Information on Medicare
Medicare is a federal health insurance for individuals who are 65 years or older, younger people who have disabilities, or individuals who are at the end-stage of renal disease or cancer.
The coverage is broken down into four different subcategories:
- Medicare Part A: Covers hospital stays, short-term nursing home stays, and in some instances in-home healthcare.
- Medicare Part B: Covers doctor’s visits, preventative care, outpatient services and medical supplies.
- Medicare Part C: Covers both Part A and B options by aligning with a private insurance agency.
- Medicare Part D: Covers prescription drugs.
It is important to evaluate your options to see which type of Medicare is the best solution for your specific needs. Not everybody needs additional coverage, but for some, it is the most cost-effective solution.
In some instances, individuals may automatically be enrolled in Medicare. However, other people must apply for the insurance at specific times.
If you have to enroll yourself, then you should follow these guidelines:
- Eligibility usually beings 3 months before your 65th birthday
- Initial Enrollment includes the month that you turn 65
- Initial Enrollment ends 3 months after your 65th birthday
It is important to know your registration dates so that you don’t miss important deadlines.
If you do happen to miss the window of opportunity, you may be responsible for a late-enrollment fee. Plus, you may have a gap in insurance coverage which could lead to hefty medical fees that you are responsible for.
Which Options Should You Choose?
You have a few options when it comes to Medicare coverage. It can be a little confusing understanding which option is right for you. The common suggestions are:
- You should enroll in Medicare Part A once you turn 65, even if you are employed. You have already paid into Medicare tax during your time of employment. This means that you will not have to pay a monthly premium.
- Everybody must pay a monthly premium for Part B, even if they have paid Medicare tax. In some instance, it may be acceptable to delay Part B coverage if you have other insurance through your employer.
- The premiums for Part B vary and will depend on your income and when you enroll in the program. The fee may increase or decrease from year to year.
- Some people opt to get additional coverage such as Part C or Part D depending on their healthcare situation. However, many people hold off on other insurance because their employer insurance is efficient.
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Being adequately insured is very important to help individuals avoid costly medical bills and ensure that people are receiving proper healthcare.
Other information about Medicare you should know about:
- If you receive Social Security benefits, then you are automatically enrolled in Medicare. All other individuals must apply for the program themselves.
- If you or your spouse are employed and have health insurance that covers you, then you may delay enrolling in Medicare without the threat of late fees or other penalties.
- Medicare is not free. Most people will still have to pay premiums and/or co-pays for their care. However, there are income-based programs and additional insurance that may assist with extra costs.
- Medicare does not cover all medical expenses. While there are many things that the program does cover, other things such as long-term stays in nursing facilities or routine dental care are not included.
What You Should Do Next
Evaluating the various options available through Medicare is important. If you are considering enrolling in the program, then you have many points to keep in mind. You should consider:
- Current healthcare coverage via employer —If you have health coverage, check to see what is include and if Medicare will be a significant advantage.
- Need for additional coverage —Do you need additional coverage, such as Plan D that covers prescription medications? Additional coverage may save you a considerable amount of money.
- Eligibility criteria —Do you fit the age, disability, or illness requirement to be eligible for the program?
- Doctors —Make sure that you have a doctor in your area that accepts the coverage and is taking new patients if you need to change doctors.
- Cost of coverage —Consider the costs of premiums and co-pays for the coverage you select.
- Travel —Make sure that your option is covered when you travel to different states.
- Dates for enrollment —Check the status of your enrollment eligibility to make sure that you don’t miss important dates.
Consider which options provide ample coverage and are also the most cost-effective for your lifestyle.
Remember that proper insurance coverage will not only protect you financially but ensure that you are receiving the best possible care for your medical situation. Reach out to your health provider to find access to resources in your area that can answer specific questions.