For more information about the author, click to view their website: Area Agency on Aging for Southwest Florida
If you or a loved one will soon be eligible for Medicare, join us for this Medicare Minute! We’ll go over all the basics you should know—from enrollment periods to coverage choices and beyond.
Some people are automatically enrolled in Medicare. For example, if you are already receiving retirement benefits from Social Security when you become Medicare-eligible, or if you’ve been collecting Social Security Disability Insurance for two years. If you are automatically enrolled, you should receive a package in the mail with your Medicare insurance card telling you so. Otherwise, there are three times to enroll in Parts A and B:
Initial Enrollment Period (IEP): The three months before, the month of, and the three months after your 65th birthday.
Special Enrollment Period (SEP): Allows you to delay Medicare enrollment without owing a late enrollment penalty. You may qualify for an SEP if:
General Enrollment Period (GEP): Every year from January 1 through March 31. You may owe a late enrollment penalty and face gaps in coverage if you use the GEP.
View the full “New to Medicare” handout by the State Health Insurance Assistance Program (SHIP) below.
The Medicare Rights Center is the author of portions of the content in these materials but is not responsible for any content not authored by the Medicare Rights Center. This document was supported, in part, by grant numbers 90SATC0002 and 90MPRC0002 from the Administration for Community Living (ACL), Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy. [April 2024]
New to Medicare
Medicare is the federal
government program that provides health care coverage, or health insurance. The
Centers for Medicare & Medicaid Services (CMS) is the federal agency that
runs Medicare. The program is funded in part by Social Security and Medicare
taxes you pay on your income, in part through premiums that people with
Medicare pay, and in part by the federal budget. Some people are eligible for
Medicare due to their age, while others are eligible due to having a disability
or chronic condition. If you are new to Medicare, there can be a lot to learn
around your enrollment and coverage choices.
Some people are
automatically enrolled in Medicare. For example, if you are already receiving
retirement benefits from Social Security when you become Medicare-eligible, or
if you’ve been collecting Social Security Disability Insurance for two years.
If you are automatically enrolled, you should receive a package in the mail
with your Medicare insurance card telling you so. Otherwise, there are three
times to enroll in Parts A and B:
Initial Enrollment Period (IEP): The three months
before, the month of, and the three months after your 65th birthday.
Special Enrollment Period (SEP): Allows you to delay
Medicare enrollment without owing a late enrollment penalty. You may qualify
for an SEP if:
· You or your spouse (or
sometimes another family member) are still working, and you are covered by the
employer health insurance. Note that you shouldn’t delay Medicare enrollment if
this employer coverage pays secondary to Medicare.
· You have experienced
other exceptional circumstances, like losing Medicaid coverage, being released
from incarceration, being misinformed by an employer, or being impacted by an
emergency or disaster.
General Enrollment Period (GEP): Every year from January
1 through March 31. You may owe a late enrollment penalty and face gaps in
coverage if you use the GEP.
New to Medicare
Choosing between
Original Medicare and Medicare Advantage is a big choice when you are new to
Medicare. Below are some key differences to consider.
To discuss your options
with a Medicare counselor, you can contact your State Health Insurance
Assistance Program (SHIP). Find your local SHIP by visiting www.shiphelp.org or call 877-839-2675.
|
Original Medicare
|
Medicare Advantage
|
Costs |
Part A and Part B
costs, including monthly Part B premium. 20% coinsurance for Medicare-covered
services if you see a participating provider and after meeting your
deductible. |
Cost-sharing depends
on the plan. Usually pay a copayment for in-network care. Plans may
charge a monthly premium in addition to Part B premium. |
Supplemental insurance |
Have the choice to
pay an additional premium for a Medigap policy to cover Medicare
cost-sharing. |
Cannot purchase a
Medigap policy. |
Provider access |
Can see any provider
and use any facility that accepts Medicare (participating and
non-participating). |
Typically, can only
see in-network providers. Some plans allow you to see out-of-network
providers at a higher cost. |
Referrals |
Do not need referrals
for specialists. |
Typically need
referrals for specialists. |
Drug coverage |
Must sign up for a
stand-alone Part D prescription drug plan. |
In most cases, plan provides
prescription drug coverage (you may be required to pay a higher premium). |
Other benefits |
Does not cover routine
vision, hearing, or dental services. |
May cover additional
services, including vision, hearing, and/or dental (you may owe an extra
premium) |
Out-of-pocket limit |
No out-of-pocket
limit. |
Annual out-of-pocket
limit. Plan pays the full cost of your care after you reach the limit. |
New to Medicare
Prescription drug plans: Part D is provided
only through private insurance companies that have contracts with the federal
government. If you have Original Medicare and want to get Part D coverage, you
must choose and enroll in a stand-alone prescription drug plan. Typically, you
should sign up for Part D when you first become eligible to enroll in Medicare,
unless you have other creditable drug coverage. Most Medicare Advantage Plans
include drug coverage.
Medigaps: Medigaps
are health insurance policies that offer standardized benefits to
work with Original Medicare, not with Medicare Advantage. They are
sold by private insurance companies. If you have a Medigap, it pays part
or all of certain remaining costs after Original Medicare pays first.
Medigaps may also cover emergency care when travelling abroad. You should
usually enroll in a Medigap during your open enrollment period, the six-month
period that begins the month you are 65 or older and enrolled in Medicare Part
B. Depending on your situation and the state in which you live, you may be able
to enroll at other times, too.
.
My Health Care Trackers
are fraud-fighting tools that are free through the Senior Medicare
Patrol (SMP) program. My Health Care Trackers include:
Using a My Health Care
Tracker and comparing your notes with your Medicare statements is a great way
to find potential billing errors, as well as Medicare fraud, abuse, or a stolen
medical identity. Ultimately, it can help you reduce your health care costs and
protect yourself against potential Medicare fraud, errors, and abuse. Contact
your local Senior Medicare Patrol (SMP) to receive a My Health Care Tracker or
need assistance with reading your Medicare statements. Contact information for
your local SMP is on the final page of this document.
New to Medicare
Local SHIP contact information |
Local SMP contact information |
SHIP
toll-free: 1-866-413-5337 |
SMP
toll-free: 1-866-413-5337 |
SHIP
email: shineinfo@aaaswfl.org |
SMP
email: shineinfo@aaaswfl.org |
SHIP
website: www.floridashine.org |
SMP
website: www.floridashine.org |
To find a
SHIP in another state: Call 877-839-2675 (and say “Medicare” |
To find an
SMP in another state: Call 877-808-2468 or visit www.smpresource.org |
SHIP Technical
Assistance Center: 877-839-2675 | www.shiphelp.org | info@shiphelp.org SMP
Resource Center: 877-808-2468 | www.smpresource.org | info@smpresource.org © 2023 Medicare Rights Center | www.medicareinteractive.org | The Medicare Rights Center is the author of portions of the content in
these materials but is not responsible for any content not authored by the
Medicare Rights Center. This document was supported, in part, by grant
numbers 90SATC0002 and 90MPRC0002 from the Administration for Community
Living (ACL), Department of Health and Human Services, Washington, D.C.
20201. Grantees undertaking projects under government sponsorship are
encouraged to express freely their findings and conclusions. Points of view or
opinions do not, therefore, necessarily represent official Administration for
Community Living policy. [April 2024] |
Helping Seniors Navigate Their Aging JourneyAs we age, many of us or our loved ones face challenges related to healthcare, daily living, and navigating complex needs. For seniors in Southwest Florida, a Geriatric Care Manager (GCM) can be an invaluable resource, offering expert guidance and support to ensure seniors maintain a high quality of life as they age in place. Whether you're seeking assistance for yourself or a loved one, a Geriatric Care Manager can help streamline the process of aging, ensuring that all needs are met with care and compassion.What is a Geriatric Care Manager?A Geriatric Care Manager is a healthcare professional who specializes in helping seniors and their families navigate the complexities of aging. They are typically trained in social work, nursing, or other health-related fields, and they provide a comprehensive approach to senior care.The primary goal of a GCM is to coordinate care and services for older adults, ensuring that they receive the right level of care in the most appropriate environmentwhether at home, in an assisted living facility, or in a skilled nursing setting. How Can a Geriatric Care Manager Help?A GCM can offer a wide range of services tailored to the unique needs of each senior. Some of the most common services include: Care Assessment Geriatric Care Managers assess the needs of the senior by evaluating physical health, mental health, daily living abilities, and social interactions. This helps determine what type of care is required and what resources are available to meet those needs. Care Plan Development Based on the assessment, a GCM develops a personalized care plan that may include medical care, home health services, financial planning, and legal assistance. The plan ensures that all of the senior's needs are met in a coordinated way. Care Coordination A GCM coordinates various services, such as home care, physical therapy, and transportation, to ensure that seniors receive continuous and appropriate care. They act as the central point of contact for families and healthcare providers. Advocacy and Support GCMs advocate for the seniors best interests in healthcare settings, ensuring they receive the necessary treatments and follow-ups. They also provide emotional support to both seniors and their families during the decision-making process. Crisis Intervention In the event of a medical crisis or emergency, a Geriatric Care Manager can quickly step in to manage the situation, ensuring the senior receives the appropriate care and support. Why is a Geriatric Care Manager Important in Southwest Florida?Southwest Florida is home to a large senior population, many of whom live independently or with minimal assistance. As the population ages, the demand for specialized care and support services has grown. Geriatric Care Managers play a crucial role in managing the healthcare needs of seniors, especially for those who may not have immediate family nearby.In Southwest Florida, many families are spread out across the country, making it difficult for them to manage the complex health and personal care needs of their aging relatives. A GCM provides a local resource for families, acting as a liaison between the senior, the family, and the various service providers.Some specific benefits of having a Geriatric Care Manager in Southwest Florida include:Navigating Florida's healthcare system With the variety of healthcare options available in the state, a GCM can help families understand Medicare, Medicaid, and insurance options.Personalized care coordination Seniors in Southwest Florida may have specialized needs due to weather-related conditions, such as managing heat-sensitive health conditions during the summer months.Expert guidance GCMs can offer professional advice on how to address medical and psychological issues that often arise with aging, such as Alzheimers, dementia, and mobility limitations. How to Find a Geriatric Care Manager in Southwest FloridaIf you or a loved one are considering the help of a Geriatric Care Manager in Southwest Florida, its essential to find a professional who is experienced, compassionate, and licensed. You can start by exploring the directory on Seniors Blue Book to find qualified GCMs in your area.Here are two helpful resources to get started:Browse Senior Resources in Southwest FloridaFind Geriatric Care Managers in Southwest FloridaBe sure to verify the credentials, experience, and areas of expertise of any potential GCM. It's important to ensure that the GCM is a good fit for both the seniors needs and the familys expectations. Final Thoughts on Geriatric Care Managers in Southwest FloridaFor families in Southwest Florida looking to navigate the complexities of aging, a Geriatric Care Manager can provide invaluable assistance. By offering comprehensive care assessments, developing personalized care plans, and coordinating services, GCMs help seniors maintain their independence and live life to the fullest. If you are looking for a Geriatric Care Manager or simply want to learn more about the options available to seniors in your area, consider visiting the Seniors Blue Book directory for trusted, local resources.
Planning for the Future with ConfidenceAs we age, the need for long-term care becomes a reality that many of us may face. Whether it's assistance with daily activities, home health care, or moving into a nursing facility, the costs associated with long-term care can be overwhelming without proper planning. Long-term care insurance provides a valuable safety net, ensuring that you or your loved one receives the care needed without depleting financial resources.In Southwest Florida, where the senior population is growing rapidly, its essential to understand the benefits of long-term care insurance, its coverage options, and how to incorporate it into your financial planning. What is Long-Term Care Insurance?Long-term care insurance (LTCI) is designed to cover the costs of services that help people with chronic illnesses, disabilities, or other health conditions that limit their ability to perform everyday activities. Unlike regular health insurance, LTCI covers non-medical services, such as personal care, assistance with daily living, and custodial care, which may not be covered by traditional health plans.Why is Long-Term Care Insurance Important in Southwest Florida?Southwest Florida is a popular retirement destination, home to a significant number of seniors who wish to remain independent while receiving the appropriate care as they age. Here are some reasons why LTCI is especially important in the region:Aging population As the senior population continues to grow in Southwest Florida, many seniors will require long-term care, either at home or in assisted living facilities.Rising costs of care Long-term care can be expensive, and many individuals may not have the financial resources to cover these costs out-of-pocket. LTCI provides a safety net.Peace of mind Having long-term care insurance gives families the peace of mind that loved ones will receive the care they need without the burden of significant financial strain. Types of Long-Term Care Insurance CoverageLong-term care insurance policies typically offer different types of coverage. The most common options include: Traditional Long-Term Care Insurance This is the most common form of long-term care insurance. It covers a broad range of care options, including home health care, assisted living, and nursing home care. Hybrid Policies Hybrid policies combine life insurance and long-term care insurance. These policies often allow policyholders to use their life insurance benefits to pay for long-term care services if needed. Short-Term Care Insurance Short-term care insurance is designed for individuals who need care for a shorter duration. Its often less expensive than traditional long-term care insurance but provides limited coverage. How Does Long-Term Care Insurance Work?LTCI works by paying for long-term care services once you meet the eligibility requirements, which often include a medical assessment. Youll choose a policy based on the type of care you expect to need, how long you want coverage, and the maximum daily benefits.Once you start receiving care, the insurance company will pay for your care up to the daily or monthly limit specified in your policy. Some policies may also have a waiting period (also called a "elimination period") before benefits are paid out. How to Choose the Right Long-Term Care Insurance Policy in Southwest FloridaChoosing the right policy can be a daunting task. Here are some steps to help guide your decision-making:Determine your needs Understand the types of long-term care services you might need. Will you require at-home assistance, or will you need to move into an assisted living or nursing facility?Evaluate your financial situation Understand how much you can afford to pay for premiums and what your budget allows.Compare policies Different insurers offer various policy terms, premiums, and coverage limits. Make sure to compare options.Consult with a financial advisor A trusted advisor can help you choose the best policy that fits your needs and budget. Long-Term Care Insurance Resources in Southwest FloridaFinding reliable resources to help navigate long-term care insurance is essential. Several organizations and agencies in Southwest Florida can provide guidance, answer questions, and connect you with the right insurance providers. Whether you're looking for assistance in evaluating policies or finding home care options, local senior resource directories can help you find reputable services and providers.Explore resources on the Seniors Blue Book: Browse Senior Resources in Southwest Florida Find Long-Term Care Insurance Providers in Southwest Florida Final Thoughts: Preparing for the Future with Long-Term Care Insurance Long-term care insurance is an essential component of retirement planning, especially in a region like Southwest Florida, where many seniors choose to age in place. By starting early and selecting the right policy, you can protect yourself and your loved ones from the financial burden of long-term care.
Securing Your Future and Peace of MindEstate planning is a crucial aspect of securing your financial legacy and ensuring that your wishes are respected. In Southwest Florida, where many retirees settle for their golden years, understanding estate planning options and resources is especially important. Whether you're planning for your future or assisting a loved one, estate planning can bring peace of mind and help prevent family disputes.This blog will walk you through the basics of estate planning, why its important, and how to navigate the process in Southwest Florida. What Is Estate Planning?Estate planning involves creating a set of legal documents that outline how your assets and responsibilities will be managed during your lifetime and after your passing. These documents ensure that your estate is handled according to your wishes, minimizing confusion, delays, and tax burdens for your loved ones.Key components of an estate plan include:Wills and Trusts Direct how your assets will be distributed after death.Powers of Attorney Appoint trusted individuals to make financial or healthcare decisions if youre unable.Living Wills Outline your medical wishes if you become incapacitated.Beneficiary Designations Specify who will receive assets like life insurance and retirement accounts. Why Estate Planning Is Important for Seniors in Southwest FloridaFor many seniors in Southwest Florida, estate planning is an essential part of ensuring a smooth transition for family members and loved ones. With its large retirement population, Southwest Florida presents unique estate planning needs due to:Aging Population: Many seniors in Southwest Florida may have complex health or financial needs that require careful planning for long-term care and end-of-life decisions.Assets and Property: Homeownership is common in Southwest Florida, and planning how your real estate and assets will be distributed can prevent legal complications.Tax Considerations: Florida has no state income tax, which can be a financial advantage. However, estate planning can still help minimize federal estate taxes and other liabilities. Steps to Create an Estate Plan Assess Your Assets and Liabilities: Make a list of your property, savings, investments, and any debts. This will help guide how your estate will be divided. Draft a Will or Trust: Decide whether you want a simple will or a more complex trust. A will is a good option for straightforward estates, while a trust can offer more flexibility and tax advantages. Choose Executors and Powers of Attorney: Appoint trusted individuals to manage your estate and make medical or financial decisions on your behalf if necessary. Review Beneficiaries: Double-check that all your beneficiary designations are up to date for accounts like life insurance, retirement plans, and bank accounts. Consult an Estate Planning Attorney: While its possible to do some of the planning on your own, consulting an estate planning attorney can help ensure that your plan is legally sound and covers all necessary details. Common Estate Planning Mistakes to AvoidWhile estate planning can seem like a daunting task, avoiding common mistakes can save your loved ones time, stress, and money:Not Updating Your Plan: Life changes like marriage, divorce, or the birth of a child should prompt an update to your estate plan.Overlooking Digital Assets: Dont forget to include digital assets like email accounts, social media, and cryptocurrency in your planning.Failing to Plan for Incapacity: In addition to a will, its essential to plan for situations where you may be unable to make decisions for yourself.Choosing the Wrong Executor: Your executor will be responsible for managing your estate after your death. Choose someone who is trustworthy, organized, and willing to take on this responsibility. Estate Planning Resources in Southwest FloridaSouthwest Florida offers various resources to help you with estate planning. Whether you're looking for legal advice, assistance with document creation, or just want to understand the process better, there are many professionals in the area who specialize in helping seniors navigate the complexities of estate planning.Start your search for trusted estate planning professionals in Southwest Florida today:Explore Estate Planning Resources in Southwest FloridaFind Estate Planning Services in Southwest Florida Final Thoughts: Secure Your Legacy TodayEstate planning is an essential part of ensuring your wishes are honored and that your loved ones are provided for after youre gone. In Southwest Florida, where many seniors choose to retire, starting the estate planning process as early as possible can prevent unnecessary complications down the road. By making informed decisions, seeking professional advice, and keeping your estate plan up to date, you can ensure that your futureand the future of your loved onesis secure.
The Area Agency on Aging for Southwest Florida (AAASWFL) is a nonprofit organization serving older adults (age 60-up) and adults with disabilities. We serve Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota counties. AAASWFL is committed to connecting older adults and adults with disabilities to resources and assistance for living safely with independence and dignity.AAASWFL is also the states designated Aging and Disability Resource Center for Southwest Florida. We provide information and resources for seniors and adults with disabilities. We also help their families and caregivers. AAASWFL can connect you with local resources like elder care, adult day care, housing assistance, home care, meals, housekeeping, legal assistance, personal care, and even volunteer opportunities.Providing Long-Term Care (LTC) services to Floridas most vulnerable citizens is a multi-agency effort. The Agency for Health Care Administration (AHCA) administers the Statewide Medicaid Managed Care (SMMC) Long-Term Care program, sets coverage policy, and gets those eligible for services enrolled in a LTC plan. The Department of Elder Affairs (DOEA) is responsible for determining medical eligibility and level of care needed. We are one of eleven regional Area Agencies on Aging in the state of Florida. Nationwide, there are more than 600 Area Agencies on Aging serving elders and adults with disabilities.Please contact the Area Agency on Aging for Southwest Florida if we can be of assistance to you, a friend or a family member!The AAASWFL Elder Helpline is available between 8:00 am-5:00 pm Monday through Friday: 866-413-5337 (866-41-ELDER)Contact Phones:Telephone: 239-652-6900FAX: 239-652-6989Toll Free: 866-413-5337 (in the State of Florida)Postal address:Area Agency on Aging for Southwest Florida2830 Winkler Avenue, Suite 112Fort Myers, FL 33916Hours of Operation:Monday-Friday: 8am 5pm
The Area Agency on Aging for Southwest Florida (AAASWFL) is a nonprofit organization serving older adults (age 60-up) and adults with disabilities. We serve Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota counties. AAASWFL is committed to connecting older adults and adults with disabilities to resources and assistance for living safely with independence and dignity.AAASWFL is also the states designated Aging and Disability Resource Center for Southwest Florida. We provide information and resources for seniors and adults with disabilities. We also help their families and caregivers. AAASWFL can connect you with local resources like elder care, adult day care, housing assistance, home care, meals, housekeeping, legal assistance, personal care, and even volunteer opportunities.Providing Long-Term Care (LTC) services to Floridas most vulnerable citizens is a multi-agency effort. The Agency for Health Care Administration (AHCA) administers the Statewide Medicaid Managed Care (SMMC) Long-Term Care program, sets coverage policy, and gets those eligible for services enrolled in a LTC plan. The Department of Elder Affairs (DOEA) is responsible for determining medical eligibility and level of care needed. We are one of eleven regional Area Agencies on Aging in the state of Florida. Nationwide, there are more than 600 Area Agencies on Aging serving elders and adults with disabilities.Please contact the Area Agency on Aging for Southwest Florida if we can be of assistance to you, a friend or a family member!The AAASWFL Elder Helpline is available between 8:00 am-5:00 pm Monday through Friday: 866-413-5337 (866-41-ELDER)Contact Phones:Telephone: 239-652-6900FAX: 239-652-6989Toll Free: 866-413-5337 (in the State of Florida)Postal address:Area Agency on Aging for Southwest Florida2830 Winkler Avenue, Suite 112Fort Myers, FL 33916Hours of Operation:Monday-Friday: 8am 5pm
The Area Agency on Aging for Southwest Florida (AAASWFL) is a nonprofit organization serving older adults (age 60-up) and adults with disabilities. We serve Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota counties. AAASWFL is committed to connecting older adults and adults with disabilities to resources and assistance for living safely with independence and dignity.AAASWFL is also the states designated Aging and Disability Resource Center for Southwest Florida. We provide information and resources for seniors and adults with disabilities. We also help their families and caregivers. AAASWFL can connect you with local resources like elder care, adult day care, housing assistance, home care, meals, housekeeping, legal assistance, personal care, and even volunteer opportunities.Providing Long-Term Care (LTC) services to Floridas most vulnerable citizens is a multi-agency effort. The Agency for Health Care Administration (AHCA) administers the Statewide Medicaid Managed Care (SMMC) Long-Term Care program, sets coverage policy, and gets those eligible for services enrolled in a LTC plan. The Department of Elder Affairs (DOEA) is responsible for determining medical eligibility and level of care needed. We are one of eleven regional Area Agencies on Aging in the state of Florida. Nationwide, there are more than 600 Area Agencies on Aging serving elders and adults with disabilities.Please contact the Area Agency on Aging for Southwest Florida if we can be of assistance to you, a friend or a family member!The AAASWFL Elder Helpline is available between 8:00 am-5:00 pm Monday through Friday: 866-413-5337 (866-41-ELDER)Contact Phones:Telephone: 239-652-6900FAX: 239-652-6989Toll Free: 866-413-5337 (in the State of Florida)Postal address:Area Agency on Aging for Southwest Florida2830 Winkler Avenue, Suite 112Fort Myers, FL 33916Hours of Operation:Monday-Friday: 8am 5pm