Most Americans become eligible for Medicare on their 65th Birthday. Your Effective date will be the First Day of the month in which you turn 65 unless your birthday is on the first of the month then your effective date will be the first of the prior month. There are requirements to be eligible that include paying into the system for 40 quarters (10 Years) or being married to a person who has paid into the system for 40 quarters. Medicare is primary Health Insurance for those over 65 and for people collecting Social Security disability for 2 years or more.
Currently, Medicare has 3 components: Part-A Hospitalization
Part-B Medical-Outpatient Expenses
Part-D Prescription Coverage
Click Here to See the publication "Medicare & You 2009" For a full Description of Medicare.
Medicare does not cover all expenses 100% so most Medicare Beneficiaries elect to supplement thier coverage. There are two options when considering supplemental coverage, Medicare Supplements and Medicare Advantage Plans. I will briefly summarize each option below.
Medicare Advantage Plans
Medicare Advantage will include the following plans: HMO, PPO, POS and Private Fee For Service. The main point of a Medicare Advantage plan is that it replaces your current Medicare and becomes your primary coverage. The plans typically have either NO MONTHLY premium or a nonimal monthly premium. In most cases, they also include a Prescription Drug Card (Part-D).
Since Advantage plans are your primary coverage, there will be restrictions placed on you when you receive care. They will have a List of Preferred Doctors and Hospitals that you must use. There is limited and reduced coverage if you work outside their list of provides. You will also have co-pays and co-insurance to pay when receiving care. Some plans have a maximum out of pocket and some do not.
Medicare Supplements (Medigap)
Medicare Supplements leave Medicare as your primary coverage and as a seconday payor, fill the "Gaps" in the current Medicare Program. Medicare Supplements do have a monthly premium and do not include a Prescription Drug card. You will need to enroll in a separate drug plan for your out-patient drug needs.
Since Medicare is your primary coverage, you will not have the restrictions on your Doctor and Hospital choice and depending on your Plan Choice, will have little or nothing out of pocket when receiving care.
WHERE DO I START?
This Section should help you make the transition to Medicare.
IF YOU ARE COLLECTING SOCIAL SECURITY ALREADY. Approximately 3 Months prior to your eligibilty date, you should receive your Red, White and Blue Medicare card. If you have not received it 2 months prior to your eligibility date, you should call Social Security at 1 (800) 772 1213 and make sure they are processing your card. Once you receive your card, you are ready to start evaluating your supplemental options.
IF YOU ARE NOT CURRENTLY COLLECTING SOCIAL SECURITY. Approximately 3 Months prior to your eligibility date (The first day of the month in which you turn age 65) you should call Social Security to start the enrollment process. You may be required to shcedule an appointment with them and may need to produce a Birth Certificate and or a Marriage Certificate. Since you are not collecting Social Security, neither Social Security or Medicare will start this process.:
Avaiable Plans
Blue Cross Offers 4 Plans: Senior Security Plans A,C and F and Senior Preferred Plan C. The Senior Security plans allows full choice of Doctor and Hospital, Senior Preferred is olny avaiable in Maricopa and Pima Counties. Senior Preferred does require you to us a select list of Doctors and Hospitals. Click Here to see a full Brochure and learn about Senior Security & Senior Preferred.
Click Here to DownLoad a Blue Cross Medicare Supplement Application
Mutual of Omaha offers 4 Plans in Arizona: Plan A, B, F & G. They all allow full choice of Doctor and Hospital. A nice feature of their plans is "Medicare Crossover". Medicare Cross over allows Medicare to file your claims automatically
