The Path to Medicare is Different for Everyone

You may be preparing for retirement and transitioning from employer-sponsored coverage. Perhaps you’re downsizing and looking for a fitness benefit that includes the gym near your new condo. Maybe you want help meeting your wellness goals or managing your diabetes and high blood pressure. No matter what your situation, it’s important to find a health plan that meets your changing health needs.

The Polyclinic Can Help You Navigate Your Medicare Options

There are many considerations when choosing a Medicare plan. We’re here to help answer your questions and connect you with experts and resources whether you’re just turning 65 or have been enrolled in Medicare for years.

What is Medicare?

Original Medicare is run by the federal government and provides health insurance to U.S. citizens and qualified legal residents age 65 and older. People under 65 with certain medical problems also qualify for it.

How to sign up for Medicare?

Whether you are already enrolled in a plan or first starting to look at your options, it’s important to know the different Medicare enrollment periods and what actions you can take during each period. Enrollment periods include:

1. Initial Enrollment Period (IEP) - seven-month window beginning three months before and ending three months after your 65th birthday

2. Annual Enrollment Period (AEP) - runs from October 15 to December 7. This is your annual window to make changes to your plan for the upcoming calendar year.

3. Open Enrollment Period (OEP) - runs from January 1 to March 31. This period is primarily for those who have enrolled in a Medicare Advantage plan and want to make changes.

4. Special Enrollment Period (SEP) - occurs when certain qualifying events happen in your life. For instance, one may be when you move to a new service area. Or within the first 12 months of your first enrollment in an MA plan, you have a one-time opportunity to change back to a Medigap policy.

Consider a Medicare Advantage Plan

At The Polyclinic, our focus is to keep you healthy, out of the hospital, and doing what you love most. As your health care provider, we recommend Medicare Advantage plans because they allow us to coordinate your care in a personalized and comprehensive way, working closely with your primary care provider and insurance company.

Get More From Your Medicare Plan

Medicare Advantage plans must include the same benefits as Original Medicare and often offer additional programs and features,* such as:

  • annual physicals
  • gym memberships
  • vision coverage
  • dental coverage
  • emergency care when traveling internationally

Supplemental or “Medigap” plans can help pay for out-of-pocket costs that Original Medicare doesn’t cover, but any extra benefits—such as prescription drug coverage and health and wellness programs—must be purchased separately and costs can add up quickly. Many Medicare Advantage patients enjoy the convenience of medical and prescription drug coverage all in one easy-to-use plan.

Preventive Care Coverage

While annual physicals are not covered by Medicare, wellness visits and specialized screenings are covered by most Medicare Advantage plans. If you have any kind of chronic condition, we will want to see you several times each year to ensure that we are on top of your conditions and that you are learning skills to monitor and take good care of yourself.

Additionally, Medicare offers an Annual Wellness Visit which complements the care we provide you throughout the rest of the year. An Annual Wellness Visit emphasizes preventive measures along with screening for common problems that are more likely to bother people as they get older. Specifically, these include issues like arthritis and pain, memory troubles, and balance problems.

Ready to Learn More?

*Extra benefits vary by plan; not all Medicare Advantage plans offer the complete selection of extra benefits mentioned. Some benefits may be available at an additional premium.

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