What You Need to Know About the ABCD’s of Medicare Benefits

What You Need to Know About the ABCD's of Medicare

Medicare is the government medical program for seniors. Medicare was instituted in 1965 to ensure that older Americans would have access to the health they needed in their retirement years.

You will become eligible for Medicare at 65 and may enroll for Medicare Benefits three months prior to the month of your 65th birthday, during the month of your 65th birthday, and three months after your 65th birthday.

Medicare has four parts: A, B, C, D

Part A is given to you by the government and covers 80% of your hospital stay.

Part B covers 80% of your doctor bills after a $135 deductible. The premium for Part B is generally taken from your social security benefit. If you are enrolled in social security, you will automatically be enrolled in Part B and will receive your notice of premium amount by mail. If you are not enrolled in social security, you will need to begin preparing for enrollment four months prior to your 65th birthday.

Part C fills the financial gap of Parts A and B and may potentially leave you with a zero balance. There are several options for Part C coverage. Part C is also often called Medicare Advantage plans and actually covers your Part A and Part B Medicare benefits through the advantage plan instead of through Original Medicare.

Part D is prescription coverage, and there are many plans to choose from.

Don't Let Medicare Surprise You

Medicare Benefits FAQ’s

  1. Why do I need to enroll in Medicare?

Enrolling in Medicare and one of the supplement plans will save you money. Not signing up for your Medicare benefits in a timely fashion may subject you to declination and a penalty fee.

  1. How much will Medicare cost me?

Rates for the different parts of Medicare can vary, but on average it may cost you as little as $325/month to be nearly 100% covered.

  1. What’s the importance of a supplement if I’m already on Medicare?

You will avoid financial penalties and thousands of dollars.

  1. Does my doctor accept Medicare?

Most primary care physicians accept Medicare and some eye specialists and dentists accept Medicare. If vision and dental coverage are important for you, and your doctor doesn’t accept Medicare, there are affordable plans available.

  1. I’m Healthy, why do I need a prescription plan?

While you may not currently have prescription needs, it is likely you may as you continue to age. Additionally, you will be penalized monthly if you do not have Medicare Part D. There are basic plans available for those who do not currently have medication needs.

  1. I’m employed, will my company pay for my coverage?

Your employer may choose to pay for Medicare. If your employer chooses not to pay, you are still eligible for Medicare benefits.

  1. Will my coverage be affected if I retire this year?

There are two ways to manage group benefits when you turn 65. You may either continue with your group benefits, or you may drop group benefits and enroll in Medicare. If you remain on group benefits and retire, you need to begin the Medicare enrollment process approximately two months prior to your retirement.

  1. I’m a veteran, how does this affect me?

Veterans may still enroll in Medicare and participate in their Veterans’ benefits.

  1. Am I covered if I travel?

You are covered in case of emergency for foreign travel with certain supplement plans. Within the United States, most facilities accept Medicare.

  1. What is Medicare Open Enrollment?

Medicare open enrollment is the time when you can choose a new Medicare Advantage (Part C) or Medicare Part D plan or make changes to the plan you have. Open Enrollment for Medicare runs from October 15 to December 7 each year.


Have more questions? Roper Insurance’s licensed and dedicated Medicare specialist can answer your questions and help you understand Medicare’s ABCD’s. Contact our Medicare specialist today by clicking here or give us a call at 303-721-1145.