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Medicare shines as a beacon of federal health insurance, specifically crafted to protect those who’ve shaped our society – our seniors aged 65 years or older. But its embrace extends further, also providing coverage for individuals with certain disabilities and medical conditions. There are four different parts of Medicare, each of which provides different types of coverage. These parts include Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. In addition to these parts, there is also a supplement insurance plan called Medigap that can help cover some of the costs that are not covered by Medicare.
What are The Different Parts of Medicare?
Medicare Part A is also known as hospital insurance. This part of Medicare provides coverage for inpatient hospital stays, as well as skilled nursing care, hospice care, and home health care. If you have paid into Medicare taxes for at least 10 years, you are eligible for premium-free Part A coverage. If you have not paid in for 10 years, you may still be able to enroll in Part A, but you will have to pay a premium.
It’s important to note that Part A does not cover all of the costs associated with hospital stays. You will still be responsible for paying deductibles, copayments, and coinsurance. Additionally, there are limits to the amount of time that you can stay in the hospital under Medicare Part A coverage.
Medicare Part B, also known as Medical Insurance, extends its coverage to a wider range of services that are crucial for maintaining your health. This includes doctor visits, outpatient care, preventive services such as vaccines and screenings, and some durable medical equipment and supplies. This essentially means that Part B covers the medical services necessary for diagnosing and treating your medical conditions.
Unlike Part A, Medicare Part B requires a monthly premium, the amount of which is determined based on your income. Furthermore, it’s worth noting that the costs for services and supplies are not completely covered. You’re typically responsible for 20% of the Medicare-approved amount for most doctor services, while Medicare covers the remaining 80%.
Medicare Part C, more commonly known as Medicare Advantage, presents a compelling alternative to conventional Medicare. These plans are provided by private insurance companies approved by Medicare, and they encapsulate all the benefits under the umbrella of Medicare Parts A and B. In fact, many Medicare Advantage plans take it a step further by offering additional benefits such as dental, vision, and hearing coverage.
The added benefit of prescription drug coverage, included in some of these plans, also sets them apart. However, it is crucial to comprehend that enrolling in a Medicare Advantage plan does not absolve you from paying your Part B premium. Furthermore, these plans typically operate within a network of providers, and you will need to utilize these network providers to receive coverage. Therefore, understanding the specifics of your Medicare Advantage plan is key to maximizing its benefits while avoiding unforeseen costs.
Medicare Part D, designed to help make prescription medications more affordable, is an essential component of comprehensive health coverage for seniors. Enrolling in Part D can significantly reduce the cost of prescription drugs, especially for those individuals who regularly require several medications. Just like other parts of Medicare, Part D is offered through private insurance companies that work in line with guidelines set by Medicare.
The monthly premium for Part D varies depending upon the specific plan you choose, as well as your income. Notably, higher-income individuals may have to pay an Income-Related Monthly Adjustment Amount (IRMAA) in addition to the standard Part D premium. Therefore, it is crucial to explore different plan options and choose one that suits your medication needs and financial circumstances.
Timing is critical when it comes to enrolling in Part D. Generally, you are eligible to enroll when you turn 65. If you fail to enroll during this initial enrollment period and decide to enroll later, you may face a late enrollment penalty, which could result in a higher monthly premium.
Medigap (Medicare Supplement)
Medigap, also known as Medicare Supplement Insurance, fills in the ‘gaps’ that aren’t covered by Original Medicare, such as copayments, coinsurance, and deductibles. Offered by private insurance companies, these plans can significantly reduce your out-of-pocket healthcare costs. However, it is important to be already enrolled in Medicare Parts A and B to qualify for a Medigap plan.
Despite their extensive coverage, Medigap plans do not include prescription drug coverage. Therefore, if you need help with medication costs, it’s advisable to enroll in a separate Medicare Part D plan. Ensuring that you have both a Medigap plan and Part D coverage can provide you with a comprehensive healthcare safety net, covering a wide range of both medical services and prescription drugs.
Medicare Enrollment Periods in New Hampshire
- Initial Enrollment Period (IEP): This is the first time you can sign up for Medicare. It starts three months before your 65th birthday and ends three months after your 65th birthday. During this period, you can enroll in Medicare Part A, Part B, Part C (also known as Medicare Advantage), or Part D (prescription drug coverage).
- General Enrollment Period (GEP): If you miss your IEP, you can sign up for Medicare Part A and/or Part B between January 1 and March 31 each year. Your coverage will start on July 1. You may have to pay higher premiums for late enrollment in Part A and/or Part B.
- Medicare Advantage Open Enrollment Period: This occurs from January 1 to March 31 every year. If you’re already enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or drop your Medicare Advantage Plan and return to Original Medicare. If you switch to Original Medicare during this period, you’ll have until March 31 to also join a Medicare Prescription Drug Plan.
- Annual Medicare Open Enrollment Period: From October 15 to December 7 each year, you can join, switch, or drop a Medicare Advantage Plan or Medicare Prescription Drug Plan. Your changes will take effect January 1 of the following year.
- Special Enrollment Periods (SEPs): Throughout the year, certain events might allow you to enroll in, change, or drop a Medicare Advantage Plan or Medicare Prescription Drug Plan outside the usual enrollment periods. These special circumstances include moving out of your plan’s service area, losing your current coverage, and other specific situations.
Medicare Resources and Assistance in New Hampshire
|Medicare.GOV||The official U.S. government site for Medicare. You can find information on how to enroll, the types of Medicare Advantage Plans, costs, coverage and frequently asked questions pertaining to New Hampshire.|
|New Hampshire State Health Insurance Assistance Program (SHIP)||SHIP provides free, unbiased counseling and assistance to Medicare beneficiaries and their families. They can help you understand your Medicare options, compare plan benefits, and navigate the enrollment process.|
|Nh Department of Insurance||This site provides comprehensive information regarding health insurance, including Medicare Advantage plans, in New Hampshire. It’s a valuable resource for state-specific regulations and options.|
|SilverSneakers||An included fitness program for Medicare Advantage members in New Hampshire, offering access to gyms and fitness classes at no extra cost.|
|Medicare Rights Center||A trusted source for Medicare information and assistance.|
|Medicare Interactive||An online resource developed by the Medicare Rights Center that answers questions about Medicare benefits, rights, and options.|
|The Cronin Agency||For Free Medicare Guidance and Advice|
|NH SS OFFICES|
- The Different Parts of Medicare in New Hampshire
- Do I Automatically Get Medicare When I Turn 65?
- Medicare Part D Plans in New Hampshire
- Medicare Advantage Plans in New Hampshire
- Medigap (Medicare Supplement) In New Hampshire
- Understanding Medicare in New Hampshire: Everything You need to know.
- Can I change my Medicare plan outside of the Annual Enrollment Period in New Hampshire
- How Marital Status and income Influence Medicare in New Hampshire.
- Do I really need supplemental insurance with Medicare in New Hampshire?
- Medicare in New Hampshire: HMO vs PPO – Unveiling the Pros and Cons of Staying in Network