By Mike Cook
If you are turning 65 in the next few months, now is a good time to start thinking about Medicare coverage.
You can sign up for Medicare three months before your birth month or three months after. So, including your birth month, that is a seven-month window. If you wait beyond that period, you can still sign up, but there is a penalty.
Medicare is easy to sign up for and a lot of help is available.
You can get started at www.medicare.gov. This site explains what Medicare is, what it covers and how much it costs.
Also visit www.medicaresolutions.com. To apply, visit ssa.gov/benefits/medicare.
You can also visit www.aarp.org/health/medicare-qa-tool/understanding-medicare and https://states.aarp.org/new-mexico/.
There are also agents who represents a single health insurance company providing Medicare coverage and independent insurance brokers who represent multiple companies. You can meet with one of them in person to get Medicare questions answered and figure out what coverage is best for you, as well as the costs and benefits of additional coverage to fill the gaps in what Medicare pays. An agent or broker can also help you figure out if the services provided by your doctor, dentist and other providers are covered under a particular plan.
Clarissa Acosta is an independent insurance broker in Las Cruces. She represents a number of health insurance companies that provide Medicare coverage in New Mexico. There is no charge to meet with her, as she is paid by the company whose coverage her clients select.
“My job as a broker is to represent the client’s needs over the company’s needs,” Acosta said. “The Medicare process is overwhelming and It’s my job to make the process less stressful. As a broker, I am contracted with four to six companies, not just one, so I can give people options. I become their guide through enrollment and a personal agent throughout their membership and future needs.”
Acosta is part of the Distinguished Choice Insurance Solutions, a New Mexico-based agency that specializes in Medicare coverages along with other health insurance (www.distinguishedchoice.com).
Contact Acosta at 505-919-9720 and [email protected].
The four parts of Medicare
Medicare is divided into four parts: A, B, C and D.
- Part A covers hospital, skilled nursing and hospice services, lab tests, surgery and home health care. It is free of charge.
- Part B covers services provided by doctors and other health care provers, outpatient care, medical equipment, home health care and some preventative services. It costs $170 a month. Medicare pays 80 percent of costs under parts A and B, and the patient pays 20 percent.
- Part C is an alternative called Managed Medicare or Medicare Advantage through which Medicare recipients can choose private health plans in addition to Medicare Part B. There is no to low premium for advantage plans, although there are deductibles and other expenses.
- Part D covers most self-administered prescription drugs. There is a penalty if you don’t have a plan D.
President Lyndon B. Johnson signed Medicare into law July 30, 1965. Former President Harry Truman and his wife, Bess, were the first recipients. Today, the program provides health insurance to about 60 million Americans.
Before Medicare, only slightly more than half of people aged 65 and older had health insurance and nearly one-third lived in poverty. Today, about 96 percent of those aged 65 and older are on Medicare, and as of 2019, about 9 percent of seniors were living in poverty.
The federal Medicaid program, which provides health care to people with limited income regardless of age, also became law in 1965. As of 2017, about 74 million low-income and disabled people (nearly one-quarter of the population) had Medicaid coverage.
Both Medicare is administered by the Centers for Medicare and Medicaid Services (CMMS), a federal agency within the U.S. Department of Health and Human Services which was created in 1977 and is based in Baltimore, Maryland. Medicaid is administered by the federal government and individual states governments.