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TroveStreet® Wisdom

TroveStreet® Wisdom: Enrolling in Medicare and Medicaid

Medicare and Medicaid have provided millions of Americans with healthcare coverage — regardless of socioeconomic status — since 1965. But not all Medicare and Medicaid plans are equal. We’ve put together some quick tips to help you get the most out of your coverage.

Understanding Medicare

Medicare is a federally funded health insurance program for adults 65 and over, or those under 65 with a disability. Whether you’re enrolling for the first time or choosing a new plan, keep these five things in mind:

  1. Medicare is highly personalized. Just because one plan is right for your neighbor or spouse doesn’t mean that plan is right for you. There are four different types of Medicare plans: Part A, Part B, Part C, and Part D. Each part covers different services. You can enroll in one or a combination. Compare Medicare plans.
  2. There is a specific window of time to enroll. Your initial enrollment period begins three months before the month you turn 65 and continues for three months after. If you do not enroll for Medicare within that time, you must wait until annual open enrollment between Oct. 15 – Dec. 7. This not only delays your coverage, but results in fees.  If you collect social security before age 65, you will be automatically enrolled and receive your Medicare card in the mail.
  3. Choosing a Medicare plan is not a one and done decision. Plans change every year, and it’s important to stay updated on how those changes may affect your coverage. If you find your plan doesn’t work for you, you can make a one time change to your plan during the open enrollment period (Jan. 1 – Mar. 31).
  4. Consider supplement plans. These are plans outside of Medicare that supplement the cost of what Medicare does not pay for, such as copays and deductibles. These plans do not offer additional health coverage. Learn more about supplement plans.
  5. Do your research and get professional advice. The choices you make at the beginning of your Medicare journey will shape the options available to you later. For example, the first time you enroll in Medicare may be the only time you can get a supplement plan without being asked about preexisting conditions.

As you age into Medicare, you will automatically receive a handbook (from Medicare) that provides an overview of how it works and the plans available to you. 

It’s also recommended to seek additional support from an independent agent.  They review your circumstances and share what are the best options for you, regardless of the insurance company.  This means you receive confidential and unbiased recommendations. 

The Pennsylvania Medicare Education and Decision Insight (PA MEDI), formerly known as APPRISE, also offers unbiased Medicare education to help you make the most informed choice about the Medicare options.  This service is offered through the York County Area Agency on Aging.  You can also contact Medicare directly.

Understanding Medicaid

Unlike Medicare, Medicaid is a federal and state program that provides health coverage to low-income families. To find out if you qualify, contact the County Assistant Office or visit COMPASS, Pennsylvania’s online health and human services platform.

If you qualify for Medicaid, the York County Area Agency on Aging can also help you through the application process.

Avoiding Insurance Scams

Sadly, financial and insurance scams and fraud cost older adults $3 billion every year. These resources can help you know what to look for and how to protect yourself.

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