Irving Medicare Plans

Irving Medicare Plans

Medicare is a federal health insurance program that provides coverage for individuals who are 65 years or older, individuals under 65 with certain disabilities, and individuals with End-Stage Renal Disease (ESRD). The program is administered by the Centers for Medicare and Medicaid Services (CMS) and is funded through payroll taxes, premiums, and general revenue.

Medicare is divided into several parts, each covering different healthcare services:

1. Medicare Part A: Also known as Hospital Insurance, Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and home health care. Most people do not pay a premium for Part A, as they or their spouse paid for it through payroll taxes while working.

2. Medicare Part B: Also known as Medical Insurance, Part B covers doctor visits, outpatient services, preventive care, and medical equipment. Most people pay a monthly premium for Part B, and the amount is based on income.

3. Medicare Part C: Also known as Medicare Advantage, Part C is offered by private insurance companies that have been approved by Medicare. Part C combines Parts A and B and often includes additional benefits like prescription drug coverage, vision, and dental care.

4. Medicare Part D: Part D covers prescription drugs and is also offered by private insurance companies approved by Medicare. Beneficiaries pay a monthly premium and copayments or coinsurance for covered prescription drugs.

Medicare works by providing eligible individuals with access to necessary healthcare services. Beneficiaries can choose to receive their Medicare coverage through Original Medicare (Parts A and B) or Medicare Advantage (Part C). In both cases, beneficiaries pay premiums, deductibles, copayments, and coinsurance for their healthcare services.

Medicare also has limitations, and some services may not be covered. Beneficiaries can purchase additional coverage, such as Medigap policies, to help cover these costs. Understanding Medicare and its various parts is important to make informed decisions about healthcare coverage and costs.

Initial Enrollment Period

When you first become eligible for Medicare, you enter what is called your Initial Enrollment Period. This is a 7-month period of time beginning 3 months before your birthday month and extending 3 months after your birthday month. For example, if you were born in July, your Initial Enrollment Period would be April 1 through October 31. This is the time to enroll in Medicare (for those not enrolled automatically) or enhance coverage with additional benefits.

Important tip: If you’re looking to add additional coverage to Original Medicare, your Initial Enrollment period is the time to do it. If you delay, you may have to wait until the General Enrollment Period (Jan 1- Mar 31) of the following year and may also be charged a late enrollment penalty.