Turning 65? What You Need To Know About Medicare.

By Britta Orr, Chief Medicare Officer

Approaching 65 signifies a big milestone: The opportunity to enroll in Medicare. While some people are eligible for Medicare before they turn 65 due to a disability or disease, this birthday marks most people’s entrance into the federal health insurance program. Many people have questions about how and when to enroll and what plan they should choose.

The process can be daunting if you’re unfamiliar with Medicare and unsure where to find the answers to your questions. Our Allina Health | Aetna team and local broker partners are always available to answer questions about Medicare enrollment. Here are the most common questions we hear that can cause some confusion.

Q. When am I eligible to sign up for Medicare?

Most people are eligible for Medicare at the age of 65. The enrollment window starts three months before your birth month and ends the third month after your birthday, giving you seven months to enroll. If you have a disability, End-Stage Renal Disease or ALS, you may be eligible to sign up before you turn 65.

Q. What is the difference between Medicare and Medicare Advantage?

There are four parts of Medicare: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage) and Part D (prescription drug insurance). Original Medicare is a combination of Part A (hospital insurance) and Part B (medical insurance). Part A is automatic, but you have to sign up for Part B. You can add on Part D (prescription drug insurance) through a private insurer.

Part C, or Medicare Advantage, combines Parts A, B and usually D. Allina Health | Aetna offers Medicare Advantage (Part C) plans. In most cases, Medicare Advantage includes hospital, medical and prescription drug insurance coverage in one plan instead of having separate pieces. Medicare Advantage can also offer extra benefits such as dental, vision and hearing coverage which are not included in Original Medicare.

Q. How many plan options are there?

There are many plans available through different health insurance companies in Minnesota. Each insurer will offer unique benefits and coverage options within their plans. For example, at Allina Health | Aetna, our Medicare Advantage plans include dental, vision and hearing coverage, a quarterly OTC allowance, fitness memberships and other supplemental benefits. It’s important to research your options and find a plan that is most suitable for you. This means looking not only at the benefits, but also the network and your prescriptions. A local broker can be a great resource to help find the right fit for your needs and budget.

Q. What if I get my benefits through the Veterans Administration? Do I still have to enroll in Medicare?

You don’t have to enroll in Medicare if you are enrolled in benefits through the VA. But, you can be enrolled in both at the same time, and Medicare (including Medicare Advantage) will cover services you receive outside the VA system. The VA recommends veterans enroll when they are eligible.

Q. What if I’m still working and covered by my employer’s health insurance plan?

If your employer has 20 or more employees, Medicare will deem your group coverage

creditable. If your employer has fewer than 20 employees, coverage is not creditable. If you are receiving creditable insurance coverage from your employer (or your spouse’s employer), you don’t have to sign up for Part B of Medicare until you lose coverage or you/your spouse stops working. But, it makes sense to sign up for Part A as soon as you’re eligible. Some employers also offer Medicare Advantage plans to their retirees.

You cannot have an employer-based Medicare Advantage plan at the same time as having an individual Medicare Advantage plan. Find more information about the specific way Medicare works with your employer plan here.

Q. How can I avoid the late enrollment penalties?

The best way to avoid late enrollment penalties is to know when your Initial Enrollment Period is and sign up in that window. If you don’t sign up in that window, you may not be able to enroll again until the Annual Enrollment Period and could experience a gap in your coverage. Also, the longer you wait, the more the Part B late enrollment penalty can be. It is not a one-time late fee, but an amount added to your monthly premium for as long as you are on Medicare which can really add up.

At Allina Health | Aetna, we know the questions don’t stop once you’ve enrolled in Medicare. Our members can connect with local Member Advocates in person, by phone or virtually about service-related needs, including complex claims, benefit questions and much more.

As you prepare for the milestone of turning 65, you should have all the answers you deserve. Do you still have questions? To learn more or schedule time with a Medicare expert, go online here.