This New Hampshire Medicare Guide will help you understand when and how to enroll in Medicare, how to cover the 20% of costs that Original Medicare doesn’t cover, and how to get the most from your Medicare coverage.
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There are 317,000 New Hampshire Medicare beneficiaries, making up 23% of the state’s total population. Most New Hampshire residents age into Medicare when they turn 65, but about 14% are on Medicare due to disability. 11% of Medicare enrollees are dually eligible, meaning they also receive Medicaid benefits to help them pay for some or all of their healthcare costs.
Medicare beneficiaries have options and can either stay on Original Medicare or switch to a Medicare Advantage plan. In New Hampshire, 74% choose to remain on Original Medicare and 26% enroll in a Medicare Advantage plan.
All US citizens have the same Medicare eligibility requirements. If you’re 65 or older, you’re eligible. You also may be eligible if you have certain disabilities, including ALS and End-Stage Kidney Disease.
The first step is to enroll in Original Medicare (also sometimes called Traditional Medicare), which includes Medicare Part A and Part B. Most people can enroll up to three months before the month they turn 65. If you’re already drawing from Social Security, you’ll be enrolled automatically. Otherwise, you’ll need to notify Social Security that you want to enroll during your Initial Enrollment Period (IEP). Your IEP is a 7-month window that starts three months before the month you turn 65 and ends three months after it.
If you’re still working, you may choose to delay your Medicare Part B enrollment. We recommend comparing your employer-linked coverage with Medicare because, oftentimes, people are able to save by moving to Medicare. If you want to stay on your employer coverage, just be sure you’re eligible for the Part B Special Enrollment Period later—or you may have to pay a late enrollment penalty!
We mentioned that Medicare beneficiaries have options, specifically one between Original Medicare and Medicare Advantage. Which type of Medicare coverage you choose is up to you, and the decision should be based on your unique health and financial situation. We’ll explain more about your options under both Original Medicare and Medicare Advantage in the next section. If you have questions about your options or need advice, we’re here to help! Just give us a call at (888) 604-0055 to get advice from one of our New Hampshire Medicare Advisors.
Once you’ve chosen the best plan to maximize the value you get from Medicare, you’re not quite done. You don’t have to re-enroll in Medicare every year, but we recommend you shop around! During the Open Enrollment Period, which lasts from October 15 - December 7 every year, you have the option to switch Medicare Advantage plans and/or Part D plans. Why would you want to switch if you were so careful to pick the best plan for your needs the first time around? Medicare plans can change, and so can your healthcare needs! While we often recommend people stay on their current plan, in some cases, we’re able to help people save thousands by switching.
Medicare Advantage (also known as Medicare Part C) provided by private insurance companies to give beneficiaries an alternative to Original Medicare. Many Medicare Advantage plans have low or no additional premiums, but you will still continue to pay your Original Medicare premiums. Advantage plans are required to provide at least the same coverage as Original Medicare.
Unlike Original Medicare, Medicare Advantage plans have out-of-pocket maximums to provide Medicare beneficiaries with some financial protection for catastrophic costs. Additionally, they generally offer additional benefits, including:
Dental, vision, and hearing benefits
Free gym memberships
Transportation to and from doctor appointments
Be careful choosing a New Hampshire Medicare Advantage plan specifically for these added benefits. You want to be sure your healthcare needs, including the doctors you prefer and the prescriptions you take, are covered first! You should also be aware of some of the drawbacks that come with Medicare Advantage plans. These include:
Limited provider networks
Higher out-of-pocket costs when compared to coverage from Original Medicare + Medigap
26% of New Hampshire Medicare beneficiaries choose to enroll in one of the 40 Medicare Advantage plans available statewide. Plan availability varies by zip code. For example, Hillsborough County has 38 Medicare Advantage plans available from nine insurance carriers and Coös County has 32 plans available from eight carriers (in 2023).
Original Medicare only covers about 80% of costs. Medicare Supplement (also known as Medigap) plans pair with Original Medicare to help cover the 20% of costs that Medicare doesn’t. They don’t provide coverage for additional healthcare services, but they do significantly reduce your out-of-pocket costs. Many Medicare beneficiaries choose to pair a Medicare Supplement plan with their Original Medicare coverage.
You cannot have both Medicare Advantage and Medicare Supplement. Most people choose to stay on Original Medicare and get a Supplement plan OR to switch to a Medicare Advantage plan. When comparing the two options, Medicare Supplement has some key benefits that you will not get with a Medicare Advantage plan, including:
You can see any doctor who accepts Medicare (about 90% of doctors nationwide)
You don’t need to get prior authorization for covered services
Out-of-pocket costs are significantly reduced, and Medigap Plan G even covers your Part A deductible!
Plan G is the most comprehensive Medicare Supplement plan, and generally considered the best. Our lead advisor, Ari Parker often shares that his mother’s outpatient knee replacement would have cost her $8,000 if she didn’t have a Medigap plan. Instead, with her Plan G, she reached the 2022 $233 Part B annual deductible, and then owed nothing else.
The best time to enroll in a Medicare Supplement plan is when you first enroll in Medicare, during the Medigap Open Enrollment period. The Medigap Open Enrollment Period lasts for six months, following your Part B effective date. During this period, you cannot be denied coverage, regardless of your age or any pre-existing medical conditions. Outside of this time, and a handful of other guaranteed issue periods, insurance companies may ask about your health history and may deny you coverage.
Most Medicare Advantage plans provide prescription coverage. If you’re on Original Medicare, you should get a standalone Part D (prescription drug) plan. There are 24 stand-alone drug plans in New Hampshire. Like with Medicare Advantage, specific plan pricing and availability depends on which county you live in.
Even if you don’t currently use any prescriptions, it’s generally recommended that you enroll in a low-cost option to avoid the Part D late enrollment penalty later.
If you have questions about Medicare options or want to compare plan benefits and pricing, schedule a free consultation with one of our licensed New Hampshire Medicare Advisors or give us a call at (888) 604-0055.
Healthcare costs can be overwhelming for many Americans. These three government programs help low-income New Hampshire Medicare beneficiaries pay for health-related expenses.
The New Hampshire Department of Health and Human Services operates the state Medicaid department and offers Medicare Savings Programs for low-income Medicare beneficiaries. These Medicare Savings Programs pay for some or all of residents’ Medicare expenses, helping them access the healthcare they need.
New Hampshire has three different types of Medicare Savings Programs, which may also be called Buy-In Programs.
1. The Qualified Medicare Beneficiaries (QMB) Program helps eligible beneficiaries pay for their Medicare Part A premiums (if applicable), their Medicare Part B premiums, Medicare deductibles, and Medicare coinsurance.
2. The Specified Low-Income Beneficiaries (SLMB or SLMB135) Programs helps by paying for eligible beneficiaries’ Medicare Part B premiums. SLMB135 beneficiaries cannot also be eligible for New Hampshire Medicaid.
3. The Qualified Disabled and Working Individuals (QDWI) Program helps by paying for eligible beneficiaries’ Part A premiums.
You can apply for these programs online by visiting NH EASY. If you need assistance determining if you’re eligible, applying, or accessing your benefits, reach out to our New Hampshire Medicare advisors at (888) 604-0055.
Extra Help is a federal program that helps pay for costs associated with prescription drug coverage, including premiums, deductibles, and coinsurance. It’s also commonly called the Part D Low-Income Subsidy (LIS).
You automatically qualify for Extra Help if you:
Receive full Medicaid coverage from New Hampshire
New Hampshire pays your Part B premium
Are eligible for Supplemental Security Income (SSI)
If you don’t automatically receive Extra Help, one of our licensed New Hampshire Medicare Advisors can help you figure out if you’re eligible and guide you through your application process.
Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:
You are 65 and older, blind, or have a disability
You have limited income and limited resources