Medicare is a government program providing health insurance for people 65 or older. Starting Medicare begins with eligibility – three months before turning 65.
- Note: You may be eligible earlier if you are disabled or have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS).
Original Medicare is made up of several parts, including:
Part A (Hospital Insurance): Helps to cover the costs of:
- Hospital inpatient care.
- Skilled nursing facility care.
- Hospice care.
- Some home healthcare.
Part B (Medical Insurance): Helps to cover the costs of:
- Services from doctors and other healthcare providers.
- Outpatient care.
- Some home healthcare.
- Medical equipment classified as durable (e.g., walkers, wheelchairs, hospital beds).
- Many preventive services (e.g., vaccines or shots, screenings, annual wellness visits).
Part D (Drug Coverage): Helps cover the cost of prescription drugs (including many vaccines or shots).
A drug plan is an addition to basic Medicare. It’s also available through many Medicare Advantage Plans (Part C).
Medicare Supplemental Insurance
Extra insurance (to cover Medigap) is provided by private companies. In most states, these standardized policies are named by letters, e.g., Plan G or Plan K.
When Does Medicare Coverage Start?
Coverage depends on when you sign up and which sign-up period you’re in.
Initial Enrollment Period
This first opportunity to enroll lasts seven months. It begins three months before age 65 and ends three months following the month you turn 65.
Missing this period means you will probably have to wait to enroll. You may also be charged a monthly penalty for late enrollment over the time you have Part B coverage. This penalty increases the longer you wait to sign up. You may also be liable for a penalty if you have to pay a Part A premium.
- Note: Extra sign-up time is available if you can’t contact the Social Security Administration due to problems with its telephone system between the beginning of January 2022 and December 30, 2022.
General Enrollment Period
This period runs between January 1 and March 31 each year, with coverage beginning on July 1. However, beginning January 1, 2023, coverage starts the month after you sign up.
- Note: You might have to pay a monthly penalty for late enrollment if you don’t qualify for a Special Enrollment Period.
Special Enrollment Period
Certain situations allow you to enroll in Part B (and Premium-Part A) during this period without being liable for a late enrollment penalty. However, this period is only available for a limited time. If you miss it, you’ll need to wait for the next General Enrollment Period, and you also might have to pay a monthly late enrollment penalty.
Starting Medicare: To Sum Up
Medicare regulations can be confusing, so you may want to consult a Medicare advisor. Additionally, here are some helpful government links to read:
How Much In-Home Care Does Medicare Cover?
Generally speaking, Medicare won’t cover non-medical in-home care if this is the only kind of help a senior needs. However, a homebound senior needing medical assistance may receive some coverage on a part-time basis, i.e., under seven days a week or fewer than eight hours a day over a 21-day period.
- Note: a Medicare Advantage plan may offer more comprehensive coverage.
The Best In-Home Care in Columbia, SC
If you are a senior or caring for one, starting Medicare is an important step to take. And, if you need assistance caring for the senior in your life, please get in touch with Caring Healthcare to see how we can help you.
