might be additional details depending on your specific situation. The experienced insurance agents at AssureSource are here to answer all your questions about Medicare.

What About Medigap?

Medicare Supplement Plans: Patching Up the Gaps
Imagine you have Medicare (the toolbox from before), but some things might still cost you money, like deductibles or coinsurance. That's where Medicare Supplement plans, also known as Medigap plans, come in. These are extra insurance plans sold by private companies that act like patches for those gaps.

Here's the Catch
Unlike Parts A, B, C, and D, you can't get a Medigap plan on its own. You generally need to already be enrolled in Original Medicare (Parts A and B) to purchase a supplement plan. Medigap plans offer different levels of coverage, so you can choose a plan that best fits your needs. However, these plans typically come with a monthly premium you pay on top of your existing Medicare premiums.

Think of It Like This
Imagine your toolbox (Medicare) is missing a specific tool, like a screwdriver (to cover a specific cost). A Medicare Supplement plan (Medigap plan) would be like buying a separate screwdriver to handle that specific need.

Important to Remember
Medigap plans don't cover prescription drugs. You might need a separate Part D plan for that. Different plans have different benefits and costs. It's important to shop around and compare plans to find one that fits your needs and budget.

Who Is Eligible for Medicare?

Generally, individuals aged 65 and older who are citizens or permanent residents of the United States may qualify for Medicare. Additionally, some younger individuals with disabilities or specific medical conditions may also be eligible.

Understanding Medicare eligibility and its fundamental aspects is crucial for making informed healthcare decisions. AssureSource's T65 Roadmap provides essential information on Medicare eligibility, coverage options, and enrollment processes. Keep exploring Medicare 101 with us for clarity and confidence, and take our survey when you feel ready to get started building your T65 Roadmap! 

Medicare Enrollment 101

Enrolling in Medicare is typically a straightforward process, and you have a few options for doing so

You can enroll in Medicare online through the official Social Security website. The online application is simple and convenient, allowing you to complete it at your own pace.

By Phone
If you prefer to enroll over the phone, you can call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778) and speak with a representative who can assist you with the enrollment process.

In Person
You also have the option to enroll in person by visiting your local Social Security office. An agent will guide you through the application process and answer any questions you may have.

Automatic Enrollment
In some cases, if you're already receiving Social Security benefits when you turn 65, you may be automatically enrolled in Medicare Parts A and B. You'll receive your Medicare card in the mail about three months before your 65th birthday.

Regardless of the method you choose, it's important to enroll in Medicare during your initial enrollment period to avoid potential late enrollment penalties and ensure timely access to healthcare coverage.

What Are the Medicare Enrollment Periods?

Medicare offers various enrollment periods to ensure individuals have opportunities to sign up for coverage

Initial Enrollment Period (IEP)
This is the first chance for most people to enroll in Medicare. It begins three months before the month of your 65th birthday, includes your birth month, and extends for three months afterward.

General Enrollment Period (GEP)
If you missed your initial enrollment period, you can sign up during the general enrollment period, which runs from January 1 to March 31 each year. Coverage begins on July 1 of the same year, and late enrollment penalties may apply.

Special Enrollment Period (SEP)
Certain qualifying events may trigger a special enrollment period, allowing you to enroll in Medicare outside of the initial or general enrollment periods without facing penalties. Examples of qualifying events include losing employer-sponsored coverage, moving to a new area, or qualifying for Medicaid.

Medicare Advantage Open Enrollment Period (MA OEP)
This period runs from January 1 to March 31 each year. During this time, individuals enrolled in a Medicare Advantage plan have the option to switch to another Medicare Advantage plan or return to Original Medicare with or without a Part D plan.

Annual Enrollment Period (AEP)
Also known as the Open Enrollment Period, it runs from October 15 to December 7 each year. During this time, you can make changes to your Medicare coverage, such as switching between Original Medicare and Medicare Advantage, changing prescription drug plans, or joining, dropping, or switching Medicare Advantage plans.

Understanding these enrollment periods is crucial for ensuring timely enrollment in Medicare and making any necessary changes to your coverage as your healthcare needs evolve.

How Can I Make Enrolling in Medicare Easy?

Enrolling in Medicare can be simplified by partnering with AssureSource. Our industry experience and personalized guidance help make the process seamless and stress-free for you.

Personalized Assistance
AssureSource's knowledgeable agents are well-versed in Medicare regulations and enrollment procedures. We provide personalized assistance tailored to your specific needs and circumstances.

Guidance Every Step of the Way
From determining your eligibility to selecting the right Medicare plan for your needs, we guide you through the entire enrollment process, ensuring you understand your options and make informed decisions.

Streamlined Application Process
We handle the paperwork and administrative tasks, making the enrollment process hassle-free. Our agents ensure your application is completed accurately and submitted on time.

Customized Solutions
AssureSource takes the time to understand your healthcare needs and preferences. We then recommend Medicare plans that align with your requirements, ensuring you have the coverage you need for peace of mind.

Ongoing Support
Our commitment to your well-being doesn't end after enrollment. AssureSource provides ongoing support, answering your questions, assisting with plan changes, and helping you navigate any challenges that may arise.

By working with AssureSource, you can trust that enrolling in Medicare will be easy and straightforward, allowing you to focus on enjoying the benefits of comprehensive healthcare coverage.
Hero border 2

Ready to Master Medicare?

Take our quick survey to tell us more about your health needs, and get started working with an AssureSource agent to create your personalized T65 Roadmap.