Turning 65

Qualifying for Medicare at 65 years old

Turning 65 years old is a big milestone! And for the majority of Americans, turning 65 means you qualify for Medicare. But what does that mean? It can seem overwhelming to begin the process, but it doesn’t have to be. Keep reading to learn more about checking your qualification, the process, and how STL Medicare Benefits can help you navigate everything when it comess to signing up for Medicare.

When am I eligible for Medicare?

Most people qualify for Medicare when they turn 65 years old. There’s a window of 7 months around your birthday (3 months before, your birthday month, and 3 months after) when you can sign up for it.

There are few exceptions to the age requirement include qualifying for Medicare earlier due to receiving Social Security disability benefits for at least 2 years or suffering from certain serious illnesses like kidney dialysis. The best way to find out for sure if you’re eligible is to check with STL Medicare Benefits or the Social Security Administration. Give us a call or fill out our form to get started and see if you qualify today!

How to Apply for Medicare at Age 65

  1. Confirm eligibility by contacting STL Medicare Benefits.
  2. Know your Initial Enrollment Period: 7 months to sign up for Part B (3 months before turning 65, your birth month, and 3 months after); missing it may result in a late enrollment penalty.
  3. Choose your Medicare coverage: Original Medicare (Parts A & B) covers hospital care and doctor visits, while Medicare Advantage Plans (Part C) combine A & B with extra benefits like vision or dental, offered by private insurers.
  4. Sign up for Medicare with STL Medicare Benefits for assistance in comparing plans and choosing the best coverage for you. Don’t hesitate to contact us for personalized guidance!

What does Medicare Cover?

Medicare provides essential healthcare coverage as you age, but understanding its parts can be tricky. Here’s a breakdown:

  • Part A (Hospital Insurance): It helps pay for inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
  • Part B (Medical Insurance): Medicare Part B helps pay for doctor visits, outpatient care, and preventive services, but Original Medicare (Parts A & B) doesn’t cover everything, which is where Medigap plans come in to help with deductibles and copays.
  • Medicare Advantage Plans (Part C): Offered by private insurers, these combine Parts A & B and may cover additional out-of-pocket costs and provide extra benefits like vision and dental.

Medicare Advantage limits doctor choice vs. Original Medicare. Coverage varies based on your plan choice, and we can assist you. Qualifying for Medicare at 65 is common, but starting Social Security retirement benefits four months before turning 65 automatically enrolls you in Parts A and B, but you can opt out of Part B if you have other health insurance.

What gaps are there in original Medicare coverage?

Here’s a breakdown of some potential gaps in Original Medicare (Parts A & B) coverage:

  • Out-of-Pocket Costs: Original Medicare doesn’t cover everything. You’ll likely encounter deductibles and copays. Medigap helps but it’s supplemental insurance plans have monthly premiums.
  • Limited coverage for extras like prescription drugs, vision care, and dental care.
  • Network restrictions: Original Medicare allows more choice of doctors than some Medicare Advantage plans, but some Medigap plans may limit provider networks.

What Additional coverage can I get to fill in Medicare gaps?

There are two main ways to fill in the gaps in Original Medicare coverage:

  1. Medigap Plans (Medicare Supplement): Private insurance that helps cover out-of-pocket costs of Original Medicare, like deductibles, copayments, and certain coinsurance amounts.
  2. Medicare Part D is insurance for prescription drugs, obtained from private insurers. It includes monthly premiums, deductibles, copayments for medications, and coverage tiers indicating which drugs are covered and at what cost.

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