Do You Have To Use Medicare When You Turn 65?

Do You Have To Use Medicare When You Turn 65?

Medicare coverage begins the month you turn 65. If you are self-employed, you may have to delay applying for Medicare until the first of the month you turn 65. (If you apply for Medicare during the first three months of the year, you must pay a penalty for the months you waited to enroll. For information about penalty exceptions, call 1-800-MEDICARE (1-877-690-1012).

Do you have to enroll in Parts A and B to have Part D prescription drug coverage?

No. You must enroll in Part A and B to be eligible for prescription drug coverage under Part D. If you don't enroll in Parts A and B, you will not be eligible for Part D prescription drug coverage.

How will Medicare cover me for services?

Medicare pays 80% of the approved charges for Part A and Part B services. The “approved charges” are based on what Medicare covers. For example, if you are in the hospital, Medicare Part A will pay for the room and board and some of the costs of your medical care, but not for the meals you eat in the hospital cafeteria. Part B will pay for the doctor's services you receive while you are in the hospital.

Are there any exceptions to the 80% coverage?

Yes. If you have other health insurance or other coverage that pays for care the same as Medicare, Medicare may pay only 20%. If you have other insurance with duplicate coverage (that is the same as Medicare), Medicare may pay only 80% of your coinsurance or deductible.

What if I have Medicare Advantage?

If you have Medicare Advantage and have prescription drug coverage through it, you will still need to enroll in Medicare Part D to get drug coverage. You can enroll in Medicare Advantage and Part D at the same time.

How much does Part D cost?

Each year, you will pay an enrollment fee and an annual deductible. You will also pay monthly premiums. These costs will vary depending on your drug coverage, as well as your state of residence and your income.

Enrollment fees are $96.40 for 2012.

The monthly enrollment fee for 2012 is $32.50.

The annual deductible will vary depending on your plan.

The monthly premium will vary depending on your plan.

When do my costs for Part D begin?

If you are enrolled in Part A and Part B, you can enroll in Part D during the general enrollment period (January 1 through March 31) or during the annual enrollment period (October 15 through December 7). If you are not enrolled in Part A and Part B, you can enroll in Part D during the general enrollment period only when you enroll in Part A and Part B.

What does it mean to enroll in Medicare Part D?

When you enroll in Part D, you will be choosing a prescription drug plan. When you enroll in Part D, you are choosing the plan you think will best meet your needs. You will have a choice of prescription drug plans, and you can switch plans during the annual enrollment period (October 15 through December 7).

Where do I enroll in Part D?

To enroll in Part D call 1-800-MEDICARE (1-877-690-1012). If you have questions about Part D, call them at 1-877-690-1012.

What if I have private drug coverage?

If you have private drug coverage, you will not be enrolled in Part D. You must enroll in Part D if you want to get drug coverage from Medicare.

What if I am already enrolled in Part D?

If you are already enrolled in Part D and you do not like your current plan, you can switch plans during the annual enrollment period (October 15 through December 7).

What is the annual enrollment period?

If you enroll in Part D during the general enrollment period (January 1 through March 31), you will be automatically enrolled in the plan your state has selected for you. During the annual enrollment period (October 15 through December 7), you can choose from the different prescription drug plans that will be available for the next year. If you enroll during the annual enrollment period, you may be able to change plans, but you may not be able to drop your Part D coverage.

What if I need help deciding which plan to choose?

Call 1-800-MEDICARE (1-877-690-1012). If you have questions about Part D, call them at 1-877-690-1012.

How long does Part D coverage last?

Medicare prescription drug coverage lasts for a year. It must be renewed each year.

What if I don't enroll in Part D?

If you don't enroll in Part D, you won't have prescription drug coverage.

What are Part D's rules for coverage?

Part D's rules are different from the rules for Parts A and B. They include:

Part D's rules say that the prescription drug coverage you get under Part D cannot duplicate the health care benefits you get from other health insurance, such as coverage from an employer. This is called the “duplicate coverage” rule.

Part D's rules say that Medicare will pay for all or part of your prescriptions if you have other insurance that pays for prescription drugs.

Part D's rules say that you must pay for all covered prescription drugs until you reach the “donut hole” coverage limit and then Medicare will pay for drug costs.

What is the donut hole?

The “donut hole” is the period of time when you will have to pay for all of your prescription drug costs. It begins in 2006, and it will last until the “donut hole” coverage limit is hit. After the don

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