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Andrew Smith

Andrew Smith

Medicare Benefits

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Medicare Benefits

Medicare is a health-insurance program for persons over the age of 65 in the United States. People under the age of 65, such as those with impairments or those who have irreversible renal failure, may be eligible for Medicare.

The program assists with health-care costs, although it does not cover all medical bills or most long-term care costs. You may receive Medicare coverage in a variety of ways. You can purchase a Medicare Supplement Insurance (Medigap) policy from a private insurance provider if you opt to have Original Medicare (Part A and Part B) coverage.

Find medicare benefits by zip code by our compare plans tool at the top of the page. The tool will make you find Medicare benefits for seniors, Medicare benefits eligibility, Medicare benefits review, and additional Medicare benefits.

The 4 Parts of Medicare Insurance (Medicare Benefits)

You get enrolled in Original Medicare (Part A and Part B) by Social Security.

  • Part A (hospital insurance) of Medicare helps pay for inpatient care in a hospital or for a short period of time in a skilled nursing facility (following a hospital stay). Part A also covers some home health and hospice services.
  • Medicare Part B (medical insurance) helps pay for outpatient treatment, home health care, durable medical equipment, and some preventive services provided by doctors and other health care professionals. 

Read More: Home health covered services

Other aspects of Medicare are managed by commercial insurance firms that adhere to Medicare’s guidelines.

  • Supplemental (Medigap) insurance helps pay for Medicare copayments, coinsurance, and deductibles.
  • All of the benefits and services covered under Parts A and B, as well as supplementary benefits like vision, hearing, and dentistry, are bundled together in a Medicare Advantage Plan (formerly known as Part C).
  • Prescription medications are covered under Medicare Part D (Medicare prescription drug coverage).

If they have worked and paid Medicare taxes long enough, most persons aged 65 and over are entitled to free medical hospital insurance (Part A). By paying a monthly payment, you can enroll in Medicare medical insurance (Part B). Larger-income participants will pay a higher monthly Part B cost.

Should I Sign Up For Medical Insurance (Part B)?

You may enroll in Medicare Part A (hospital insurance) and Part B (medical insurance) using our online application (medical insurance). You have the option to decline Part B coverage since it requires a premium.

If you’re 65 years old and eligible, your initial enrollment period starts three months before your birthday including the month you turn 65, and concludes three months following your birthday.

If you postpone enrolling in Medicare Part B and subsequently decide to do so, your coverage may be delayed, and you may have to pay a higher monthly premium for the duration of your Part B coverage. Unless you qualify for a “Special Enrollment Period,” your monthly premium will increase by 10% for each 12-month period during which you were eligible for Part B but did not enroll (SEP).

If you don’t sign up for Medicare Part B during your initial enrollment period, you’ll have another chance each year from January 1 to March 31 during a “general enrollment period.” The year you enroll, your coverage begins on July 1 of that year. 

If you have a Health Savings Account (HSA) or health insurance via your current job, you should check with your HR department or insurance provider to see how Medicare may affect you.

Special Enrollment Period (SEP)

You may not need to enroll for Medicare Part B at age 65 if you have medical insurance via your or your spouse’s current employer’s group health plan. You may be eligible for a “Special Enrollment Period” (SEP) during which you can sign up for Part B:

  • You or your spouse can continue to be covered under the group health plan at any time during the month.
  • The 8-month term begins the month following the conclusion of your group health plan coverage or the job on which it is based, whichever occurs first.

How To Apply Online For Just Medicare

If you are within three months of turning 65 and are not yet ready to begin receiving monthly Social Security payments, you can use our online retirement application to enroll in Medicare alone and wait to apply for your retirement or spouse’s benefits later. It takes less than ten minutes, and there are no forms to sign or paperwork to complete.

Apply for Medicare Only

Return to Saved Application | Check Application Status | Replace Medicare Card

To learn what papers and information you’ll need to apply, go to the Checklist For The Online Medicare, Retirement, and Spouses Application.

Medicare Cards

Your Medicare card carries a Medicare number that is unique to you to help secure your identity. If you haven’t received your red, white, and blue Medicare card, it’s possible that something has gone wrong, such as your mailing address. By logging in or creating a personal Social Security account, you may change your postal address.

Already Enrolled in Medicare

You can receive information and services online if you have Medicare. Learn how to take control of your benefits.

Please complete form CMS-40B, Application for Enrollment in Medicare – Part B, if you are enrolled in Medicare Part A and want to enroll in Part B. (medical insurance). You must also fill out form CMS-L564, Request for Work Information if you are applying for Medicare Part B due to a loss of employment or group health coverage.

You can submit your registration request during the Special Enrollment Period using one of the following methods:

  1. Go to “Apply Online for Medicare Part B During a Special Enrollment Period” and complete CMS-40B and CMS-L564. Then upload your evidence of Group Health Plan or Large Group Health Plan.
  2. Your CMS-40B, CMS-L564, and secondary proof should be faxed or mailed to your local Social Security office (see list of secondary evidence below).

Note: When completing the forms CMS-40B and CMS-L564

  • In the notes area of the CMS-40B form or online application, write “I want Part B coverage to begin (MM/YY).”
  • If at all feasible, have your employer complete Section B.

If your employer is unable to complete Section B, please fill out that section on behalf of your employer as best you can without your employer’s signature and submit one of the supplementary proof options below:

  • Income tax form that shows health insurance premiums paid.
  • W-2s reflect pre-tax medical contributions.
  • Pay stubs that reflect health insurance premium deductions.
  • Health insurance cards with a policy effective date.
  • Explanations of benefits paid by the GHP or LGHP.
  • Statements or receipts that reflect payment of health insurance premiums.

Unless you choose otherwise, you’ll get Original Medicare (Parts A and B). To assist pay for expenditures that Original Medicare does not cover, you can add a medication plan (Part D) or purchase a Medigap coverage. You can join a Medicare Advantage Plan (Part C) to have all of your Medicare benefits (including medicines and other benefits like vision, hearing, and dentistry) packaged into one plan.

Extra Help may be available to persons with low resources and income to help pay for Part D prescription expenses.

What Happens After I Apply?

Medicare is administered by the Centers for Medicare & Medicaid Services (CMS). They will send you a Medicare packet along with a Welcome letter and your Medicare card after you have been enrolled. You’ll also get a copy of the Medicare guide, which contains vital details about your Medicare coverage options.

Other Medicare Enrollment Options

If you live in Puerto Rico, you will not automatically be enrolled in Medicare Part B (medical insurance). If you don’t sign up for it during your initial enrollment time, you’ll be charged a fee. Please contact us at +1 (973) 590-2695 to join up (TTY 1-800-325-0778). You can also contact the Social Security Administration in your area. 

If you do not live in the U.S. or one of its territories you can also contact the Federal Benefits Unit that provides service to your country of residence.

FAQs

What are the different types of home health care services?
  • Doctor’s attention is required. A doctor may come to a patient’s house to diagnose and treat his or her illness(es)….
  • Nursing care….
  • Physical, occupational, and/or speech therapy are some of the options.
  • Social services in the medical field…
  • Home health aides provide assistance.
  • Care for a housekeeper or basic assistance.

Home care provides non-clinical assistance, such as meal preparation and companionship, whereas home health care, sometimes known as “home health,” provides expert medical assistance. Both types of care are accessible in the comfort of your loved one’s home and can help them age in place safely.

More to explorer

Part D / Prescription Drug Benefits

Part D / Prescription Drug Benefits

Introduction to Medicare Part D Before 2006, Medicare covered some medicines given during a hospital stay (Medicare Part A) or a doctor’s

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