Medicare is a Federal Health Insurance Program. To be eligible for Medicare you must be a US Citizen or Legal Resident and one of the following.
Part A and Part B are known as Original Medicare. This means Medicare is the primary provider for your health insurance payments. Part C (Medicare Advantage), Part D, and Medicare Supplements are insurance plans offered by independent insurance companies. These plans cover some of the costs associated with original Medicare.
Part D is Prescription Drug Coverage offered through independent insurance companies. Part D Prescription Drug plans differ between insurance companies and are required to be the same or better than Medicare Guidelines. For 2022, the Part D Prescription Drug Guidelines are:
If not enrolled into a Part D Prescription Drug Plan or have other creditable drug coverage when first eligible, you may have a Late Enrollment Penalty.
Medicare Supplements aka “MediGap” plans are offered by independent insurance companies and help cover most of the costs that Original Medicare does not.
For every 12 months you go without Part B or other credible coverage (employer or union plan) you will be charged a 10% penalty. You may not be able to enroll into Part B until the Medicare Open Enrollment Period which runs January 1st – March 31st every year and will become effective July 1st
A penalty assessed if you do not go onto a Part D Drug Plan when you first become eligible. You will be charged 1% of the national average of a Part D plan for each month you do not have credible coverage.
HMO: Health Maintenance Organization
PPO: Preferred Provider Organization
PFFS: Private Fee For Service
MSA: Medical Savings Account
Initial Enrollment Period: 7 Months total, 3 months before, the month of, and 3 months after your Part B effective date Open Enrollment Period: October 15th – December 7th yearly
Medicare Advantage Disenrollment Period: January 1st – February 15th
Special Enrollment Periods: Happen throughout the year (loss of employer coverage, move out of the plans service area, receive assistance from the state, etc)
(True Out of Pocket Costs)
TROOP = Deductibles + Copays + Co-insurance + Drug Company payments
Open Enrollment for Medicare Supplements is the month Part B becomes effective and the 5 months that follow.