Medicare Explained
We Break Down Medicare for You
For many Texans, Medicare can feel like a confusing maze of options. You may be turning 65 soon, which is the age that most people become eligible for Medicare. With this eligibility comes piles of information about Medicare, it’s parts, and the different companies who try to sell you a plan. How do you know which plan and company are best for you? And when do you sign up? Don’t worry — we have answers.
How We Can Help
Medicare is a federal health insurance program for folks 65 and older, and under 65 with certain disabilities or end-stage renal disease (ESRD, aka kidney failure).
Its history takes us back to 1965, when President Lyndon B. Johnson signed a bill into law — allowing eligible individuals to get the healthcare benefits they needed from a government program. At first, the coverage was limited to Part A and Part B (called traditional or Original Medicare).
Over time, the coverage has expanded to cover more people. And now, more than 50 million Americans are on Medicare.
Original Medicare will provide coverage for 80% of your healthcare costs. There are supplemental policies that you can purchase to help with the remaining 20%.
Is Medicare Automatic?
Some people get Part A and Part B automatically. Others have to actively sign up through Social Security. Most of the time, it depends on whether you’re receiving Social Security benefits.
If you’ll be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least four months before you turn 65, you don’t need to sign up for Medicare. You’ll get your Medicare card in the mail three months before your 65th birthday.
Get the right coverage at the right price.
Medicare Enrollment Periods
We can help you understand all the enrollment periods and what they mean for you. Here’s a quick list, and you can view the drawing below for more details:
- Initial Enrollment Period (IEP)
- Annual Election Period (AEP)
- General Enrollment Period
- Medicare Advantage Open Enrollment (MAOEP)
- Special Enrollment Period (SEP)
- Medigap Open Enrollment Period
October 15 - December 7
Annual Enrollment Period (AEP)
Anybody with Medicare can make a change
January 1 -
March 31
Open Enrollment Period (MAOEP)
Anybody with Medicare Advantage can make a change
Depends on Eligibility
Initial Enrollment Period (IEP)
For people aging in. Begins three months before your 65th birthday and ends the three months after.
January 1 -
March 31
General Enrollment Period
Anybody who missed their IEP can enroll.
Depends on Eligibility
Special Enrollment Period (SEP)
Timing depends on eligibility, life if you move or something happens beyond your control.
Medicare vs. Medicaid
It’s important to understand the key difference between Medicare and Medicaid. The Medicare program is tailored to folks age 65+ while Medicaid is primarily intended for low-income individuals. So, eligibility for Medicare has mostly to do with your age. Eligibility for Medicaid has mostly to do with your annual income.
Some people qualify for both programs — we call them dual eligibles. In that case, Medicare is the primary insurance and Medicaid is secondary.
Reach Out to Oak Haven Insurance
When you need to understand the basics of Medicare coverage, look to Oak Haven Insurance for answers. We’re located just north of Austin, TX, and we’re here to help you with your Medicare options. For more information, keep browsing our site or contact us online.
