What You Need to Know

If you’re about to turn 65 and confused about your Medicare options, you’re not alone. Rest assured that Pledger Insurance Agency has solutions — our goal is to help you understand your options so you can make the decisions that are right for you.

Your first step is to choose your coverage options. There are two ways to access Medicare: through original Medicare or a Medicare Advantage plan.

Original Medicare

Original Medicare is made up of two parts:

Part A provides your hospital insurance

Part B provides medical insurance for things like doctor visits and check-ups

Everyone can have Part A, regardless of whether you’re still employed. To enroll, you need to sign up during the 7-month time period that begins three months before you turn 65, includes the month you turn 65, and continues for three months afterward.

If you’re still working at age 65 and covered by your employer’s health insurance, then in most cases you don’t need to sign up for Part B yet. Once you stop working, you’ll have a special enrollment period of eight months after your employment ends in which to sign up for Part B.

Medicare Advantage

Medicare Advantage plans, typically HMO or PPO products, are insurance plans that combine the benefits of Part A and B and, in most cases, includes prescription drug coverage and may include extra benefits and services for an additional cost.

Prescription Drug Coverage

Medicare Part A and Part B do not cover prescription drug benefits. For prescription drug coverage, you can enroll in a separate Part D plan. Many Medicare Advantage plans already offer prescription drug coverage (Part D) as part of their benefits package.

Supplemental Coverage (Medigap Plans)

Some people who are covered by original Medicare purchase a separate Medigap plan, also known as Medicare supplemental insurance. These plans help “fill the gap” by partially or fully covering expenses that original Medicare doesn’t provide.

The Annual Election Period for Medicare is October 15 through December 7. This is the time each year when you can switch from original Medicare to a Medicare Advantage plan; change from your Medicare Advantage plan back to original Medicare; or switch from one Medicare Advantage plan to another.