Understanding your Medicare coverage options and finding a plan that suits your health care needs is important to your overall health. To make this process easier, this webpage contains the following to provide the information you need:
- Important dates for enrolling or changing plans
- Resources to support your decision
- Medicare plans accepted at MU Health Care
- Differences between Original Medicare and Medicare Advantage
- Answers to commonly asked questions
Medicare Enrollment: Dates to Know
January 1 – March 31: Medicare Advantage Open Enrollment Period
If you have Medicare Advantage coverage, you can make a one-time change in plans during the Medicare Advantage Open Enrollment Period January 1 through March 31, 2025 During this period, you can switch to a different Medicare Advantage plan or to Original (Traditional) Medicare. If you make a Medicare Advantage change during the January-March enrollment period, your coverage will go into effect on the first of the month following the month you enroll. For example, if you make a change during the month of February, your coverage will begin on March 1.
October 15 – December 7: Medicare Annual Enrollment
Anyone with Original Medicare, Medicare Advantage or Medicare Supplements have the opportunity to change during the Medicare Annual Enrollment Period in the fall, from October 15 through December 7, . During this period, you can make changes to your Medicare plan if you wish.
Your 65th Birthday
The initial enrollment period for Medicare occurs around your 65th birthday. You can enroll starting 3 months before you turn 65 and have until 3 months after you turn 65 to enroll in a plan. If you are working at the age of 65 and have insurance through your employer, there is a special enrollment period for you to sign up once you retire.
Resources for Our Patients
If you would like more information about your coverage options, visit Medicare.gov/plan-compare to compare plans, call 1-800-MEDICARE (1-800-633-4427) or contact your local insurance agent.
MU Health Care participates with the following Medicare plans:
- Medicare Advantage
- Aetna
- Anthem Blue Cross Blue Shield (terminating March 31, 2025)
- Humana
- United Healthcare
- Wellcare (Centene)
- Original Medicare and all Medicare Supplements
- Medicare Part A (hospital insurance). Medicare Part A helps cover inpatient care in hospitals, skilled nursing facilities, hospice and home health care.
- Medicare Part B (medical insurance). Medicare Part B helps cover services provided by doctors and other health care providers, outpatient care, durable medical equipment and home health care. It also helps cover some preventive services.
- Medicare Supplements (private insurance). Medigap helps patients pay for out-of-pocket costs, including deductibles, copays, coinsurance and more.
Most people pay a monthly Medicare Part B premium. If you have limited income and resources, you may qualify for help with paying your Medicare Part B premium and/or prescription drug coverage costs. You can apply for help at your Family Support Division county office.
What is the Difference Between Original Medicare and Medicare Advantage?
| Original/Traditional Medicare | Medicare Advantage |
|---|---|
| Government-owned | Private insurance |
| Part A covers hospital care. Part B covers medical/doctor appointments. Part D covers prescription and pharmacy benefits. | Medicare Advantage is also known as "Medicare Part C" and includes Part A, Part B, and usually Part D. |
| Visit any doctor or hospital in the U.S. that takes Medicare. | You can see the physicians and hospitals in your plan's network and service area. |
| Rarely requires referrals. | Prior authorizations are required before certain types of care can be delivered or paid for. |
| Easier to get specialty care, like hospital visits, surgeries, and skilled nursing or rehabilitative care. | Often requires prior approval for specialty care, which may result in delays in care and denials for payment. |
| Some benefits like eye exams, routine dental, and hearing care are not covered. | Some plans may cover benefits like vision, hearing and dental services. |
| Medigap Supplement Insurance (Medigap) can cover 20% out-of-pocket costs. | Out-of-pocket costs will vary. |
| Separate premium for Medicare drug coverage (Part D). | Most plans include Medicare drug coverage (Part D). |
| There is no annual limit on out-of-pocket costs. | There is an annual limit on out-of-pocket costs. |
Frequently Asked Questions
How to Sign Up for Medicare and Understanding Your Options
What Medicare plan(s) do I need?
For Original Medicare, you need Part A (hospital care, home health, and hospice) and Part B (doctor visits, labs, and outpatient services). You may also sign up for Part D (prescription drugs).
Part C is Medicare Advantage, obtained through private insurance.
When can I enroll in Medicare?
The initial enrollment period is within the 3 months before you turn 65, including the month you turn 65, and ends 3 months after the month you turn 65 (7 months total). Some individuals under 65 are eligible with disability benefits from Social Security or the Railroad Retirement Board.
Original Medicare and Medicare Advantage:
Medicare Annual Enrollment is October 15 through December 7 each year. You can change plans as often as you'd like during this period.
Medicare Advantage Open Enrollment is January 1 through March 31. You can make a one-time change (only if you are enrolled in a Medicare Advantage plan) during this period to Original Medicare (Part A and Part B) or a different Medicare Advantage plan.
Where can I sign up?
Depending on which Medicare plan you want to enroll in, there are two different locations:
Original Medicare
If you are 65 and older, you can sign up for Medicare Parts A and B on the Social Security website (SSA.gov/Medicare-sign-up) or call the Social Security Office Monday through Friday, 8 a.m. to 7 p.m. at 1-800-772-1213. You can also call Medicare at 1-800-633-4227.
Medicare Advantage
You can enroll at Medicare.gov/plan-compare or call Medicare at 1-800-633-4227.
How do I learn more about Medigap supplemental plans?
Medigap supplemental plans help patients pay for out-of-pocket costs, including deductibles, copays, coinsurance and more, and require separate enrollment, which can sometimes take up to 30 days to take effect. Also note that if you leave a Medicare Advantage Plan, pre-existing conditions could impact the cost for your Medigap policy.
Visit Medicare.gov/medigap-supplemental-insurance-plans to compare plans in your area.
Is it possible to change my insurance plan?
Yes. Patients who have Medicare Advantage coverage have a few opportunities to adjust their Medicare Advantage coverage.
You can make a one-time change to your Medicare Advantage coverage during the Open Enrollment Period January 1 through March 31. During this period, you can switch to a different Medicare Advantage plan or to Original Medicare. If you make a Medicare Advantage enrollment change during the January-March change period, your coverage will go into effect on the first of the month following the month you enroll. For example, if you make a change during the month of February, your coverage will begin on March 1.
You also have an opportunity to change during Annual Enrollment Period in the fall, from October 15 through December 7. During this period, you can make changes to your Medicare plan as often as you'd like.
For assistance comparing Medicare plans, visit Medicare.gov/plan-compare, call 1-800-MEDICARE (1-800-633-4227) or contact your local insurance agent.
In what Medicare plans does MU Health Care participate?
MU Health Care participates with the following Medicare plans:
Medicare Advantage
• Aetna
• Anthem Blue Cross Blue Shield (terminating March 31, 2025)
• Humana
• United Healthcare
• Wellcare (Centene)
Original Medicare and all Medicare Supplements
How do I know which plan is best to choose?
For assistance comparing Medicare plans, visit Medicare.gov/plan-compare, call 1-800-MEDICARE (1-800-633-4227) or contact your local insurance agent.
To learn more about Medicare Supplement plans, visit Medicare.gov/medigap-supplemental-insurance-plans to compare plans in your area.