Medicare Basics
Medicare is a federal health insurance program primarily for individuals aged 65 and older, but it also covers younger people with certain disabilities and conditions. Understanding Medicare is essential as you approach eligibility. There are different parts of Medicare, each providing distinct types of coverage.
Types of Medicare
Part A (Hospital Insurance)
Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B (Medical Insurance)
Covers certain doctors' services, outpatient care, medical supplies, and preventive services.
Part C (Medicare Advantage)
An alternative to Original Medicare, offered by private insurance companies approved by Medicare. It includes Part A and Part B, often with additional benefits.
Part D (Prescription Drug Coverage)
Helps cover the cost of prescription drugs.
Medicare Advantage
Medicare Advantage plans, also known as Part C, are offered by private insurance companies. These plans provide all of your Part A and Part B coverage and often include additional benefits like vision, dental, and hearing. Some plans also offer prescription drug coverage.
Medicare Part B
Medicare Part B covers medical insurance for services like doctor's visits, outpatient care, preventive services, and medical supplies. There is a monthly premium for Medicare Part B, which varies based on your income.
Original Medicare
Original Medicare includes Part A and Part B. It provides coverage for hospital and medical insurance but does not cover everything. For instance, prescription drugs, dental, vision, and hearing are not covered by Original Medicare. You may need additional Medicare Supplement Insurance (Medigap) to help cover the costs that Original Medicare does not.
Medicare Enrollment
You can enroll in Medicare during the Initial Enrollment Period, which starts three months before you turn 65 and ends three months after your birthday month. If you miss this window, you can sign up during the General Enrollment Period from January 1 to March 31 each year, but you may pay a late enrollment penalty.
Medicaid
Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, like nursing home care and personal care services. You can be eligible for both Medicare and Medicaid, known as "dual eligibility."
Medicare Cost
The cost of Medicare varies based on the parts and plans you choose. Here's a breakdown:
- Part A: Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes while working. If not, you may need to pay a premium.
- Part B: There is a standard monthly premium for Part B, which can be higher based on your income.
- Medicare Advantage (Part C): Costs vary by plan and may include additional premiums, deductibles, and co-payments.
- Part D: Costs include monthly premiums, co-payments, and deductibles, which vary by plan.
- Medigap Plans: These are additional policies that help cover out-of-pocket costs not covered by Original Medicare. Costs vary based on the plan and provider.
Medicare Supplement Insurance
Medicare Supplement Insurance, also known as Medigap, helps cover the costs that Original Medicare does not, such as copayments, coinsurance, and deductibles. These plans are offered by private insurance companies and can be a valuable addition to your Medicare coverage.
How Medicare Works
Medicare works by providing health insurance coverage through various parts and plans. You can choose Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Depending on your needs, you may also consider adding a Part D plan for prescription drugs and a Medigap plan for additional coverage.
Apply for Medicare
You can apply for Medicare online, by phone, or in person at your local Social Security office. It's recommended to apply three months before you turn 65 to ensure your coverage starts on time. If you are already receiving Social Security benefits, you will be automatically enrolled in Parts A and B.
Medicare Eligibility
To be eligible for Medicare, you must be 65 years or older, or under 65 with certain disabilities or conditions. You must also be a U.S. citizen or permanent legal resident for at least five continuous years.
Choosing a Medicare Plan
When choosing a Medicare plan, consider your health needs, budget, and preferred healthcare providers. You can compare different plans based on coverage, costs, and additional benefits. It's essential to review your options during the Medicare Advantage Open Enrollment period to ensure you have the best plan for your needs.
Let's Help You Apply for Medicare
Ready to learn more or need help choosing the right Medicare plan? Call BoomerBaby at 1 (800) 903-8044. Our friendly team is here to assist you!