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Medicare in Elizabeth, NJ

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Medicare serves as a cornerstone of health coverage for many Americans, providing vital health services to eligible individuals. Understanding eligibility and enrollment is crucial for maximizing your benefits and ensuring seamless coverage as you navigate this federal program.

Who is Eligible?

Generally, this federal health insurance is for people 65 or older. You may be able to get it earlier if you have a disability, end-stage renal disease (permanent kidney failure requiring dialysis or a transplant) or amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease).

Am I Automatically Signed Up for it at Age 65?

If you are approaching age 65 and already receive Social Security or Railroad Retirement benefits through early retirement, you will be automatically enrolled in Medicare Parts A (hospital insurance) and B (medical insurance) when you turn 65.

What if I Am Not Automatically Enrolled in Medicare?

If you aren’t automatically signed up for Medicare, you may have three opportunities to apply for coverage:

  • Initial enrollment period (IEP)—This seven-month period includes the three months before your 65th birthday, the month of your birthday and the three months after. It’s the first opportunity for eligible individuals to sign up for Medicare Part A and Part B.
  • Special enrollment period (SEP)—If you’re covered under a group health plan through an employer, you might qualify for a SEP. This period allows you to sign up for Part A and/or Part B as long as you or your spouse (or family member if you’re disabled) is working and you’re covered by a group health plan through the employer or union.
  • General enrollment period (GEP)—If you didn’t sign up for Part A and/or Part B during your IEP and aren’t eligible for a SEP, you can apply between January 1 and March 31 each year.

What Is the Difference Between Medicare Supplement and Medicare Advantage Plans?

Understanding the differences between Medicare Supplement and Medicare Advantage plans is crucial for informed healthcare planning.

  • Medicare Supplement plans act as a secondary layer of coverage, kicking in after the Original plan has contributed its share. These plans offer flexibility, with no network restrictions or referral requirements for specialist visits.
  • Medicare Advantage plans serve as your primary coverage and replace Original Medicare. They often have network limitations and higher out-of-pocket costs but may include additional benefits not found in Original Medicare, such as dental, vision and prescription drug coverage.

Enrolling in both a Medicare Supplement and a Medicare Advantage plan is not permitted.

Do I Need to Renew My Coverage?

The annual renewal of Original Medicare coverage is automatic, ensuring continued access to health services without the need to reapply each year. Similarly, supplementary plans are automatically renewable, contingent on continuing monthly premium payments. Medicare Advantage participants also enjoy automatic renewal, with the flexibility to change plans annually to better meet their evolving health needs.

Contact Us

Contact Upix Agency in Elizabeth, New Jersey, today for more information and guidance on your Medicare options.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.

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