Are you eligible for Medicare now? Or maybe you will be soon. WellFirst Health — provided by SSM Health Plan — will help you understand your Medicare coverage options.
All Medicare Advantage plans offered by WellFirst Health include medical and comprehensive dental coverage. Most plans include prescription drug coverage, and some cover in-home and virtual support and companionship. All plans have added benefits like over-the-counter allowance, hearing, vision, transportation, meals, chiropractic, nurse line, fitness benefits and wellness rewards.
You are eligible for Medicare if you are a legal U.S. resident and one of the following applies to you:
You are age 65 or older
You are any age and have a qualifying permanent disability
You are any age and have been diagnosed with end-stage renal disease
Learn about the ABCDs of Medicare
Administered by the federal govenment
Once you decide to join Medicare, you have a few different options. The federal government refers to these Medicare benefits and options as Parts A, B, C and D. No matter which option you choose, the first step is the same: Enroll in Original Medicare, also known as Parts A and B.
Hospital insurance inpatient care
Inpatient acute care
Inpatient mental health care
Skilled nursing facility care
Home health services
Inpatient tests and services
Medical insurance outpatient care
Doctor visits (including annual wellness visit)
Clinical lab services
Some preventive care
Durable medical equipment, such as oxygen and wheelchairs
Diagnostic tests such as X-rays and MRIs
Original Medicare doesn't cover everything. Many Medicare recipients select plans from private insurance companies such as WellFirst Health for more coverage options and to spend less out-of-pocket.
Replaces Original Medicare Parts A and B
Has an annual maximum out-of-pocket
May include Part D coverage (drug prescription)
May have additional benefits like dental, vision and more
Prescription drug coverage
Covers prescription medications
Offered in Medicare Advantage plans with Part D, or can be purchased separately in addition to Original Medicare.
When to sign up for Medicare
Initial Enrollment Period (IEP)
This is the seven-month period in which you can enroll in Medicare for the first time. If you are enrolling for the first time due to disability, your IEP timing is based on your disability date.
Annual Enrollment Period (AEP)
You can make changes to your medical and prescription drug coverage every year from Oct. 15–Dec. 7. Your changes are effective Jan. 1 of the following year.
Open Enrollment Period (OEP)
From Jan. 1 - March 31, if you currently have a Medicare Advantage plan you may switch to another Medicare Advantage plan, or disenroll from your current Medicare Advantage plan and return to Original Medicare.
Special Enrollment Period (SEP)
This is a period when Medicare recipients may change medical and prescription drug coverage outside of AEP, if they meet certain requirements and have a qualifying event, such as moving to a new service area or leaving an employer-based plan.
Questions about your qualifications?
For information about Medicare eligibility and enrollment policies and limitations, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227).