Do you know the basics of Medicare? What are the parts of Medicare? Are there any penalties? What are my options? Read on for more information.

WHAT IS MEDICARE?
Medicare is the federal government program that provides health care coverage to eligible people. Although it was proposed in 1945, it did not take effect until 1965. Medicare is health insurance for people who meet the following criteria:

• 65 and older
• Received Social Security benefits for at least 24 months
• With ESRD or end-stage renal disease

WHAT ARE THE PARTS OF MEDICARE?
Part A - Hospital Coverage
Part B – Medical Coverage
Part C – Medicare Advantage
Part D – Prescription Drug Coverage

As outlined above, there are four parts to Medicare:

• Part A covers hospital costs and related expenses such as care in a nursing home facility, hospice care and some home health care.
• Part B pays for medical care such as a doctor’s visit but not in a hospital setting. It also covers preventative health services to keep
  patients in the best of health. Together, Parts A and B are considered Original Medicare.
• Part C is called Medicare Advantage. It is additional coverage that can be purchased from private companies, and it offers more benefits and perks than Original Medicare.
• Part D pertains to coverage for prescription medications. It has four stages:
  
  • Annual deductible
  • Initial coverage
  • Coverage gap
  • Catastrophic coverage.

Some Medicare beneficiaries qualify for Low Income Subsidy or LIS, also called Extra Help which is a Medicare program designed to assist people with limited incomes and resources to pay Medicare prescription drug costs. To qualify for LIS, their yearly income must be below a set amount; to find out if you qualify, contact the Social Security office.

WHAT ARE THE MEDICARE ENROLLMENT PERIODS?

• AEP - Annual Enrollment Period - October 15 to December 7 of each year
• OEP – Open Enrollment Period - January 1 to March 31 of each year
• IEP – The 7-month period when someone is eligible for Medicare – it begins 3 months before turning 65, includes their birthday month and ends 3 months after they turn 65.
• ICEP – The period when they can enroll in a Medicare Advantage Plan for the first time.
• SEP – The period when they can make changes to their Medicare Advantage and Medicare drug coverage due to certain events like calamities, extenuating circumstances or they move residences or lose coverage.
• LOCK- IN PERIOD – The period from December 8 to October 14; they cannot change their Medicare Advantage coverage, but they can go back to Original Medicare. What most people do not realize is that there are penalties for late enrollment in Original Medicare and Part D plans. These penalties vary but all are costly and can be avoided. For Original Medicare, Parts A and B, they must enroll as soon as they’re eligible, or have left other creditable coverage. Creditable coverage is other insurance coverage, through an employer for example or coverage through their spouse. Enrolling in Medicare as soon as you are eligible is the best way to avoid late enrollment penalties.

WHAT ARE YOUR MEDICARE OPTIONS?

• Original Medicare includes Part A for hospital insurance and Part B for medical insurance.
• For prescription drug coverage, you can select a Part D prescription plan to add to your Original Medicare or supplemental plan.<.li>
• Medicare Advantage plan or part C. With a Medicare Advantage plan, you’ll have Parts A and B, and usually Part D, too.
• Medicare Supplements help pay your share or responsibility in some of the healthcare costs that Original Medicare does not cover like copayments, coinsurance and deductibles.

These plans are offered by private companies and are overseen by CMS. Some Medicare Advantage plans have lower out-of-pocket costs than Original Medicare; they also offer extra benefits such as vision, hearing, and dental coverage.

To learn more about MEDICARE, know your rights, maximize your benefits, understand your options, and avoid penalties, contact Sunset Insurance Enterprises at 732-690-6511 or fill out a consent to contact form in this website. Please note, however, that we do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Call 1-800-MEDICARE to talk with a customer support representative or visit the Meducare,gov website to explore all your options.