Going through open enrollment? We can help.
Doctor's office
Enter your doctor's name to get office information.
Find labs in your network
Enter your primary care doctor's name to find labs in your network.
Find urgent care centers in your network
Enter your primary care doctor's name to find urgent care centers in your network.
FollowMyHealth®
Driving Directions
Cart
Update Information
Forgot Password

Please enter your e-mail address.

Sharp Health News

5 things you need to know about Medicare

April 5, 2019

5 things you need to know about Medicare

Medicare is an essential government health insurance program for millions of older and disabled Americans. Navigating the ins and outs of Medicare can be a challenge, especially if you are new to it.

Whether you are signing up this year, in the near future or are helping someone else enroll, here are five things you need to know about Medicare.

1. Know when your enrollment period begins and ends.

Medicare is a complex system. To get the most out of these benefits, you'll need to know the kinds of choices and deadlines that exist.

In most cases, you won't receive any official notice about when or how to enroll. That means you have to make an effort to find out when your personal deadline is to enroll in Medicare.

For example, if you are eligible based on age, your initial enrollment period is a seven-month window that starts three months before your 65th birthday and ends three months after it.

2. If you don't enroll on time, your costs may go up or you may experience a delay in coverage.

If you don't sign up for Medicare when you first become eligible (during your initial enrollment period) and you aren't automatically enrolled, permanent late penalties can be added on to your monthly premium.

Keep in mind that there are other factors, aside from when you enroll, that contribute to whether or not you'll face a penalty. In most cases, you will not pay a penalty if you have other creditable coverage, such as through an employer. To be sure, you should always confirm with Medicare before delaying enrollment.

3. Medicare is not free, and it doesn't cover everything.

Medicare covers many medical services, such as doctor's visits, hospital visits and medical equipment, but there are gaps for dental, hearing and vision care. Medicare also does not provide family or dependent coverage.

You will most likely have to pay monthly Part B premiums to receive services, unless you qualify for a low-income program that will cover your costs. You may also be charged a premium if you enroll in a Medicare Advantage plan or Part D prescription drug plan.

4. When you're Medicare-eligible, you can choose between two types of plan.

Medicare is made up of three basic building blocks:

  • Part A — provides hospital insurance
  • Part B — covers costs for doctors' services, outpatient care and medical equipment
  • Part D — covers prescription drug costs
Original Medicare includes Part A and Part B. You can sign up for extra coverage with a Medigap plan, which offers to pay for certain health care costs that aren't covered by Medicare. You can also sign up for prescription drug coverage with a Part D plan.

Medicare Advantage plans, on the other hand, are an all-in-one alternative to Original Medicare — they include Part A, Part B and, usually, Part D. Some Medicare Advantage plans also provide extra benefits like vision, hearing or dental care that aren't covered by Original Medicare.

Medicare Advantage is also known as Part C. Some Medicare Advantage plans charge no additional premium — you only have to pay your Part B premium.

5. Free help is available.

Learning about Medicare is no easy task, which is why there are resources dedicated to helping you understand everything you need to know. No matter your income level, you can get help to find the best option for you:

Medicare: Call Medicare's help line at 800-633-4227 (TTY 877-486-2048) for general information and help with coverage.

Social Security: Call Social Security at 800-772-1213 (TTY 800-325-0778) for information and help signing up for Medicare or applying for Extra Help benefits in the Part D drug program.

State Health Insurance Assistance Program (SHIP): SHIP offers counsel and advice on Medicare and long-term care insurance. In California, the SHIP is called the Health Insurance Counseling & Advocacy Program (HICAP). Call HICAP at 800-434-0222 to find a location near you.

Learn more at a free upcoming Understanding Medicare seminar, sponsored by Sharp HealthCare, the official health and wellness partner of the City of San Diego.

You might also like:

Choose the doctor who's right for you.

At Sharp, we make it easy to find an exceptional doctor — right where you live and work.

All Categories
Contact Sharp HealthCare
Call us

1-800-827-4277

If this is a life- or limb-threatening emergency, please call 911 immediately.


Email us

Please do not use this form to convey personal or medical information.

How would you like to be contacted?
Date of birth
Optional


Find other numbers

View our phone directory

What's This?

These important numbers are located on your billing statement.

Find your Sharp Rees-Stealy account number

Find your Sharp Rees-Stealy account number

Find your Sharp hospital account number

Find your Sharp hospital account number

Find your SharpCare account number

Find your SharpCare account number
What's GDPR?

The General Data Protection Regulation (GDPR) governs the processing of personal information gathered from individuals while they are in the European Union (EU) and parts of the EEA (European Economic Area, which currently includes Iceland, Lichtenstein and Norway).

We are sorry, but we are unable to process hospital price estimates if you live or are travelling within the EU or affiliated nations.

To learn more, call us at 858-499-5901.

What's This?

Many surgery and procedure names sound similar. If possible, please provide the current procedure terminology (CPT) code, which can be found on the order from your doctor.

If you cannot provide the CPT code, please contact your doctor's office for the CPT or a detailed description of services.