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What are Medicare Part A and Part B?

Medicare Part A is sometimes called “Hospital Insurance.” It helps cover inpatient hospital care, skilled nursing facility care, hospice care, and home health care.

Most people should enroll in Medicare Part A when they turn 65, even if they have health insurance from an employer. This is because most people paid Medicare taxes while they worked and therefore do not pay a monthly premium for Part A. However, some people may want to consider delaying Medicare Part A until a later date, such as people who contribute to a Health Savings Account (HSA) or those who have to pay a premium for Part A.

Medicare Part B is sometimes called “Medical Insurance.” It helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services, including certain vaccines and cancer screenings.

Most people also need to enroll in Part B when they turn 65. Only people who have health insurance from their (or their spouse’s) current employer have the option to delay enrolling in Part B.

When should I enroll in Medicare Part A and Part B?

The decision when to enroll in Medicare is up to each individual and is based a a number of factors. Excluding a situation involving a disability that triggers a per age 65 enrollment in Medicare, most members should enroll in Medicare parts A&B as early as possible (even if they have health insurance through an employer) during the seven (7) month initial enrollment period in which a person reaches age 65. The initial enrollment period starts three months before age 65, the month a person turns age 65 and three months after a person turns 65. If you have health insurance coverage through your employer, you may opt to delay your enrollment in Medicare Part B if you are still working or if you are a dependent under your spouse and she/he is still working. However, you may chose to enroll in Part A&B at the same time to avoid a problem from a failure to timely enroll in Medicare Part B at a later date.

Medicare has a step by step guide to help you determine when you should enroll in Medicare based on your specific circumstances: https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-can-i-sign-up-for-medicare.

it is important to remember that the Jefferson-Lewis et. al. School Employees' Plan coverage will not pay claims on a primary basis if it was determined that benefits should have been paid by Medicare coverage and coverage through Medicare was not in place. In situations where Medicare coverage was not in force when it should have been, the Plan will generally pay claims as if Medicare coverage was in force.