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Medicare Basics

How Does Medicare Work?
Medicare has four basic parts that help with health care costs. Each part provides coverage for different types of health care services.
  • Part A: Hospital insurance
  • Part B: Medical insurance
  • Part C (Medicare Advantage): Includes Parts A and B, sometimes Part D
  • Part D: Outpatient prescription drugs
When are you eligible for Medicare?

If you answer YES to at least one of the following questions, you may be eligible.

  • Are you age 65 or older and have Social Security or Railroad Retirement Board benefits?
  • Are you under age 65 with certain disabilities?
  • Do you have ALS (amyotrophic lateral sclerosis) or, at any age, End-Stage Renal Disease?
  • Have you or your spouse worked for at least 10 years in Medicare-covered employment?

In order to be eligible for a Medicare Supplement Insurance Plan, or a Part C or Part D plan, you must be enrolled in Medicare Part A and Medicare Part B.

You must continue to pay your Medicare Part B premium.

If you answer YES to at least one of the following questions, you may be eligible.

  • Are you age 65 or older and have Social Security or Railroad Retirement Board benefits?
  • Are you under age 65 with certain disabilities?
  • Do you have ALS (amyotrophic lateral sclerosis) or, at any age, End-Stage Renal Disease?
  • Have you or your spouse worked for at least 10 years in Medicare-covered employment?

In order to be eligible for a Medicare Supplement Insurance Plan, or a Part C or Part D plan, you must be enrolled in Medicare Part A and Medicare Part B.

You must continue to pay your Medicare Part B premium.

When do I enroll?

If you are nearing 65, you can enroll in Medicare during the seven months of the initial enrollment period. The initial enrollment period includes the three months before your 65th birthday, the month of your 65th birthday and the three months after the month of your 65th birthday.

 

Medicare Part A: Hospital Insurance
  • If you are getting benefits from Social Security, you automatically get Part A benefits starting the first day of the month that you turn 65.
  • You will receive a package of information from Medicare at the beginning of your initial Medicare enrollment period.
  • The package will contain your Medicare card and information about your benefits.
  • For most people, Medicare Part A is free.

 

Medicare Part B: Medical
  • There are three opportunities to sign up for Part B: the initial Medicare enrollment period, the special Medicare enrollment period and the general Medicare enrollment period.
  • If you or your spouse are still working and are enrolled in a group health plan, you may decide to delay enrolling in Part B until you retire. This is because you may have “Creditable Coverage”; check with your employer benefits administrator to see if this applies to you. Then you may be eligible for the “Special Enrollment Period” once you retire.

There are three enrollment periods for Medicare.

 

Initial Enrollment Period General Enrollment Period Special Enrollment Period
Who is eligible? People turning 65 or have been receiving Social Security Disability benefits for 24 months People who missed the Initial Enrollment Period or declined or canceled Medicare Part B coverage and did not have any other coverage People who have employer or union medical benefits or dropped prior Part B coverage to return to work. COBRA and retiree health plan participants are not eligible for a Special
Enrollment Period.
When is the enrollment period? Seven months that include:

  • 3 months before your 65th birthday month
  • Your 65th birthday month
  • 3 months after your 65th birthday month
January 1 to March 31 each year
During this time, you may enroll in Part B, but your benefits will not go into effect until July 1 of the same calendar year.
You have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):

  • The month after the employment ends
  • The month after group health plan insurance based on current employment ends
What is the late enrollment penalty?
  • The monthly premium goes up 10 percent for each 12-month period that you could have had Medicare, but didn’t take it.
  • The penalty increases as Medicare premiums increase.
No penalty if you enroll within the 8-month window
Want more information? Contact K&B.
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Medicare Advantage Plan Notice:
HMO, HMO-POS and PPO plans provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association.  HCSC is a Medicare Advantage organization with a Medicare contract.  Enrollment in HCSC’s plans depends on contract renewal.

Out-of-network/non-contracted providers are under no obligation to treat Blue Cross and Blue Shield of Illinois members, except in emergency situations.  Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Medicare Part D Plan Notice:
Prescription drug plans provided by Blue Cross and Blue Shield of Illinois, which refers to HCSC Insurance Services Company (HISC), an Independent Licensee of the Blue Cross and Blue Shield Association. A Medicare-approved Part D sponsor. Enrollment in HISC's plans depends on contract renewal.

Medicare Supplement Notice:
Not connected with or endorsed by the U.S. Government or Federal Medicare Program.

Medicare Supplement insurance plans are offered by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

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Last updated 10/10/19
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