Centers for Medicare & Medicaid Services Page 6
FACT SHEET: Medicare Decisions for Those Over 65 and Planning to Retire in the Next 6 Months
You must have both Part A and Part B to purchase (and keep) a Medigap policy.
Other important things to know:
• Medigap policies do not cover prescription drugs. If you purchase a Medigap policy,
you will need to join a separate prescription drug plan to get your Medicare drug
coverage (Part D).
• If you have a Medigap policy, you do not need a Medicare Advantage Plan (like an
HMO or PPO).
• The best time to buy a Medigap policy is during your 6-month Medigap open
enrollment period. During this time you can buy any Medigap policy sold in your
state, even if you have health problems. If you are 65 or older, this period
automatically starts the rst month you are enrolled in Medicare Part B.
To nd out which companies sell Medigap policies in your area, visit the Medicare Plan
Finder at Medicare.gov/nd-a-plan/questions/Medigap-home.aspx. Or call your State
Insurance Department.
!
WARNING: If you apply for Medigap coverage after your Medigap open enrollment
period ends, the insurance company is allowed to deny you or charge you a higher
premium based on your health.
What is a Medicare Advantage Plan?
Medicare Advantage Plans, sometimes called “Part C,” are oered by private
companies approved by Medicare. Medicare Advantage Plans include HMOs, PPOs,
and Private Fee-for-Service plans. If you join a Medicare Advantage Plan, you still have
Medicare, but you will get your coverage through the Medicare Advantage Plan and
not from “Original Medicare.”
You must have both Part A and Part B to enroll in (and keep) a Medicare Advantage Plan.
Other important things to know:
• All Medicare Advantage Plans must cover all of the benets available under
Medicare Part A and Part B. However, plans can charge dierent costs and have
dierent rules for how you get services (like whether you need a referral to see a
specialist or if you have to go to certain doctors or hospitals).
• You must continue to pay your Part B premium while in a Medicare Advantage Plan.
• Many Medicare Advantage Plans include Medicare prescription drug coverage
(Part D) and other benets that Original Medicare doesn’t cover.
• If you have a Medicare Advantage Plan, you do not need a Medigap policy.
• You can enroll in a Medicare Advantage Plan during a two-month “Special Enrollment
Period” that begins the month that you no longer have employer-sponsored health
coverage. You can also enroll each year during the fall open enrollment period,
which runs from October 15 to December 7.
To nd out which Medicare Advantage Plans are available in your area, visit the
Medicare Plan Finder at Medicare.gov/nd-a-plan. Or call 1-800-MEDICARE
(1-800-633-4227). TTY users should call 1-877-486-2048.
You have completed Decision 2. Go to Decision 3 on the next page.
My Medigap Open
Enrollment Period
Look on your Medicare card to
nd out the eective date for
your Part B coverage:
My Part B coverage is
eective on
/ /
Your Medigap open enrollment
period will end 6 months after
your Part B eective date:
My Medigap open enrollment
period will end on
/ /
My Medicare Advantage
Special Enrollment Period
My employer-sponsored health
coverage will end on
/ /
Your Special Enrollment Period
to buy a Medicare Advantage
Plan will end 2 months after
your health coverage ends:
My Special Enrollment
Period to enroll in a Medicare
Advantage Plan will end on
/ /