When’s the right time to enroll in Medicare coverage or switch plans?

You’re not alone if you need to make important decisions on your Medicare coverage. This article is a good start to getting your questions answered. If you’re turning 65 soon, or if you’re currently receiving both Medicare and Medicaid benefits and want to switch your Medicare plan, keep reading for some helpful tips on how to enroll and get the most out of your new Medicare benefits. You’re eligible to apply for Medicare three months before the month you turn 65 and three months after your birth month (seven months total). If you’re a dual-eligible member, you can change from Original Medicare to a Medicare Advantage plan at any time, or vice versa. You can also change from one Medicare Advantage plan to another.

In order to be eligible for a Medicare Advantage plan, you must already be enrolled in Original Medicare (Parts A & B) and cannot have End-Stage Renal Disease (ESRD-Kidney Failure).

There are four different parts (or types) of Medicare coverage—Original Medicare (Parts A & B), Medicare Advantage (MA) plans (Part C), and Prescription Drug Plans (Part D or PDP). While most Medicare Advantage plans include Part D prescription drug coverage (MAPD), you should always ask if it’s also part of your benefits before you enroll.

To get the most savings, you’ll want to pick a Medicare plan that best reflects your healthcare needs so that you can control your out-of-pocket costs. To avoid being surprised by any additional expenses, be sure to ask about the deductibles and copays that will apply to your new Medicare plan. You should also check to see if your current doctors and/or specialists are in-network, since that may also affect your future costs.

If you enroll in a Medicare plan that provides Part D prescription drug coverage, you’ll be able to avoid extra costs at the pharmacy. Remember, Original Medicare doesn’t cover prescription drugs, so you may want to enroll in a standalone Prescription Drug Plan (PDP) or join an MAPD plan to make your medications more affordable.

If you have limited income and resources, you might be able to get help paying your premiums, deductibles, and copays. Just call your Local Department of Social Services to find out more.

Medicare Advantage (MA) plans offer many health and wellness benefits that Original Medicare doesn’t, such as access to dental, vision, and hearing care; transportation services; alternative medicine; and over-the-counter (OTC) drug programs. While all MA plans cover preventive dental care, the MA benefits offered through some health insurance plans (e.g., Healthfirst) also cover comprehensive dental care (such as root canals, crowns, and dentures). Having this benefit could help minimize your out-of-pocket expenses.

If you’re not enrolled in Medicare Part A or B yet, just call Social Security at 1-800-772-1234 or visit www.ssa.gov to get started. If you fail to enroll during your Special Enrollment Period, you must wait until the General Enrollment Period (GEP), between January 1 and March 31. You may have to pay a 10% premium penalty for every year you’re not enrolled in Medicare Part B. You also won’t have coverage for doctor’s visits, flu shots, physical therapy, lab tests, or X-rays until you enroll.

Are you looking for more help with choosing the right Medicare plan for your needs and budget? Look to Healthfirst for a variety of Medicare Advantage plans that will give you access to the care you need, when you need it. Just visit www.healthfirst.org or call 1-844-787-3487.

Healthfirst Medicare Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-305-0408 (TTY 1-888-867-4132). 1-866-305-0408 (TTY 1-888-542-3821).