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News from the Social Security Administration

Medicare Is The Best Care If You Are Age 65 Or Older

If you are age 65 or older and haven’t signed up for Medicare Part B (Medical Insurance), now is the time to consider doing so. The general enrollment period for Medicare Part B runs from Jan. 1 through Mar. 31 each year. Before you make a decision about general enrollment, we want to share some important information.

Remember: Most people are automatically enrolled in Medicare Part B when they become eligible. If you don’t enroll in Medicare Part B when you first become eligible, you may have to wait until the general enrollment period, which is Jan. 1 through Mar. 31 of each year. At that time, you may have to pay a higher Medicare Part B premium.

What is Medicare?

Medicare is health insurance for people receiving Social Security who are age 65 or older or those who have received Social Security disability benefits for more than two years. Some people are covered only by one of the four parts of Medicare; others opt to pay extra for more coverage. Understanding Medicare can save you money; here are the facts.

The four parts of Medicare are parts A, B, C and D.

Part A (Hospital Insurance) helps cover inpatient hospital care, skilled nursing care, hospice care and home health care. Most people get Medicare Part A premium-free, because it was earned by working and paying Social Security taxes.

Part B (Medical Insurance) helps cover services from doctors and other outpatient health care providers, outpatient care, home health care, durable medical equipment and some preventive services. Most people pay a premium for Part B.

Part C (Medicare Advantage) allows you to choose to receive all of your health care services through a provider organization. These plans include all benefits and services covered under Part A and Part B; usually includes Medicare prescription drug coverage as part of the plan; and may include extra benefits and services for an additional cost. You must have Part A and Part B to enroll in Part C. Monthly premiums vary depending on your state, private insurer and whether you select a health maintenance organization or a preferred provider organization.

Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs. Many people pay a premium for Part D. However, people with low income and resources may qualify for Extra Help from Social Security to pay the premium and deductible. To see if you qualify for extra help visit www.ssa.gov/prescriptionhelp.

Most people first become eligible for Medicare at age 65, and there is a monthly premium for Medicare Part B. In 2014, the premium for most people is $104.90-the same as it was in 2013. Some high-income individuals pay more than the standard premium. Your Medicare Part B premium also can be higher if you do not enroll when you are first eligiblem (also known as your initial enrollment period). There also is a Medicare Part B deductible of $147 in 2014.

You can delay your Medicare Part B enrollment without having to pay higher premiums if you are covered under a group health plan based on your own current employment or the current employment of any family member. You can sign up for Medicare Part B without paying higher premiums:

– in any month you are covered under a group health plan based on your own current employment or the current employment of any family member; or

– within eight months after your employment or group health plan coverage ends, whichever comes first.

If you are disabled and working (or you have coverage from a working family member), the same rules apply.

It’s important to note that people who have Medicare coverage are not affected by the Affordable Care Act. Medicare is not a part of the Affordable Care Act’s Health Insurance Marketplace. If you are a Medicare beneficiary, your Medicare benefits are not changing. You do not need to replace your Medicare coverage with Marketplace coverage. For more information about the Marketplace, visit www.healthcare.gov.

For more information about Medicare Parts A, B, C and D, visit www.medicare.gov. Or read our publication on Medicare at www.socialsecurity.gov/pubs.