Understanding Medicare Step by step H35281634 w. What is Medicare? Medicare is the Largest Health Insurance Provider.

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Presentation transcript:

Understanding Medicare Step by step H w

What is Medicare? Medicare is the Largest Health Insurance Provider

Who Qualifies for Medicare? Individuals age 65+ who qualify Individuals under age 65 with disabilities Individuals under age 65 with End-Stage Renal Disease (ESRD)

Four Parts of Medicare Part APart BPart D Medicare Advantage Part C

Part A / Hospital Insurance Part A inpatient hospital skilled nursing hospice home health

Part B / Medical Insurance doctor visits outpatient surgery immunizations lab tests medical equipment ambulance monthly premium Part B Late Enrollment Penalty

Original Medicare Part BPart A Original Medicare +

Part D / Prescription Drug Coverage Prescription Drug Coverage private carrier monthly premium Part D

Added to your monthly premium Penalty applies if 63+ days without creditable coverage Part D / Late Enrollment Penalty

Part C / Medicare Advantage Part DPart BPart A Routine Care Wellness Programs Part C / Medicare Advantage ++++

Supplemental Insurance Original Medicare Part A + B Part D Prescription Drug Plan Includes Parts A + B Most Include Part D

Original Medicare Part BPart A Deductibles 80/20

+ Supplement Plan Original Medicare Copayment Coinsurance Deductible

+ + Supplement Plan Original Medicare Part BPart A 1 Part D $ Bill ID Card $ Bill ID Card $ Bill ID Card Deductibles 80/20

Part C / Medicare Advantage Maximum Out-Of-Pocket Limit This limit does not apply to your monthly plan premium or Part D prescription drug costs. Part DPart BPart A Routine Care Wellness Programs ++++ Financial Protection

Signing up for Medicare Step by step

? Original Medicare Medicare Eligibility Part BPart A

Medicare Eligibility Age 65+ U.S. citizen or permanent legal resident Eligible for Social Security or Railroad Retirement benefits Under Age 65 Entitled to Social Security disability benefits Have End-Stage Renal Disease (ESRD)

Initial Enrollment Period Retired or Retiring soon and turning 65 65

Part B Part A

Initial Enrollment Period Month of Enrollment JanFebMarchAprilMayJuneJuly Coverage Begins Apr 1stApr 1stApr 1stMay 1st June 1stJuly 1stAug 1st

Enroll any time you are covered by employer’s or union’s plan Special Enrollment Period [ Still Working and Turning 65 ]

Special Enrollment Period COBRA and retiree health plans do not qualify

General Enrollment Period Sign up

General Enrollment Period Sign up No coverage

Part C / Medicare Advantage

Initial Coverage Election Period (ICEP) Initial Coverage Election Period (ICEP) for Part C 65

? Part B Part A

Annual Election Period Sign up for Medicare Advantage Plan / Part C or switch from one Medicare Advantage Plan to another [ Already Enrolled ]

Special Enrollment Period

Enroll within two months from the date employment or health coverage ends.

Special Enrollment Period Qualifying Events Lose your employer coverage Qualify for Extra Help for your Part D prescription drugs Have both Medicare and Medicaid Move out of your Plan’s service area Live in an institution (such as a nursing home)

Part B art D Questions? We’re here to help. Or, visit connecticare.com/medicare Call ConnectiCare toll-free at (TTY/TDD ) seven days a week, from 8 a.m. to 8 p.m. ConnectiCare, Inc. is an HMO/HMO-POS plan with a Medicare contract. Enrollment in ConnectiCare depends on contract renewal. © 2016 ConnectiCare, Inc. & Affiliates