Each year, the Centers for Medicare and Medicaid Services (CMS) releases a handbook titled Medicare & You. The handbook, which is made available to all current and future Medicare beneficiaries, is published in the fall for the upcoming year.
The Medicare & You 2020 guide is now available.
Below is a review of the 2019 Medicare & You guide.
Where to get Medicare & You 2019
If you are currently enrolled in Medicare, you should have received a printed copy of Medicare & You 2019 by the end of October, 2018. If you have not received your copy, please call 1-800-633-4227 to request one.
Whether or not you are enrolled in Medicare, you may view an electronic version of Medicare & You 2019 and you can download it if you wish.
What does Medicare & You 2019 cover?
Medicare & You 2019 is 120 pages long, but here is a brief summary of what you can expect to find in the guide.
- Information about your new Medicare card
Medicare beneficiaries are set to receive a new Medicare card in the mail by April of 2019. Medicare & You 2019 contains information about the new card and what to do with your old Medicare card.
- Your Medicare options
If you’re new to Medicare or are considering other Medicare plan options outside of Original Medicare (Medicare Part A and Part B), the handbook includes information about Medicare Advantage (Part C), Medicare Part D prescription drug plans and Medicare Supplement Insurance (Medigap).
- Signing up for Medicare
There are a number of key dates and enrollment periods during which you can sign up for Medicare. Medicare & You 2019 helps explain Medicare enrollment and can help guide you as you sign up.
- Medicare and private insurance
There are situations in which Medicare can work in tandem with private insurance such as employer coverage. The handbook outlines some of the details of what you can expect, such as who is your primary payer and your secondary payer.
- Medicare costs
Although Medicare is government-funded, there are plenty of Medicare out-of-pocket costs for beneficiaries to know about.
- What Medicare covers
Medicare covers a wide range of services and items, and the Medicare & You guidebook discusses many of these in detail.
- Financial assistance for Medicare
Medicare & You 2019 includes information about Medicare Savings Programs and other resources for beneficiaries who need some financial assistance to help cover some of their Medicare costs.
- Medicare rights and fraud prevention
The handbook discusses your rights as a Medicare beneficiary and includes information about Medicare fraud and identity theft.
- Additional Medicare resources
Medicare & You 2019 includes a number of resources available to beneficiaries seeking answers to common Medicare questions, including the contact information for all State Health Insurance Information Programs (SHIPs).
Your local SHIP can provide free and confidential counseling to help you understand your Medicare coverage.
There are many Medicare terms to understand, and the guidebook includes a glossary of definitions for your reference.
The better you understand Medicare, the more effectively you may be able to use your benefits. Use Medicare & You 2019 to learn the ins and outs of the Medicare program or call 1-800-MEDICARE with any questions.
Understanding the basics of Medicare
There are four basic parts of Medicare, as well as Medicare Supplement Insurance:
- Medicare Part A
Part A provides coverage for inpatient care at you receive hospitals and skilled nursing facilities. Everyone who is enrolled in Medicare will typically have Part A.
- Medicare Part B
Part B provides coverage for doctor’s appointments and other types of outpatient care, along with durable medical equipment (DME). Part B is optional for all beneficiaries.
- Medicare Part C
Also known as Medicare Advantage, this type of Medicare insurance provides all of the same benefits as Part A and Part B combined into a single plan.
Many Medicare Advantage plans also offer some additional benefits not covered by Original Medicare (Part A and Part B). Some of these extra benefits may include coverage of prescription drugs, routine dental and vision coverage, hearing aids and gym memberships.
- Medicare Part D
Part D plans provide coverage exclusively for prescription drugs. Most Medicare Advantage plans include Part D coverage. If you have Original Medicare, you may also be able to enroll in a Part D plan.
- Medicare Supplement Insurance
Also known as Medigap, these plans are used to supplement your Part A and Part B coverage.
A Medigap plan helps fill in the gaps left by Original Medicare by covering certain costs such as deductibles, coinsurance, copayments and other out-of-pocket Medicare expenses.
You can have a Medigap plan if you have Medicare Part A and Part B. You can also have Part A, Part B, a Part D drug plan and a Medigap plan.
Medigap and Medicare Advantage plans are not the same thing. You cannot be enrolled in a Medigap plan and a Medicare Advantage plan at the same time.
Part A and B of Medicare are provided by the federal government. Medicare Advantage, Medicare Part D and Medicare Supplement Insurance are sold by private insurance companies.
How much does Medicare cost?
Each type of Medicare coverage can come with its own costs.
- 2019 Part A costs
Most people do not pay a premium for Part A of Medicare. You may qualify for premium-free Part A if you worked and paid Medicare taxes for at least 40 quarters (10 full years).
If you paid Medicare taxes for fewer than 40 quarters, your Part A coverage will require a premium of either $240 or $437 per month in 2019, depending on the number of quarters you paid Medicare taxes.
- 2019 Part B costs
Most beneficiaries pay the Part B standard premium of $135.50 per month.
However, higher income earners may more for their Part B coverage. This higher amount is called the Income-Related Monthly Adjusted Amount, or IRMAA.
The highest income earners will pay $460.50 per month for their Part B coverage in 2019.
Medicare Advantage, Medicare Part D and Medicare Supplement Insurance do not have standardized costs because they are sold by private insurance companies. The premiums for these plans will typically vary according to location, carrier and plan selection.
In addition to monthly premiums, Medicare Advantage plans and Part D plans may feature deductibles and cost-sharing requirements like copayments or coinsurance.
Some Medicare Advantage plans feature $0 premiums, and some Part D plans may offer $0 deductibles. Plan costs and availability may vary by location.
How do I sign up for Medicare?
There are a few different times of the year (Medicare enrollment periods) during which you may be able to enroll in different types of Medicare plans, which include your Medicare Initial Enrollment Period and the Medicare Annual Enrollment Period.
Initial Enrollment Period (IEP)
Medicare beneficiaries are given an Initial Enrollment Period when they first become eligible for Medicare.
This period begins three months before you turn 65 years old, includes the month of your birthday and continues for another three months.
During this time, you may be able to enroll in different types of Medicare coverage, depending on your eligibility.
Annual Enrollment Period (AEP)
The Annual Enrollment Period (also known as the Medicare Open Enrollment Period for Medicare Advantage and prescription drug plans) lasts from October 15 to December 7 each year.
Depending on your situation, you may be able to make a number of changes to your Medicare coverage during this fall open enrollment period, such as adding, switching or dropping a Medicare Advantage plan or a Medicare Part D plan.
What if I have additional Medicare questions?
If you have questions about the Medicare coverage options available where you live, such as Medicare Advantage plans that may offer prescription drug coverage, you can get the answers you need by calling to speak with a licensed insurance agent.
Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.