Medicare is federal health insurance for adults 65 and older and is what many individuals pay into overtime. Some individuals with disabilities and those with End-Stage Renal Disease are also eligible for coverage to ensure they obtain medical services. There are many different parts of Medicare and the coverage they offer to older adults.
Understanding Medicare: Things You Should Know
Types of Medicare
There are different services that are covered depending on the type of Medicare plan you’ve obtained and the types of people who are eligible to receive coverage.
Medicare Part A – This covers hospital stays, hospice care, different types of home healthcare, and skilled nursing facilities.
Medicare Part B – This part covers some types of doctor services, as well as preventative services and medical supplies.
Medicare Part C – This covers prescription drugs, including vaccines or shots that the policyholder needs according to Medicare expert from Clearmatchmedicare.
After you enroll in Medicare, you’ll need to decide how to get the coverage, whether you select Original Medicare or Medicare Advantage.
What is Original Medicare?
Original Medicare allows you to have access to Medicare Part A, as well as Medicare Part B. This requires paying a deductible each year, which is often 20 percent of the approved service you’ve obtained. You have the option of adding a separate plan if you need to obtain drug coverage.
A lot of medical care and supplies are covered under Original Medicare, but some are exceeded from the plan. You can also obtain a Medicare Supplement Insurance plan, which will help in paying the remaining costs for the health care services you receive. You can even obtain coverage for medical services you receive overseas.
Some dental services are covered by the plan if you need a procedure or surgery in the hospital.
What is Medicare Advantage?
Medicare Advantage is useful for assisting in the cost of prescription drugs that you obtain. You’re required to obtain a Medicare-approved plan, which varies in cost and the types of drugs that are approved to be covered. Both generic and brand-name prescription drugs are typically covered.
The monthly premiums vary depending on the type of plan that you’re approved for after you apply. Additional costs may accumulate with your plan throughout the year.
How to Enroll in Medicare
Enrolling in Medicare is easy if you’re over the age of 65 and are already receiving social security benefits because you automatically obtain coverage. You can have access to both Medicare Plan A and Medicare Plan B.
If you currently don’t receive social security benefits, you’ll have to access the Social Security Administration website to sign up. You can sign up within seven months of when you turn 65, whether it’s three months before or after your birthday. Waiting too long to enroll can lead to penalties.
The Cost of Medicare
If you’re eligible for Medicare Part A, you don’t have to worry about paying any premiums for the services you receive if you or your spouse has paid into Medicare taxes in the past 10 years. These taxes are included in any payroll taxes you’ve previously paid with your employment.
If you’re eligible but haven’t paid into Medicare, you can expect to pay an average of $471 each month. Monthly premiums are required for the other parts of Medicare that are available.
What Medicare Doesn’t Cover
When you obtain Medicare or are applying for coverage, you’ll need to be aware of what it doesn’t cover. It doesn’t cover any long-term care that is needed if you’re disabled or are suffering from an ailment. It also won’t cover the cost of hearing aids, cosmetic surgery, massage therapy, dental care, medical services you receive in other countries, eye exams and glasses, and hearing aids.
What is Medigap?
Medigap is a branch of Medicare that is another policy you can obtain if you need assistance with the different costs of services or supplies that Part B doesn’t cover. This includes coinsurance or deductibles that you must pay. 10 different types of Medigap are available, depending on the types of services you expect to receive in the future. Unfortunately, this plan doesn’t work in conjunction with Medicare Advantage, which requires obtaining only one of the plans.
Once you obtain Medigap, you can use the coverage to help pay for the cost of acupuncture, international travel, shingles vaccine, cataract surgery, home health care, assisted living, chiropractic care, eye exams, COVID tests and vaccines, hearing aids, and dental care.
Can I Obtain Medicare if I Already Have an Insurance Plan?
If you already have insurance through a private provider, you may still be eligible for Medicare, but it depends on the plan you’ve obtained. It can depend on the size of the company where you’re employed. Some people are eligible for Medicare Plan A or Plan B if they work at an establishment that has less than 20 employees. If your place of employment has more than 20 employees, you can contact the benefits manager to inquire if you currently have group health plan coverage. If you have this coverage, it’s possible to obtain Part A or Part B at a later time without suffering from any penalties.
If you have private insurance or have obtained insurance through the marketplace, you can try to obtain Medicare Part A without paying any premiums for the services. You also have the option of choosing Part B or keeping your current coverage if it costs less than a Medicare plan.
Keep in mind that waiting too long to obtain Part A or Part B of Medicare can come with hefty fines, making it necessary to start the process as soon as possible.
