New to Medicare
Feeling lost? We are here to guide you.
From start to finish, the process of enrolling on Medicare can be overwhelming for those that are newly eligible or transitioning from an employer group health plan. The stacks of Medicare plan advertisements and television commercials can often lead to even more confusion. To receive unbiased guidance on all aspects of Medicare, you’ve come to the right place. Here at MySquare Insurance Solutions, we are experienced and knowledgeable Licensed Agents that will provide a clear and precise roadmap in order to simplify the path to Medicare each step of the way.
We believe education and a personal consultation is key to ensuring you are on the best Medicare health plan for your specific medical needs and budget. Our goal is to maximize your benefits while reducing your out-of pocket costs. By contracting with multiple plans instead of just one, we can offer unbiased advice at no cost to you. With us by your side, you will have the confidence in knowing you’ve made the right decision for your healthcare.
From start to finish, the process of enrolling on Medicare can be overwhelming for those that are newly eligible or transitioning from an employer group health plan. The stacks of Medicare plan advertisements and television commercials can often lead to even more confusion. To receive expert guidance on all aspects of Medicare, you’ve come to the right place. Here at MySquare Insurance Solutions, we are experienced and knowledgeable Licensed Agents that will provide a clear and precise roadmap in order to simplify the path to Medicare each step of the way.
We believe education and a personal consultation is key to ensuring you are on the best Medicare health plan for your specific medical needs and budget. Our goal is to maximize your benefits while reducing your out-of pocket costs. By contracting with multiple plans instead of just one, we can offer unbiased advice at no cost to you. With us by your side, you will have the confidence in knowing you’ve made the right decision for your healthcare.
What is Medicare?
Original Medicare is a Federal program and it’s the foundation on which all other Medicare plans rely.
Americans who qualify for this program include individuals who are:
Age 65 and older
Collecting SSDI (Social Security Disability) for at least 24 months
Diagnosed with Amyotrophic Lateral Sclerosis (also known as Lou Gehrig's disease)
Diagnosed with End-Stage Renal Disease
What is Medicare?
Original Medicare is a Federal program and it’s the foundation on which all other Medicare plans rely.
Americans who qualify for this program include individuals who are:
Age 65 and older
Collecting SSDI (Social Security Disability) for at least 24 months
Diagnosed with Amyotrophic Lateral Sclerosis (also known as Lou Gehrig's disease)
Diagnosed with End-Stage Renal Disease
The Four Parts of Medicare:
Medicare Part A and Part B are supported by the Federal Government and referred to as Original Medicare. Medicare Part C and Part D are offered through Medicare-approved private insurance companies. You will only enroll in Medicare Part A and Part B through the Social Security Administration. They will not ask about your coverage decision for any other Medicare plans. All other Medicare enrollments such as Medicare Advantage, Medicare Supplement (Medigap), and Part D will be completed by licensed insurance agents, like us.
Medicare Part A:
- Coverage for hospital services such as inpatient hospitalizations, skilled nursing, home healthcare, and hospice.
- Part A is premium-free if you have paid the Medicare tax for at least 40 quarters.
Medicare Part B:
- Coverage for office visits, lab services, diagnostic tests, urgent or emergency care, and other outpatient costs.
- Most Medicare beneficiaries will pay a Part B premium. While Part B is optional, it is highly recommended to enroll when first eligible to prevent a large gap in medical coverage and possible Late Enrollment Penalties.
Medicare Part (Medicare Advantage):
- Medicare Advantage plans combine benefits and services covered under Medicare Parts A and B, and often include Medicare Part D.
- These plans are offered by Medicare-approved private insurance companies.
- Several Medicare Advantage Plans may include additional benefits.
Medicare Part D:
- Medicare beneficiaries access prescription drug coverage through Part D.
- These plans are offered by Medicare-approved private insurance companies.
- Medicare Advantage policyholders usually receive Part D prescription drug benefits through their plan.
- Original Medicare participants with or without a Medicare Supplement (Medigap) policy will need to add their coverage through a Stand-Alone Part D plan.
The Four Parts of Medicare:
Medicare Part A and Part B are supported by the Federal Government and referred to as Original Medicare. Medicare Part C and Part D are offered through Medicare-approved private insurance companies. You will only enroll in Medicare Part A and Part B through the Social Security Administration. They will not ask about your coverage decision for any other Medicare plans. All other Medicare enrollments such as Medicare Advantage, Medicare Supplement (Medigap), and Part D will be completed by licensed insurance agents, like us.
Medicare Part A:
- Coverage for hospital services such as inpatient hospitalizations, skilled nursing, home healthcare, and hospice.
- Part A is premium-free if you have paid the Medicare tax for at least 40 quarters.
Medicare Part B:
- Coverage for office visits, lab services, diagnostic tests, urgent or emergency care, and other outpatient costs.
- Most Medicare beneficiaries will pay a Part B premium. While Part B is optional, it is highly recommended to enroll when first eligible to prevent a large gap in medical coverage and possible Late Enrollment Penalties.
Medicare Part C (Medicare Advantage):
- Medicare Advantage plans combine benefits and services covered under Medicare Parts A and B, and often include Medicare Part D.
- These plans are offered by Medicare-approved private insurance companies.
- Several Medicare Advantage Plans include additional benefits, such as routine vision, hearing, and dental coverage.
Medicare Part D:
- Medicare beneficiaries access prescription drug coverage through Part D.
- These plans are offered by Medicare-approved private insurance companies.
- Medicare Advantage policyholders usually receive Part D prescription drug benefits through their plan.
- Original Medicare participants with or without a Medicare Supplement (Medigap) policy will need to add their coverage through a Stand-Alone Part D plan.
Enrollment Periods:
Initial Enrollment Period (IEP):
- As you approach your 65th birthday, you will enter your Initial Enrollment Period (IEP) for Medicare.
- This is a 7-month period centered around the month of your 65th birthday.
- It begins on the first day of the month three months prior to your 65th birthday.
- It ends on the last day of the month three months after your 65th birthday.
General Enrollment Period (GEP):
- If you do not enroll in Medicare Part B during your IEP, you can enroll during the General Enrollment Period which occurs from January 1 – March 31 each year.
- Your effective date will be July 1st.
Special Enrollment Period (SEP):
- A Special Enrollment Period (SEP) is dependent on qualifying to apply outside of the traditional enrollment periods above.
- This usually requires that you submit documentation to the Social Security Administration showing proof of creditable Employer Group Health Plan coverage back to your Initial Enrollment Period at age 65.
- We advise that you speak to your Medicare Square agent about your personal qualifications and forms that may need to be completed.
How to Apply for Original Medicare:
- The fastest and easiest way to apply for Medicare Parts A & B is through an online application via the Social Security Administration website: https://www.ssa.gov/benefits/medicare/
- You will be automatically enrolled if you are collecting Social Security or Railroad Retirement Benefits.
- If you delayed Medicare past age 65 due to coverage from an Employer Group Health Plan, you will need to complete two Social Security forms. Contact us to be sent the most up-to-date versions.
How to Apply for Original Medicare:
- The fastest and easiest way to apply for Medicare Parts A & B is through an online application via the Social Security Administration website: https://www.ssa.gov/benefits/medicare/
- You will be automatically enrolled if you are collecting Social Security or Railroad Retirement Benefits.
- If you delayed Medicare past age 65 due to coverage from an Employer Group Health Plan, you will need to complete two Social Security forms. Contact us to be sent the most up-to-date versions.
What Medicare Doesn’t Cover
Original Medicare covers a lot of necessary benefits, but there are exceptions. These are some important exclusions:
- Most dental procedures
- Routine vision exams
- Glasses or contacts
- Routine hearing exams
- Hearing aids
- Long-term care (Custodial care)
- Prescription drugs (This is only accessed through Part D.)
- Acupuncture
- Over-the-Counter items such as vitamins
This list is not exhaustive and you may notice some benefits that you want to access while on Medicare. There may be a private insurance plan that will provide the coverage that you need.
What Medicare Doesn’t Cover
Original Medicare covers a lot of necessary benefits, but there are exceptions. These are some important exclusions:
- Most dental procedures
- Routine vision exams
- Glasses or contacts
- Routine hearing exams
- Hearing aids
- Long-term care (Custodial care)
- Prescription drugs (This is only accessed through Part D.)
- Acupuncture
- Over-the-Counter items such as vitamins
This list is not exhaustive and you may notice some benefits that you want to access while on Medicare. There may be a private insurance plan that will provide the coverage that you need.