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Medicare

Medicare in Michigan

February 1, 2022

Medicare in Michigan

If you’re nearing 65 in Michigan, you probably have a lot of questions about Medicare and how to take advantage of it. This guide will help you understand the different parts of Medicare, who’s eligible, and how to enroll.

Medicare in Michigan by the Numbers

If you have questions about Medicare, you’re not alone. More than two million people are enrolled in Medicare in Michigan, and likely had questions when they started the process to enroll.

  • Original Medicare: 1,145,746
  • Medicare Advantage: 947,707

Medicare is an important health benefit and can make a lot of difference when it comes to taking care of your medical needs. When you know the details, you will have an easier time choosing the coverage that works for you.

Medicare in Michigan Eligibility

Medicare is health coverage intended for those who are 65 and older and likely retired from the workforce, along with those who have specific health conditions.

How do you qualify for Medicare in Michigan? You’ll need to be a U.S. citizen or permanent resident who has lived in the United States for at least five years. Also, at least one of the following criteria must be true for you:

  • You’re age 65 or older
  • You’re under 65 but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board
  • You have end-stage renal disease (ESRD)
  • You have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease

It’s important to sign up for Medicare when you’re first eligible. You’ll avoid late enrollment penalties and you’ll have the largest number of options available to you.

How Does Medicare Work in Michigan?

Medicare in Michigan functions as a health insurance coverage, as it does in the rest of the United States. There are different parts of Medicare, and each one serves to cover different health needs.

For example, Medicare Part A is known as hospital insurance and covers in-patient hospital stays and related care.Medicare Part B is like traditional medical insurance and covers doctor’s visits, medical equipment, preventive care, and more. Medicare Part D is drug coverage and helps you get the prescription drug care you need.

Together, Medicare Parts A and B are known as Original Medicare. Part D is optional but most recipients of Original Medicare choose to purchase it. Medicare Part F, known as Medigap or Medicare Supplement, is another optional coverage you can buy to help you pay for your out-of-pocket costs with Original Medicare.

Medicare Part C is called Medicare Advantage. Medicare Advantage plans are a full replacement for Original Medicare. They are sold by individual insurance companies and often include drug coverage and additional benefits. However, they operate with limited in-network providers, so it’s important to choose a coverage that’s right for you.

Like other health insurance coverage, Medicare options have out-of-pocket costs including a deductible along with copayment or coinsurance amounts when you receive treatment. Visit this guide to changes to Medicare to learn more about Medicare premiums and deductibles.

At What Age Can You Get Medicare in Michigan?

What age does Medicare start in Michigan? For most people, the initial enrollment period is around their 65th birthday. However, if you qualify for a medical condition rather than your age, the initial enrollment period could be different.

Most Americans are enrolled in Medicare Part A and Part B automatically. Part A is free for people who paid Medicare taxes from their employment income for a specific period of time or have a spouse who did so. Part B has a monthly premium, as does Part D.

Medicare Part C has a monthly premium as well. Sometimes it’s the same as your Part B premium would have been, and sometimes it’s a bit more. If you decide on Medicare Advantage, be sure to compare plans to ensure you get one that fits your needs.

How Do I Sign Up for Medicare in Michigan?

If you are not automatically enrolled in Medicare, you can sign up by:

  • Contacting your local Social Security office
  • Calling 1-800-772-1213 to enroll over the phone
  • If you retired from a railroad, calling the Railroad Retirement Board at 1-877-772-5772
  • Signing up for Part A online at www.socialsecurity.gov and Part B using Form CMS-40B

Can You Have Medicare and Medicaid in Michigan?

Lower-income Michigan residents often qualify to receive healthcare through a state program known as Medicaid. Due to age or health conditions, you might also qualify for Medicare at the same time.

Being eligible for both coverages is known as being “dual-eligible.” In this case, Medicare covers your needs first. Anything that might not be covered by Medicare is then covered under Medicaid. There are specific prescriptions and types of care that Medicare doesn’t cover that would be covered under Medicaid, such as personal care services or nursing home care.

When you are dual-eligible, you automatically qualify for extra help paying for Medicare Part D premiums and copayments. You may also qualify for help with other Medicare costs, depending on your income.

Does Medicare Cover Dental in Michigan?

Original Medicare does not include coverage for dental care. If you want dental coverage, you can shop for separate dental insurance from private insurance companies.

Another option is to look for a Medicare Part C plan that includes dental coverage. Be sure to compare the costs and benefits to what it would cost to have Original Medicare and a dental plan.

What's the Best Medicare Advantage Plan in Michigan?

Medicare Advantage plans, which are Medicare Part C, are very popular among Medicare recipients. Often, you can get additional benefits and more predictable out-of-pocket costs with a Part C plan.

Each Medicare Advantage plan is different, and it pays to shop around and compare. Monthly premiums, drug coverage, additional benefits, and out-of-pocket costs are just a few of the things to consider.

The most important consideration when deciding on the best Medicare Advantage plan in Michigan for your needs is the medical network. Like other health insurance coverage, Medicare Advantage plans often limit care to a specific network of providers. If you live and stay in that area most of the time, that may not be a concern. However, if you travel regularly or have doctors that are out-of-network, you may not want to choose that plan.

There is no single best Medicare Advantage plan, but you can choose the one that’s best for your needs.

Learn More About Medicare and Medicare Advantage in Michigan

Understanding Medicare options isn’t easy, but this guide helps answer a lot of common questions. If you want help comparing Medicare plans or have more questions, we’re here to help. Simply contact us to talk to a licensed agent today!

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