Medicare Information

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Click on this helpful video for information on Medicare Parts A and B or read below for diagram details.

Of course, Sterling Insurance is here to answer any additional questions you might have. Call us today! 

When are you eligible for Medicare?

You're eligible for Original Medicare (Parts A and B) if:

You're at least 65 years old, or you're under 65 and qualify on the basis of a disability or other special situation.

AND

You're a U.S. citizen or a legal resident who has lived in the U.S. for at least five consecutive years.

When can you enroll?

Initial Enrollment Period

When you turn 65 or otherwise become eligible for Medicare, you'll have your Initial Enrollment Period. Your Initial Enrollment Period begins three months before and ends three months after the month of your 65th birthday (a seven-month window). If you have employer or plan-sponsored coverage when you first become eligible, you won't need to enroll until you retire or otherwise lose that coverage. Prescription drug (Part D) coverage must be creditable or you may be subject to a late-enrollment penalty when you enroll in a plan with Part D benefits.

Open Enrollment, October 15 - December 7

During Open Enrollment you can add, drop or switch your Medicare plan coverage. You might also see this called the Annual Enrollment Period.

Special Election Period

Some individuals may also qualify for a Special Election Period. Depending on certain circumstances, you may be able to enroll in a  Medicare plan outside of the Initial Enrollment Period or Open Enrollment time frames. You may qualify for a Special Election Period if you:

  • Retire and lose you employer coverage
  • Move out of the plan's service area
  • Receive assistance from the state
  • Have been diagnosed with certain qualifying disabilities or chronic health conditions

Special Needs Plans have other eligibility requirements. 

Medicare Advantage Disenrollment Period

Between January 1 and February 14, you may disenroll from a Medicare Advantage Plan and return to Original Medicare. 

Medicare choices.

After you enroll in Original Medicare (Parts A and B), there are two ways to get additional coverage.
Enroll in Original Medicare when you become eligible.

Original Medicare
Provided by the government
Part A covers hospital stays
Part B covers doctor and outpatient visits
If you need to add more coverage, you have two options.
Add one or both of the following to Original Medicare:
Add additional coverage by choosing a Medicare Advantage plan:
Covers some or all of the costs not covered by Parts A and B
Part C combines Parts A (hospital) and B (doctor)
Provides additional benefits
Part D covers prescription drugs
Most plans cover prescription drugs
Here are 2 additional videos for your review. These cover Parts C and D.

Of course, Sterling Insurance is here to answer any additional questions you might have.


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