At MCS Classicare (HMO) we take care of you so you feel better every day. That’s why we want to get you familiar and provide you with the tools you need to stay informed on matters related to your health and wellness.
Introducing your Medicare Orientation Guide especially designed by MCS Classicare for current and future Medicare beneficiaries. Whether you are nearing age 65 or already receiving benefits under the Medicare program, it’s important to keep yourself informed when you make important decisions.
This practical guide is easy to read, and contains essential information to guide you through the Medicare enrollment process, provides important dates to consider, and features other topics of interest that contribute to improving your quality of life.
Helps pay for hospitalization services and those provided by specialized care centers, hospices and home health care providers.
Most people get Medicare Part A automatically since they or their spouses paid Medicare taxes.
Helps pay for medical services and other outpatient care, such as medical supplies and others.
Most people pay an established standard monthly premium.
Those who have Medicare Parts A and B can choose to receive all their healthcare services through a private organization approved by Medicare.
Helps pay for medications doctors prescribe as part of your treatment.
Administered by the federal government and provides for Medicare Part A and Part B (you can choose one or both parts). You must pay a deductible and, usually, co-insurance each time you receive services.
Puede tener la Parte A y/o B de Medicare y además inscribirse a un Plan de Medicamentos Recetados de Medicare. Los costos y beneficios varian por plan.
Supplementary Medicare insurance to help pay some of the healthcare costs not covered by Original Medicare.
Medicare Advantage plans provide all Medicare Parts A and B service coverage, with most offering prescription drug coverage as well. They may also include additional benefits.
If you are already receiving Social Security retirement or disability benefits, you will be notified in a few months in advance regarding your Medicare eligibility, and receive the information you need. Since you must pay a premium for Medicare Part B, it’s your option to choose it or not.
If you are not yet receiving retirement benefits, contact Social Security three months before you turn 65 to register for Medicare.You can enroll in Medicare even if you don’t plan to retire at age 65.
If you are not receiving Social Security benefits and will not receive them at age 65, contact Social Security to apply for Medicare benefits. If you are already receiving Social Security benefits, you don’t have to do anything – you will be enrolled automatically in Medicare Part A.
Once you have Medicare Part A for the first time, you have a 7-month period to enroll in Part B.A delay on your part could result in higher premiums.This initial enrollment period begins three months before you turn 65, including your birthday month, and ends three months after your birthday (see the following example).
Once you enroll in Medicare, you will receive a red, white and blue card that indicates whether you have Part A, Part B or both. Keep your card in a safe place so you have it available when you need it.
Medicare Advantage plans provide all services covered under Medicare Parts A and B. Therefore, you must have Parts A and B to enroll in one of these plans. Usually, they offer additional benefits and many include the Part D option (prescription drug coverage). Generally, you pay a monthly premium and co-payments that will most likely be less than the co-insurance and deductibles you would pay under Original Medicare. Medicare Advantage plans are offered by private companies approved by Medicare. Costs and benefits vary by plan.
We have provided a comparative chart for some of the services covered by Original Medicare and those not covered, but which may be covered by a Medicare Advantage Plan. Remember that Medicare Advantage plans provide all the services covered by Medicare Part A and Part B.
Make sure the services you need are covered.
Check to see if the hospital you go to and their doctors are in the plan’s network. Also, verify the size of the network and the need for referrals.
Check to see if the prescription drugs you are taking are covered. Become familiar with the coverage and services, such as the convenience of receiving your medications by mail.
Ask if the plan includes additional services free of charge, such as talks, health clinics, and entertainment initiatives.
Become familiar with the quality of the services provided (customer care, service offices, etc.).
It is important to understand the monthly payments (premiums), co-payments and others.
You can enroll in a Medicare Advantage Plan three months before or three months after you meet these requirements. You can also enroll during your birthday month.
You have between October 15 and December 7 to join a Medicare Advantage plan. Coverage begins on January 1 of the following year, provided your plan receives your enrollment application by December 7. These dates may change from year to year.
MCS Classicare (HMO), offers a special needs plan for people with chronic conditions.
For more information on the plan ratings, visit www.medicare.gov/publications and review the informative sheet titled “Using Medicare Quality Information to Compare Plans.” You can also call 1.800.633.4227. TTY users can call 1.877.486.2048.
Periodic assessments and screenings are an important part of staying healthy. They allow for the detection of certain conditions, so that decisions can be made regarding the management and treatment of chronic diseases.The following table lists tests that should be performed according to your age and gender. For those with a family history of certain health conditions or at higher risk, your doctor might recommend these screenings before the appointed time.
This is a general preventive recommendations guide.To see all preventive services covered by Medicare, refer to the Medicare & You manual at: https://www.medicare.gov/publications/10050-medicare-and-you.pdf
Medicare Basics. Start with the basics of Medicare before you dive into decision-making: https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics.
Medicare & You 2025 - National Medicare Handbook. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Centers for Medicare & Medicaid Services. CMS Product No. 10050. December 2024. https://www.medicare.gov/publications/10050-medicare-and-you.pdf
What Can I Ask? Getting Information. National Institute Of Aging: https://www.nia.nih.gov/health/doctor-patient-communication/talking-with-your-doctor .