If you’re new to Medicare, this checklist can guide you step-by-step through the process. Our local Medicare agents can help you understand everything you need to know about Medicare plans NC if you’re based in North Carolina. It’s also important to realize that If your needs change after selecting a plan, you can make changes during specific times of the year. Let us help you compare your options.
Health Plans of NC, Kelly Quinn
The first step is to confirm whether you’re signed up for Original Medicare, also known as Basic Medicare. Original Medicare consists of Part A, hospital insurance, and Part B, medical insurance. At minimum, ensuring you’re signed up for Part A hospital insurance is a good idea.
Your Medicare Initial Enrollment Period usually occurs around your 65th birthday. Understanding when your enrollment period begins and ends is essential to ensure you’re fully covered. Missing the period can also mean you’re subject to late fees.
The enrollment period starts three months before you turn 65 and continues the month of your birthday and three months after your birthday. Also, note that if your birthday is on the 1st of the month, your initial enrollment period begins four months before your birthday. It’s also possible to qualify for Medicare before reaching your 65th birthday month if you have a disability or illness.
Automatic Enrollment for Original Medicare Part A and Part B
You may be automatically enrolled in Medicare Part A and Part B in some instances. For example, if you’re already receiving Social Security benefits, you will be automatically enrolled by your 65th birthday. If you have been automatically enrolled, you’ll receive a red, white, and blue Medicare card approximately three months before your 65th birthday.
Option to Delay Medicare Part B
You may want to delay enrolling in Medicare Part B, depending on your circumstances. The most common reason for postponing Part B is if you are currently covered by your employer’s health plan. Suppose you discover that staying with your employer-based health plan will save you money. In that case, you can delay enrollment in Part B by consulting the information in your Welcome to Medicare Packet.
If you’re considering delaying enrollment in Part B, be mindful that several Original Medicare coverage options require enrollment in Part A and Part B. If you’re in North Carolina, one of our specialized Medicare agents can help you assess what’s best for you.
Although there’s typically no monthly premium with Medicare Part A, there usually is for Medicare Part B, which is based on your income. If you have similar coverage through your employer, check with your employer’s group health insurance plan administrator to determine how Medicare Part B coverage works. If you have questions, contact one of our local NC Medicare agents.
The best time to enroll is during your Initial Enrollment Period (IEP), around your 65th birthday. You can enroll in several ways:
Visit SSA.gov and enroll online.
Visit your local Social Security office in person.
Call the Social Security office at 1-800-772-1213 (TTY users call 1-800-325-0778). You can call from 8 AM to 7 PM Monday through Friday in all US time zones.
If you don’t enroll during your IEP period, you must wait until the Medicare General Enrollment period. This enrollment period runs from January 1 to March 31 each year. Your coverage will begin on July 1 of the same year. It’s essential to be aware that you may have to pay late enrollment penalties and that these penalties increase over time.
There are two ways to get your Medicare Part A and Part B benefits:
Medicare Advantage (Also known as Part C)
The Medicare Advantage program allows you to get Medicare coverage through a private insurance company approved by Medicare. The Medicare Advantage plan covers some benefits that Original Medicare doesn’t. For example, routine vision, hearing, and dental coverage are not included in Original Medicare but may be covered with a Medicare Advantage plan. Additional benefits may consist of fitness plans or allowances for eyeglasses.
Directly through the Government
When you receive Original Medicare coverage by default, it’s through the government.
You can enroll in a stand-alone Medicare Part D Prescription plan to stay with the Original Medicare (Basic Medicare) plan but add expanded features. You can also purchase a Medicare Supplement (Medigap) insurance plan to help pay the out-of-pocket costs of Original Medicare.
Medicare Supplement plans are guaranteed to be issued during your 6-month Medigap Open Enrollment Period, which starts the first month you have Medicare Part B. There are no health questions to answer during that period. Be aware that you may be turned down outside the enrollment period or have to pay higher premiums if you have health problems.
Remember, Original Medicare and Medicare Supplement plans do NOT cover:
Prescription drugs
Routine Vision, Dental, or Hearing visits
When choosing Medicare coverage, carefully consider your health needs and options. Also, consider your budget and other factors, such as your family health history.
Before you make any decisions, it's a good idea to compare Medicare plans in North Carolina. Comparing Medicare Advantage versus Original Medicare (with optional Medicare Part D and Medicare Supplement insurance) can help you understand the best option for you. Contact our agents directly if you need any assistance with Medicare plans in North Carolina.
Once you’ve compared the options available, it’s time to choose your Medicare coverage.
Most plans require you to enroll in both Medicare Parts A and B. Although coverage plans may have different enrollment dates, you can usually enroll during your IEP.
Plans often have monthly premiums, though some Medicare Advantage plans don’t have any premiums. When considering monthly costs, make sure you assess your health needs. Paying a monthly premium may mean more money out of your pocket now, but it can save you money in the long run when you require care. There is also a monthly premium for Medicare Part B, based on your income.
It is possible to change your Medicare plan if your needs change. For example, suppose you signed up for Original Medicare during your IEP but now want expanded coverage. In that case, you can update your plan during the annual enrollment period. This is from October 15 to December 7.
Changes are also possible during the Medicare Advantage Open Enrollment Period from January 1 to March 31. However, during the Medicare Advantage Open Enrollment Period, you cannot change from Original Medicare to a Medicare Advantage plan. You also can’t join, switch, or drop a Medicare prescription drug plan.
If you’re interested in discussing Medicare plans in NC, you can easily compare plans online or chat with one of our specialist agents. We can provide open enrollment tips, inform you about Medicare Advantage's open enrollment period in 2022, and answer any specific NC open enrollment questions. We’re passionate about helping people in North Carolina find the right coverage for them. Contact us today.