New to Medicare

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Whether you're eligible for Medicare insurance coverage now or will be soon, Prevea360 Medicare Advantage provided by Dean Health Plan is here to help you understand your Medicare coverage options. We also offer Medicare Educational Sessions throughout the year to discuss everything you need to know about Medicare coverage.

Medicare Basics

New to Medicare? Shopping during Annual Enrollment?

This short video is a smart start for anyone new to Medicare and anyone shopping options during the Annual Enrollment Period. Learn what Medicare Advantage options are available to you.

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Eligibility
You are Medicare-eligible if you are a legal U.S. resident and one of the following applies to you:
  • You are age 65 or older
  • You are any age and have a qualifying permanent disability
  • You are any age and have been diagnosed with end-stage renal disease (ESRD)

The ABCDs of Medicare

Once you decide to join Medicare, you have a few different options. The federal government refers to these Medicare benefits and options as Parts A, B, C and D.
 
No matter which option you choose, the first step is the same: Enroll in Original Medicare, also known as Parts A and B.
 

Original Medicare is Parts A and B

To those enrolled in Medicare, the federal government provides hospital insurance/coverage for inpatient care (Part A) and medical insurance/coverage for outpatient care (Part B). For example, Part A covers hospital room stays and home health services, and Part B covers doctor visits and durable medical equipment.
 

Take Advantage with Parts C and D

Original Medicare doesn’t cover everything. Many Medicare recipients elect to buy additional coverage from private insurance companies, and many choose Medicare Advantage plans, also known as Part C.
Members often find that these plans cover deductibles, set an annual out-of-pocket maximum, provide additional benefits not covered by Original Medicare and provide coverage for prescription drugs, also known as Part D.

Medicare enrollment periods

Annual Enrollment Period (AEP)

You can make changes to your medical and prescription drug coverage every year from Oct. 15–Dec. 7. Your changes are effective Jan. 1.
 

Initial Enrollment Period (IEP) 

This is the seven-month period in which you can enroll in Medicare for the first time. If you are enrolling for the first time due to disability, your IEP timing is based on your disability date.
 

Special Enrollment Period (SEP) 

This is a period when Medicare recipients may change medical and prescription drug coverage outside of AEP, if they meet certain requirements and have a qualifying event, such as moving to a new service area or leaving an employer-based plan.
 

Enroll online

If you are new to Medicare or if you qualify for special enrollment, you can enroll in a Prevea360 Medicare Advantage plan using our online portal.
 
Questions about your qualifications? Contact Prevea360 Medicare Advantage Sales Support at 1-877-234-0126 (TTY: 711).
 
For more information about Medicare eligibility and enrollment policies and limitations, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
 

Medicare booklets

 

What is Medicare

Medicare is a Health Insurance Program for:
  • People age 65 or older.
  • People under age 65 with certain disabilities.
  • People of all ages with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant).
 
You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in Original Medicare. You may want to consider a Medicare Prescription Drug Plan to add drug coverage. Or, you may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D coverage. You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall.
 
As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have Original Medicare, or you belong to a Medicare Advantage Plan (like an HMO or PPO). For more information see the Your Medicare Coverage database.
 

Who is Eligible?

Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. 
 
If you aren't yet 65, you might also qualify for coverage if you have a disability or with end-stage renal disease (permanent kidney failure requiring dialysis or transplant).
 
Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:
  • You already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You are eligible to get Social Security or Railroad benefits but haven't yet filed for them.
  • You or your spouse had Medicare-covered government employment.
 
If you are under 65, you can get Part A without having to pay premiums if you have:
  • Received Social Security or Railroad Retirement Board disability benefits for 24 months.
  • End-stage renal disease and meet certain requirements.
 
While you don't have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. The standard Part B premium amount is $134 (or higher depending on your income). However, most people who get Social Security benefits will pay less than this amount ($109 on average). This is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you don't get any of the above payments, Medicare sends you a bill for your Part B premium every three months.
 
Note: You will be eligible for Medicare when you turn 65 even if you are not eligible for Social Security retirement benefits.
 

What are the parts of Medicare?

Medicare Part A (Hospital insurance)

  • Helps cover inpatient care in hospitals (includes critical access hospitals, inpatient rehabilitations facilities and long-term care hospitals).
  • Helps cover skilled nursing facility (not custodial or long-term care), hospice and home health care services.
 

Medicare Part B (Medical insurance)

  • Helps cover doctor services and outpatient care.
  • Helps cover some preventive services to help maintain a person’s health and keep certain illnesses from getting worse.
  • Generally pays 80% of the Medicare-approved amount for covered services.
 

Medicare Part C (Medicare Advantage Plans)

  • A way to get Medicare benefits through private companies approved by and under contract with Medicare.
  • Includes Part A, Part B and usually other benefits Medicare doesn’t cover. Most plans also provide prescription drug coverage.
 

Medicare Part D (Prescription drug coverage)

  • Run by private companies approved by Medicare, which can either be Medicare Advantage Plans or separate Medicare Prescription Drug Plans.
  • Helps cover prescription drug costs.
  • Each plan can vary in cost and drugs covered.
 

Medicare Contacts (for Wisconsin Residents)

  • If you live outside of Wisconsin and are looking for contact information, or the agency you are looking for is not listed, see the government Medicare site.
Organization name Agency name Can answer my question about Contact information
1-800-Medicare 1-800-Medicare General Medicare and health plan information, ordering Medicare booklets Toll Free: 800-633-4227
24 hours a day/7 days a week
CMS RO Centers for Medicare & Medicaid Services Regional Office CMS, Chicago Regional Office Information on local seminars and health fairs on Medicare health plan choices or to report a complaint directly to CMS. Toll free: 312-353-7180
See website
Railroad Retirement Board (For Railroad Retirement beneficiaries only) Railroad Retirement Board (RRB) RRB benefits, lost RRB Medicare card, address change and enrolling in Medicare Toll free: 877-772-5772
See website
State Health Insurance Assistance Program Wisconsin  - SHIP Medigap policies, long-term care insurance, Medicare health plan choices, Medicare rights and protections and help with filing an appeal Toll free: 800-242-1060, Local: 608-267-3201, Spanish: 888-701-1255
See website
Social Security Administration Social Security Administration (SSA) Address changes, Medicare Part A or Part B, lost Medicare card and Social Security benefits. Toll free: 800-772-1213 See website
State Department of Insurance Office of the Commissioner of Insurance of Wisconsin Medigap policies available in my area and insurance questions Toll free: 800-236-8517, Local: 608-266-3585
See website