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Are you turning 65 this year? Here's what you need to know about Medicare options

Dan Tufto

Humana California Medicare President

More than 10,000 Americans turn 65 every day. That’s more than 3.6 million new people learning to navigate Medicare each year.

If you were born in 1958, you are joining the 6.69 million individuals in California eligible for the government’s health insurance program this year.

Here are the key things I recommend people understand before enrolling in Medicare to get the health insurance coverage that best fits their lifestyle.

1. Know their initial enrollment period. If you’re already getting Social Security, you’ll likely automatically get Original Medicare starting the first day of the month you turn 65. If not, you have a seven-month window in which to enroll in Original Medicare, starting three months before your birthday month and ending three months after. For example, if your birthday is in July, the initial enrollment period is April through October. It’s a good idea to enroll before the month you’ll turn 65, since, in most cases, you’ll gain coverage the first day of their birthday month. Otherwise, your coverage may be delayed. Missing this enrollment period could result in future penalties if they later decide to enroll in Original Medicare.

2. Know what to do if you still have insurance through an employer. If you or your spouse has group health insurance from a current employer, you could delay enrolling in Medicare until the employment or coverage ends.

3. Understand the different types of coverage. Since everyone has unique health needs, the good news is you have options when it comes to Medicare. However, evaluating all those options can feel overwhelming. The first choice you have to make is between Original Medicare and a Medicare Advantage plan to cover your medical appointments and visits to the hospital.

Original Medicare is managed by the federal government and includes Part A for hospital insurance and Part B for medical insurance. It covers about 80% of medical costs and allows you to use any health provider who accepts Medicare; however, it does not cover most prescription drugs, hearing, vision or dental care.

If you choose Original Medicare, you can choose to add a prescription drug plan for Part D through a private insurer. If you are concerned about the cost of personally covering 20% of your medical expenses through Original Medicare, you can purchase Medicare Supplemental Insurance, or Medigap, to make your out-of-pocket costs more predictable.

Medicare Advantage plans for Part C are all-in-one plans offered by private insurers, like Humana, that cover everything included with Original Medicare and may include additional benefits, like dental, hearing and vision care, prescription drugs, transportation to medical appointments, fitness programs and flexible spending allowances, depending on the plans available in your area.

Many Medicare Advantage plans also have $0 premiums; however, these plans do have provider networks, so check if your doctors are included in plans you’re considering.

As with any major decision, proper research goes a long way toward making the best plan choice for your personal health care needs. More information is available at http://medicare.gov and http://humana.com/Medicare.

Dan Tufto is president of Humana California Medicare.

 

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