It’s no stretch to say we’re all living in very uncertain times where things are rapidly changing. Health guidelines, business operations, and even social gatherings are all being altered minute by minute. And if you’re nearing the age of retirement, you may have another shift coming in your routine. If you’re turning 65 soon, keep reading to learn about Medicare and find out if it’s the right choice for you.

Purpose of Medicare

Medicare was started with the idea that the program would guarantee affordable and comprehensive health care to older populations. This mission is still the basis of what Medicare operates on today. According to the Kaiser Family Foundation, nearly 60 million Americans were Medicare beneficiaries in 2018.

Many would be forced to wipe out their savings or go without care if they did get seriously ill. Medicare works to keep older adults healthy and living longer by providing preventive services and individual protective screenings at low or no cost to recipients. While the majority of qualifying adults choose to enroll in Medicare once they are able, there are a few specific sets of people that may opt-out of Medicare coverage for a few reasons, which we will cover in the next section.

Medicare Eligibility

So, at this point, you may be wondering who exactly is Medicare for? Well, let’s first take a look at who meets Medicare’s basic eligibility requirements:

  • People who are 65 or older
  • Certain younger people with disabilities
  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

Keep in mind, there are additional stipulations about timeframes for enrollment in Parts A and B as well as Medicare Advantage plans vs. Advantage Plans, which can be somewhat complicated. These standards are based on your age, whether you’re still working or retired, and if you’re receiving Social Security benefits.

Also, it’s important for those still employed to understand their company’s health insurance policies when it comes to Medicare enrollment. Usually, as long as you are actively signed up for group health insurance from an employer, you can delay enrolling in Medicare until your employment ends and won’t face late penalties if you wish to join later.

How to Choose the Right Coverage 

Now that you have a better idea of the general rules for Medicare eligibility, let’s take a more in-depth look into the various Medicare coverage options and when you can sign up.

If you’re rapidly approaching your 65th birthday, you’ll want to pay close attention to your “Initial Enrollment Period” dates for Medicare Part A and Part B. These initial enrollment dates start within the three months leading up to you turning 65 and extend to the three months that follow your birthday. This is arguably the best time to sign up for the majority of eligible candidates as missing this enrollment period can result in enrollees paying more out of pocket for premiums, especially those which cover essential medical services.

Once you’ve signed up for Original Medicare, you then become eligible for Medicare Part C, Medicare Part D, or prescription drug coverage and various other Medicare supplemental plans. Because of the complexity of enrollment and Medicare eligibility, it can help to work with a trusted insurance advisor such as Anthem, to ensure you’re getting the coverage you need. Other factors to talk with your advisor about include doctor and hospital choice as well as travel coverage.

Get Started With Medicare

For those approaching Medicare eligibility, now is a crucial time to review your health needs so you can find the right plan for your health and finances. While Medicare is a tremendous asset to many, it’s not without its complexities, and for many, it’s easy to get lost in the fine print. Working with a trusted insurance provider who can help you navigate Medicare’s recent changes can help save your sanity and keep money in your pocketbook.

Cite this article as:
Editorial Staff, "Is Medicare a Viable Choice for You? Find Out," in Medicalopedia, August 5, 2020, [Permalink: https://www.medicalopedia.org/9129/is-medicare-a-viable-choice-for-you-find-out/].