You Are Now or soon to be 65: Welcome to Medicare!
Happy birthday, and Welcome to Medicare! US Citizens and permanent legal residents can qualify for Medicare in the state of New Jersey on the first day of their 65th birthday month. If you were born the first day of the month you will qualify for Medicare the first day of the month prior to your birthday month.
Medicare 101: What Is Medicare?
Medicare is run and administered by the federal government but the plans available to you vary based on the state you live in. If you or your spouse worked in the country for 10 years you can get Medicare Part A (hospital) for no charge however Part B (doctor) of Medicare has a monthly fee to it.
If you are collecting Social Security retirement benefits you are automatically enrolled in Parts A (hospital) and Part B (doctor) when you reach age 65. If if you’re not collecting Social Security you will need to manually enroll in Medicare Part A & B. This can be done by applying through your local Social Security office or on Social Security’s website.
Medicare 101: What Are The Types Of Medicare?
-
Original Medicare -
- Medicare Part A, which covers hospital care, home health, or care in nursing facilities,
- Medicare Part B, which is for doctors, outpatient hospital visits, X-rays, and lab tests.
- Prescription Drug Plan (Part D) - Insurance policies which are regulated by Medicare but run through private insurance companies. These plans help pay the cost of medications but follow a structure regulated by Medicare.
- Medicare Advantage (Part C) - Insurance policies which use private companies to administer your Medicare coverage. These plans must be at least as good as what you would get with Original Medicare, but will have different cost sharing. Many of these plans include additional benefits such as prescriptions (you don’t have to have a separate drug plan) coverage. In New Jersey Medicare Advantage plans are either an HMO or PPO which have networks of doctors and hospitals. It’s important to know whether your doctors and hospitals will accept this option before enrolling.
- Medigap - Also called Medicare supplemental plans. These can help pay the deductibles and coinsurance that are not covered by Original Medicare.
When to enroll in Medicare
-
If you are receiving Social Security benefits before age 65
-
You will be automatically enrolled in Medicare Part A (Hospital) and Part B (Doctor). You may choose to enroll in a Medicare Supplement, Prescription Drug Plan, or Medicare Advantage plan.
-
-
If you are NOT receiving Social Security benefits before age 65
- You will need to apply for Part A (Hospital) and Part B (Doctor) at 65. You can apply for Part A & Part B at Social Security's website or delay enrolling in Medicare because you enrolled in other credible health insurance coverage (typically employer coverage).