5 common questions about aging into Medicare

Get answers to important Medicare questions.

  

As you get closer to your 65th birthday, you’ll need to make decisions about your Medicare coverage. To help make enrollment even easier, Don Truong, director of sales at Sharp Health Plan, offers these answers to some of the most common Medicare questions.

1

What Medicare options are available?

“Medicare has three main parts,” Truong explains. “Part A covers hospital insurance, Part B covers medical insurance and Part D provides drug coverage.” Original Medicare includes Parts A and B. You will need to enroll in a separate Part D plan for drug coverage. Unlike other types of health insurance, Medicare doesn’t offer plans for couples or families. You, your spouse and any dependents can enroll in separate plans.

For those who’d like more coverage, a Medicare Advantage plan (Part C) could be ideal. “A Medicare Advantage plan combines Parts A and B, and often, Part D, coverage into one plan. It can offer extra benefits, such as dental, hearing and vision,” adds Truong.

Medicare supplements, also known as Medigap, are available too. Medigap plans help to cover the costs that aren’t included in Original Medicare. And while these plans may have high monthly premiums and do not cover Part D prescription drugs, you can be seen by any doctor, nationwide, who accepts Medicare.

2

When can I enroll in Medicare?

There are a few important enrollment periods to keep in mind. When you turn 65, your initial enrollment period begins.

Initial enrollment period (IEP)

You'll have seven months to sign up for Medicare," Truong explains. "This is the initial enrollment period, which typically starts three months before your 65th birthday and ends three months after the month you turn 65."

If your birthday falls on the first day of the month, your initial enrollment period will begin and end earlier: starting four months before you turn 65 and ending 2 months after the month you turn 65.

Open enrollment periods (OEP)

If you miss the initial enrollment period, you can sign up for Medicare during the open enrollment period: October 15 - December 7. Medicare Advantage also has a general enrollment period from January 1 - March 31.

How to avoid penalties

Signing up during the general enrollment period may require you to pay a monthly late penalty if you don't qualify for a special enrollment period. These periods are determined by qualifying life events, such as losing your current coverage or retiring after age 65. To avoid penalties, be sure to sign up within the initial enrollment period.

3

When will my coverage start?

“Generally, coverage begins on the first of the month, but the exact date will depend on the month you enroll,” Truong says.

When you receive your Medicare Red, White and Blue card in the mail, you can check the lower right corner for the date that your Part A or Part B coverage will begin. If you have a Medicare Advantage plan, you’ll find your coverage effective date (or the day your coverage begins) on the member ID card from your health plan.

4

How does retirement affect my Medicare coverage?

“Consider your health insurance options several months before you retire,” Truong suggests. “You should also check with your employer to find out when your coverage will end to avoid penalties or a gap in coverage.”

When your job-based health insurance coverage ends, you’ll be able to enroll in Medicare during a special enrollment period.

You don’t need to retire to qualify for Medicare coverage. If you or your spouse are still working, you can keep your employer-based health insurance until you’re ready to disenroll or you can enroll in Original Medicare.

5

How do I know which Medicare plan is right for me?

“Before you turn 65, take some time to evaluate your health needs and compare plans,” Truong says. To get more information, Sharp Health Plan offers free Medicare seminars and consultations that explain how Medicare works and how to enroll in a plan. Seminars are available in English and Spanish. Sharp Health Plan offers additional resources explaining the parts of Medicare and the services they cover, eligibility and enrollment information and more.

“The quality of your health plan matters, too,” adds Truong. “Sharp Health Plan’s newest offering, the Sharp Direct Advantage® VIP Plan, provides all the benefits of Original Medicare, with more value and savings to enjoy.”

Medicare evaluates plans based on a 5-star rating system each year. Plans are rated on a scale of one to five stars, where one star indicates poor performance, and five stars indicates excellent performance.

Sharp Health Plan received 5 out of 5 stars from Medicare for 2022 and was the highest member-rated Medicare Advantage plan in San Diego,” Truong says.1

Don’t wait to learn more about Medicare: Avoid gaps in coverage and other fees by researching the different plans and enrollment periods before your 65th birthday.

1 Based on a 91% base group in the area of members’ overall rating of their health plan from the 2021 Consumer Assessment of Healthcare Providers and Systems® score survey results achieved by Sharp Health Plan and SCAN Health Plan.

  

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Sharp Direct Advantage is offered by Sharp Health Plan. Sharp Health Plan is an HMO with a Medicare contract. Enrollment with Sharp Health Plan depends on contract renewal. Read the full disclaimer.

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Page Last Updated: 4/04/2022
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