Medicare may sound confusing, but don’t worry. We’re here to help you know about your options.
Medicare’s Annual Enrollment Period is October 15th through December 7th. Now is the time to review your Medicare coverage.
At Vivant Health, we want to help make it easier to find the best plan for your needs. We are contracted with five Medicare Advantage plans, ensuring you have plenty of options to choose from. Our trusted team is a great resource to guide you.
Your health is our priority, and we’re with you every step of the way.
Medicare is a federal health insurance program designed primarily for individuals who are 65 or older, but it also covers certain younger individuals with disabilities and those with end-stage renal disease (ESRD). Medicare is divided into four parts:
(Inpatient Hospital Insurance)
(Outpatient Medical Insurance)
(Medicare Advantage Plan)
(Drug Coverage)
Original Medicare covers Part A and Part B. Medicare Advantage, also known as Part C, is an alternative to Original Medicare. These plans are offered by private companies that contract with Medicare to provide all of your Part A and Part B benefits.
You’ll also get additional services like vision, dental, and hearing coverage. Many Medicare Advantage plans also include prescription drug coverage (Part D). Medicare Advantage plans cover more of your healthcare needs and may save you money.
Generally, Medicare is for people 65 or older.
U.S. citizen or permanent resident for at least five years
You or your spouse has worked 40 quarters (10 years) and paid Medicare payroll taxes while working.
Qualify to get (or are already getting) retirement or disability benefits from Social Security (or Railroad Retirement Board).
You are permanently disabled
Have ESRD (permanent kidney failure requiring dialysis or a transplant)
Have ALS (also called Lou Gehrig’s disease)
Medicare Advantage plans are required by law to cover all services provided by Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). These include:
- Inpatient hospital stays
Skilled nursing facility stays
Hospice Care
Primary and specialty care visits
Outpatient mental health visits
Lab and X-ray
Preventative services and wellness screenings
Durable Medical Equipment (DME)
Ambulance coverage
Part B Drugs
Medicare Advantage plans provide Part A (Hospital Insurance) and Part B (Medical Insurance) benefits to individuals who qualify for both parts of Medicare. These plans are contracted with Medicare and offered by private insurance companies that combine parts A & B and often include Part D (Drug Coverage) as well as additional benefits not covered by Medicare. These additional benefits may include:
Drug coverage
Vision allowance
Dental coverage
Transportation
Fitness benefit
Over the Counter
Predictable out of pocket costs
Medicare Enrollment Periods
-
Initial Election Period (IEP):
If you are newly eligible for Medicare, your Initial Election Period is the seven-month window that begins three months before the month you turn 65, includes your birthday month, and ends three months after. -
Annual Election Period (AEP):
Each year from October 15 to December 7, all Medicare beneficiaries have the chance to review and change their Medicare coverage. This is when you can make an adjustment that best fits your needs. -
Special Election Period (SEP):
Certain life events may qualify you for the SEP, which means you can enroll in a Medicare Advantage plan outside the normal enrollment periods. These events include moving to a new service area, losing other health coverage, or changes in your eligibility status, such as becoming eligible for Medicare before age 65 due to a disability, ALS (Lou Gehrig’s disease), or end-stage renal disease (ESRD).
Have Questions or Need Help?
Reach out to Vivant Health for more information about your Medicare options and to learn about our contracted health plans in your area.
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