It’s Time for Medicare Open Enrollment

5 Things to Know About Your Medicare Benefits

With the open enrollment period for Medicare just around the corner, now is the time to start thinking about strategies that will enable you to maximize your Medicare benefits. With this in mind, here are five things you should know about Medicare:



Who is eligible for Medicare and how do you sign up?
Medicare is a federal program that provides health coverage to all Americans who qualify. Once you reach age 65, you are automatically eligible to receive Medicare benefits, regardless of whether you are retired or have started claiming Social Security benefits yet. However, if you are not yet receiving Social Security benefits, you have to apply for Medicare when you turn 65. In other words, you won’t be enrolled automatically like you would be if you were receiving Social Security. You can apply for Medicare three months before your 65th birthday and you must apply no later than three months after you turn 65. You can apply for Medicare online — the application process usually takes less than 10 minutes.
What is the Medicare open enrollment period and when is it?
Medicare open enrollment is the time during which you can make changes to your Medicare coverage. The period begins on October 15 and runs through December 7. Any changes made during open enrollment will become effective on the following January 1.
What are the different parts of Medicare?
There are four different components to Medicare:
Part A: This covers some hospitalization costs and limited hospice, skilled nursing and home health care. There are usually no premiums for Medicare Part A, but there may be co-pays for some services and an annual deductible of $1,484 in 2021. Part B: This covers routine doctor’s office visits as well as preventive health services, most outpatient care and medical supplies. A standard monthly premium of $148.50 is charged for Medicare Part B in 2021, though high earners may pay more. There’s also an annual deductible of $203. Part C: Known as Medicare Advantage (or MA) plans, this is offered by private companies that contract with Medicare to provide Part A and Part B Medicare benefits together via managed care plans similar to HMOs and PPOs. MA plans often offer coverage for extras like vision, dental and health and wellness programs. Part D: This voluntary program covers prescription drugs. It is usually included as part of an MA plan.
What is Medicare Supplemental(or Medigap) insurance — and do I need it?
Medicare doesn’t cover all healthcare expenses in retirement. That’s why many retirees choose to purchase Medicare Supplemental insurance, or Medigap as it’s often called. Medigap policies are sold by private insurers to help cover the many out-of-pocket healthcare expenses retirees face. Keep in mind, however, that Medigap policies generally don’t cover things like vision and dental care, long-term care, hearing aids or eyeglasses that also aren’t covered by Medicare. Also, if you join a Medicare Advantage plan, you don’t need a Medigap policy.
What’s the difference between Medicare and Medicaid?
Eligibility for Medicare isn’t based on income — anyone who meets the age criteria or has a qualifying disability is eligible to receive benefits. Conversely, Medicaid is designed to provide health coverage for low-income individuals and families regardless of their age. Medicaid is a federal-state program that’s run by state governments following broad federal guidelines. Patients covered by Medicaid generally don’t have to pay any of the costs associated with covered medical expenses.The details of which kinds of medical expenses are covered by Medicaid vary from one state to another. For example, states can decide whether to provide dental services to eligible adults, but dental services must be provided for Medicaid-eligible individuals who are under age 21. Eligibility for Medicaid also varies from state to state — visit to find contact information for your state. If you have more questions about Medicare, please give us a call. We’d be happy to help you strategize ways to maximize your Medicare benefits.


The opinions expressed, and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. The opinions and advice expressed in this communication are based on The Mather Group’s research and professional experience and are expressed as of the publishing date of this communication. The Mather Group makes no warranty or representation, express or implied, nor does The Mather Group accept any liability, with respect to the information and data set forth herein. The Mather Group specifically disclaims any duty to update any of the information and data contained in this communication. The information and data in this communication does not constitute legal, tax, accounting, investment, or other professional advice nor is it intended to provide comprehensive tax advice or financial planning with respect to every aspect of a client's financial situation.

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