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Eligibility You are 65 or qualify due to disability You are a US citizen or legal resident for 5 years It does not matter if you are or are not collecting Social Security It does not matter what age your spouse is If you do not enroll when eligible you may pay a penalty

Enrollment Initial Enrollment – at age 65 or after age 65 when coming off of group coverage After 24 months with qualifying disability at any age Annual Open Enrollment – Oct. 15th – Dec 7th. Special Enrollment Periods – moving into a new area, discontinuation of a plan, skilled nursing care, low income/Medicaid Open Enrollment Period – can change plan selection for 90 days after effective date in many but not all cases

Part A Most people don’t pay a premium Provides help with the cost of a hospital stay, skilled nursing services after a hospital stay plus some other skilled care, i.e. hospice Most people don’t pay a premium $1,364 hospital deductible (per stay of up to 60 days) additional co-pays beyond that Go to any hospital in the U.S. that is qualified and accepting Medicare patients

Part B Provides help with the cost of doctor visits and other medical services that do not require an inpatient hospital stay Premium is 135.50/month for most, if you have a higher income you may pay more Annual deductible of $185 You usually pay 20% of the medical cost, there is no cap on your total spending Go to any doctor in the U.S. that is qualified and accepting Medicare patients

Medicare Supplement Plans Private insurance that helps pay your part of cost sharing in traditional Medicare Parts A & B. Also known as Medigap plans 10 standardized plans – A through N Premium costs can vary significantly from company to company and state to state. Predictable monthly premiums versus unknown medical expenses

Medicare Supplement Plans Private insurance that helps pay your part of cost sharing in traditional Medicare Parts A & B. Also known as Medigap plans 10 standardized plans – A through N Premium costs can vary significantly from company to company and state to state. Predictable monthly premiums versus unknown medical expenses

Part D Provides help with the cost of prescription drugs through private insurance companies Medicare provides guidelines about the types of drugs to be covered Each plan has its own formulary and network Costs can vary significantly from plan to plan Your level of cost sharing will change depending on the total cost of the drugs you use

Part D cost sharing Annual deductible of up to $415 Initial coverage limit of $3,820 Donut hole or coverage gap Catastrophic coverage - $5,100 and above Drug copays drop to 5%

Medicare Part C Advantage Plans A single plan offered by private insurance companies that combines coverage for Medicare Parts A & B. Most Plans include Part D Must cover all services provided by Original Medicare Provides cap on total out of pocket medical expenses May offer additional benefits and options

Medicare Part C – cont. HMO type plans Receive care from in network Doctors and Hospitals Care outside of network is not covered – unless it is an emergency. Some plans also provide urgent care services out of network Primary Care physician refers to specialists

Medicare Part C – cont. PPO type plans Receive care from in network or out of network Doctors and Hospitals May have higher co-insurance or co-pays for out of network care

Provides help with your share of prescription drug costs Part D Extra Help Provides help with your share of prescription drug costs Low Income Subsidy (Federal) State Programs Patient assistance programs www.goodrx.com www.rxassist.org

Social Security Administration Resources Medicare 1-800-MEDICARE (1-800-633-4227) TTY 1-877-487-2049 24 hours/day, 7 days/week www.medicare.gov Social Security Administration 1-800-772-1213 TTY 1-800-325-0778 www.ssa.gov