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Medicare

Enrollment in Medicare

The enrollment process in Medicare can seem daunting, but a lot of the work and efforts actually goes into finding the coverage option you want with Medicare. Luckily, that is where AIS Medicare & More can help and make it a pretty easy and seamless process!

If you are already drawing Social Security or Railroad Retirement Board, your Medicare Part A and Part B will automatically start the first of the month you turn 65 (if you were born on the first of the month, your benefits will start the month prior).

If you are not drawing Social Security or Railroad Retirement Board, you will need to enroll Medicare Part A and Part B yourself. Typically you want to start this process 3 months prior to your 65th birthday. 

If you are under 65 and disabled, you will automatically be enrolled in Medicare after receiving Social Security Disability benefits for 24 months.

If you have ALS, you will automatically be enrolled in Medicare the month your Social Security Disability benefits start. 

If you have ESRD, you will need to enroll in Medicare yourself by contacting Social Security, coverage is able to start on the fourth month of dialysis.

AIS Medicare & More agents specialize in Medicare insurance and are going to work to ensure that the plan you choose is the option that meets your health and financial needs

Parts of Medicare

Medicare can be broken down into 4 main parts, or letters. Each letter is going to be tied to a specific coverage. Below we are going to breakdown each Part of Medicare and explain what coverage is provided by each letter.

Medicare Part A is labeled as inpatient services, because it primarily provides coverage while admitted to the hospital. Part A covers inpatient hospital care, skilled nursing facilities, hospice care, and some home health care services. 

For most people Medicare Part A has no monthly premium to have it become active. As long as you or your spouse have paid into Medicare taxes for 10 or more years, you will not pay a premium for Part A. You will see other costs associated with inpatient care such as deductibles, copays, and coinsurance. 

Medicare Part B is labeled as outpatient services, because it primarily provides coverage while not admitted to the hospital. Part B covers medical services, preventative services, doctor visits, outpatient care, ambulance services, Durable Medical Equipment, Mental health, and many other services.

For most people Medicare Part B will have a monthly premium unlike Part A. The monthly premium that Part B charges can change every year. The Part B monthly premium can be adjusted to a higher premium for households with high income, this is called IRMAA (Income Related Medicare Adjustment Amount). You will also see other costs associated with outpatient services, such as deductible, copays, and coinsurance. 

Medicare Part C is labeled as Medicare Advantage.  Medicare Part C if elected as your coverage will combine Part A, Part B, and Part D into a Medicare Advantage policy. Part C becomes your primary insurance, so instead of the Federal government processing and paying all of your medical bills- the private insurance company would process and pay. 

Medicare Part C policies must provide at least the benefits and coverage that Part A and Part B provide, but most of these plans provide more coverage. The Part C premium is determined by the insurance company you go with, most of these plans are $0 a month, but some do have monthly premiums.

Medicare Part D is labeled as Prescription Drug Coverage. Similar to Part C, Part D is only offered by private insurance companies. The Federal government set rules and regulations for coverage being provided, but is managed and offered by private companies. You can get a plan as a stand alone drug plan or through getting a Medicare Advantage plan. 

Medicare Part D plan premium will vary depending on where you reside. With both Medicare Advantage plans and stand alone Drug plans, there are $0 monthly premium plans available. The monthly cost can change based on location, company and policy you choose. Each plan will have its own formulary, so you need to ensure that the plan you choose covers all your drugs.

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