New to Medicare

Explore your options

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. 

We have Medicare Advantage plan options that include medical and drug coverage, as well as extra benefits — including a Part B premium reduction, over-the-counter allowance, transportation to medical appointments, meals post-discharge, routine chiropractic care, hearing aid and eyewear allowances, fitness benefits, in-home support and wellness rewards. 

We also offer a Medicare Advantage plan without Part D coverage. This is an excellent choice if you already have prescription drug coverage through a State Prescription Drug Assistance Program, TRICARE for Life, the VA or an employer plan.

Free Medicare seminars & webinars

In addition to creating a health care experience that is focused on your health and well-being, we offer a wide range of FREE Medicare resources to help you understand your options and find a plan that fits your specific health care needs.

See our seminars and webinars

Eligibility

You are eligible for Medicare if you are a legal U.S. resident and one of the following applies to you:

• You are within three months of turning 65 years old or are over 65 years old
• 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

Original Medicare

Administered by the federal government

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.
 

Part A

Hospital coverage inpatient care

Hospital room

• Inpatient acute care
• Inpatient mental health care
• Skilled nursing facility care
• Home health services
• Inpatient tests and services
• Other

Part B

Medical coverage outpatient care

• Doctor visits (including annual wellness visit)
• Outpatient services
• Clinical lab services
• Some preventive care
• Durable medical equipment, such as oxygen and wheelchairs
• Diagnostic tests such as X-rays and MRIs
• Other

Additional coverage

Original Medicare doesn't cover everything. Many Medicare recipients select plans from private health plan companies such as WellFirst Health — Provided by SSM Health Plan — for more coverage options and to spend less out-of-pocket.

Part C

Medicare Advantage

• 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

Part D

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. Learn more about SEP.

Medicare basics

• Medicare Education Guide
• Medicare and You
• Who Pays First
• Your Medicare Benefits
• Get Adobe Reader

Questions? Contact us.

Members

Talk with our Customer Care Center at 877-301-3326 (TTY:711).
 

Not a member?

Talk with one of our Medicare sales reps at 833-942-2158 (TTY:711) You can also call to ask for information in alternate formats and languages.