Age 65 is when most people first qualify for the federal health insurance known as Medicare, but people should start thinking about how they want to participate in the program well before that.
People who are newly qualified because they’re turning 65 have a seven-month period to enroll – their birthday month as well as three months before and three months after. For those enrolling later – for example, because they have health insurance from their employer – Medicare has an open enrollment period each year between October 15 and December 7.
People with a chronic health condition or a disability may qualify for Medicare earlier than age 65, according to Deepak Goyal, executive medical director at South Dakota-based Monument Health.
“End stage kidney disease requiring transplantation or dialysis [is one qualifier], as is amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. And there might be some other Social Security disability insurance clauses that could qualify patients for Medicare,” Goyal said. “It’s best to check with Medicare.gov and the Social Security Administration for details.”
Medicare comprises four main parts:
- Part A is hospital insurance
- Part B is used for physician visits
- Part C is a Medicare Advantage plan, which comprises the other three parts
- Part D is used for prescription drugs
New enrollees need to decide whether to use traditional Medicare (Parts A, B and C) or Medicare Advantage. The latter plans tend to have low premiums but limitations such as what medications are covered and which doctors enrollees can see.
There’s also another type of private insurance, called Medigap, that can help fill some of the holes left uncovered by traditional Medicare in Parts A, B, and D.