What You Should Know About Medicare Before You Enroll: Join the Livingto100.Club
Guest Author, Sharon Wagner
Medicare is a valuable resource that was created to provide affordable care for seniors and younger people with disabilities. For those looking to sign up or who are unfamiliar with the program, the numerous letters and plan names can easily confuse you. While it might seem overwhelming at first glance, Medicare is less a foreign language than what it initially appears. Here’s a glance at Medicare to help you understand how it works and which plan is right for you.
PARTS A & B: ORIGINAL MEDICARE
On the surface, Medicare is broken into four parts: Parts A, B, C, and D. Parts A and B are called Original Medicare, and it focuses on hospital and medical insurance (respectively). Original Medicare is managed by the federal government to provide eligible recipients with coverage and access to hospitals, doctors, and other healthcare providers.
Part A covers hospital insurance that includes inpatient care, care received at a hospital or a skilled nursing home, and in some circumstances, care given at home. Most people over the age of 65 are automatically eligible if they are already collecting retirement benefits. In most instances, you will not have to pay a monthly premium if you paid taxes on Medicare over the years; however, you will be responsible for any copays, coinsurance, and/or deductibles.
Part B addresses medical insurance that covers necessary services to treat your health. These services include outpatient care, preventive services, and other common medical needs. Those who are eligible for Part A are also eligible for Part B. Unlike Part A, there are monthly premiums that you are responsible to pay.
PART C: MEDICARE ADVANTAGE PLANS
Outside of Original Medicare, you also have the option to seek out Medicare Advantage Plans. Medicare Advantage, or Part C, is a plan is provided by a Medicare-approved private company that offers coverage for all of Original Medicare benefits under Parts A and B. In some instances, Medicare Advantage might even offer additional coverage that is not provided under Original Medicare for things such as vision, dental, and/or prescriptions. Take a look at Aetna’s Medicare Advantage plans to see if you could become one of the 1.4 million-plus people who subscribe to these supplemental plans.
PART D: MEDICATION
Also known as the Medicare prescription drug benefit, Part D is an optional program that offers prescription drug coverage to everyone with Medicare. You can get your medication covered by enrolling in Part D or through a Medicare Advantage Plan that includes it. Anyone with Part A or B is eligible for Part D, but unlike Original Medicare, Part D coverage is not standardized, and is provided through private insurance companies. Part D coverage is optional, but enrollment during initial eligibility is encouraged. You might have to pay a late enrollment fee if you join later.
FILLING IN THE GAPS
Medicare Supplement Insurance, also known as Medigap, is an additional plan that you can buy from private companies to pay for healthcare costs that Original Medicare doesn’t cover. Copayments and deductibles might fall under this category. Think of it as filling in the gaps that Medicare doesn’t cover. Medigap will not pay for any costs that are accrued outside of your Medicare coverage.
Once you get through the options that you have, be sure to select the plan that best fits your health needs and your financial situation. Every senior will have different medical criteria and different plans that they can afford, but it’s important to not cut any corners for your own care. There are few things in life that you should make compromises on, and healthcare isn’t one of them.
(Our thanks to the author for this useful information. She can be contacted at Sharon.Wagner@seniorfriendly.info.)
Photo Credit: Pixabay
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