My husband and I both started on Medicare recently.
If you have not yet checked out Medicare's own website, do so.
See this publication in particular: https://www.medicare.gov/medicare-and-you
In addition, I found the following book very informative and easy to understand:
Medicare For Dummies 4th edition (for 2021):
link to Amazon listing:
https://www.amazon.com/Medicare-Dummies-Patricia-Barry/dp/1119689937/ref=sr_1_2?crid=1G6QHJ2VW062C&dchild=1&keywords=medicare+for+dummies+2021+4th+edition&qid=1613569032&sprefix=medicare+for+dummies,aps,185&sr=8-2
I learned all I needed to know from Medicare.gov and from books, but if it's all just too much for you it may be best to get the help of a licensed insurance agent who knows Medicare. Google to find one in your area.
You mentioned your husband's on COBRA and that it will end the first day of the month he turns 65. Medicare begins the first day of the month one turns 65 so there should not be any gap. But it's important to apply for part B a few months before you want it to start, as it takes time for the Part B application to be processed. Also, you can't sign up for a part D prescription plan until you have your Medicare number-- so all the more reason to allow enough time.
Here is some very basic information about Medicare:
Part A starts at 65 and is mostly for hospital care. This is funded by payroll taxes.
Part B is basically for outpatient care (doctor visits, lab work, mammograms, PT etc.) One can start on this at 65 (as I did recently) but if one has other qualifying health insurance one can delay this and get a "special enrollment period" later (as my husband did).
For 2021 the
premium is $148.50 per month. If one receives Social Security the Medicare premium is deducted from one's SS payment each month. Also, if one receives Social Security one is automatically enrolled in Part B at age 65; otherwise one must enroll oneself.
There is also a yearly
deductible for Medicare. For 2021 the deductible is $203.
Some go a different route with
Part C, a.k.a.
Medicare Advantage Plans. These substitute for traditional Medicare Parts A and B and for Medicare Supplement Plans (a.k.a. Medigap, see below) and sometime also include a drug plan that substitutes for Part D. There can be limitation in which doctors are in network, so do your homework carefully if you go this route.
Part D is an outpatient prescription drug plan (that is, meds you take at home, as opposed to meds given to you while in a hospital or in the doctors office.) There is an easy-to-use tool on Medicare.gov (
https://www.medicare.gov/plan-compare/#/?lang=en&year=2021) to help you find the most inexpensive plan for you based on your current meds. You can enroll in a part D plan online through that tool.
You can (and should) use this tool every year during Open Enrollment to re-evaluate whether it will still be the cheapest plan the following year, as plans and formularies change all the time.
While you don't have enroll in Part D it is best to do so; you may not need expensive meds now but if you get a diagnosis later that requires expensive meds, you will wish you had-- and
if you enroll late, there is a penalty for every month for the rest of your life.
There are significant lifelong penalties if one does not sign up for Part B and Part D (or a comparable Part C plan) by the deadlines.
Do NOT miss deadlines.
Medicare Supplement Plans (a.k.a.
Medigap)
These are insurance products that you purchase from an insurance company. The premium can be up to several hundred dollars each month. Why would you want one? Here is why:
Medicare only covers 80% and you are responsible for the other 20% and
there is no out of pocket limit!
This means you could potentially be on the hook for a massive bill if you ever need costly medical care. This is why Medigap plans are so important. Medigap pays the 20% that Medicare doesn't cover. This is very oversimplified but that's it, basically.
There are various Medigap plans -- A through N. They cost different amounts because of what they cover. (e.g. with some plans your premium is lower but there are copays and/or deductibles.) You choose the plan that best fits your budget, your tolerance for dealing with medical bills, how much you travel, etc.) This page on the Medicare website explains:
https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
Every Plan G or Plan N (for example) will cover the exact same things as every other Plan G or Plan N
no matter what state you are in or which insurance company you buy it from. However, every insurance company has its own price for the plans. You can pay more or pay less for the exact same coverage, depending on the company you buy it from, so you need to do some careful shopping. This is where an agent can be particularly helpful if you have time constraints. But you can easily find out which Medigap plans are available in your area by looking at the
Medicare and You publication put out by Medicare. You can call the companies and find out the premiums and choose the one that best suits you. That is what we did.
I just want to add that you should choose your Medigap plan with the long term in mind. If you sign up when your are first eligible you cannot be charged more or denied outright for pre-existing conditions, but if you sign up later, or change plans later, you may be subject to underwriting.
So think about what your medical needs may be later on, because you just may need to keep the same plan for the rest of your life.
