The ABCs of Medicare and What You Need to Know
There’s something golden about turning 65. All of your previous challenges with healthcare insurance melt away (for the most part) when you’re a senior. As long as you worked for at least 10 years and paid Medicare taxes, then you automatically qualify for Medicare at age 65. In some cases, you can enroll in Medicare earlier if you have a disability or advanced kidney disease. However, for healthy seniors, you’re already in the club. Enrollment periods open early in the year for coverage starting in July, but initial enrollment begins shortly before your 65th birthday. This article will help you learn the ABCs of Medicare.
Medicare Overview
Medicare offers full coverage for your medical needs in a similar manner as private health insurance. As with all systems and plans, Medicare can be confusing to someone who’s new to this. There are many parts, information, and criteria to consider before you decide to settle on a plan that works for you.
Medicare has four parts: A, B, C, and D. Parts A and B are also known as Original Medicare, and both are tied to Social Security benefits. If you qualify for Social Security benefits, then you automatically get Part A and B coverage. If you don’t get Social Security, then you’ll need to sign up separately for Parts A and B. All Medicare services may come with co-pays, co-insurance, and deductibles.
Medicare Part A
Medicare Part A covers hospital insurance, which includes hospital stays, hospice care, skilled nursing, and home health care. A perk of Part A is that there are no premiums if you’ve already paid Medicare taxes for at least 10 years. If you never need to use this service, then you’ll never pay a penny for it.
Medicare Part B
Medicare Part B covers non-hospital medical insurance, such as doctor visits, preventive care, and outpatient care. Common healthcare services within the senior population typically fall under this category. Like private insurance, there are premiums for this service, as well as co-pays and deductibles.
Medicare Part C
Part C is referred to as Medicare Advantage, which is a private insurance plan under contract with Medicare. Medicare Advantage plans offer benefits from Part A and B, essentially replacing those plans with privately run insurance programs. With Part C, you might also receive more coverage for areas Medicare doesn’t cover, such as prescription drugs, dental, and vision. You’ll have to pay a premium for Medicare Advantage, but it could also cover the premium for Parts B and D. Because these are privately run programs, costs will vary, so shop around and compare options online.
Medicare Part D
Part D covers prescription drugs. Prescription Drug Plans (PDPs) are privately run programs by insurance companies under contract with Medicare. PDPs are added to Original Medicare, and they cover both brand name and generic drugs. Not only are your prescriptions covered, but your prescription costs can also be lower and protected from future price hikes. Keep in mind, however, that the plan might require you to pay premiums, deductibles, co-pays, co-insurance.
Medigap Or Medicare Supplemental Insurance
Also known as Medicare Supplemental Insurance, Medigap is another private insurance plan that covers the things that Original Medicare (A and B) doesn’t. Unlike Part C, which is designed to replace A and B, Medigap is its own form of supplemental coverage that’s added to your Medicare plan. You cannot have both Medicare Advantage and Medigap, so you’d have to choose one. The cost difference is that Medigap has higher premiums, but it will save you on out-of-pocket costs for services that wouldn’t be covered under Medicare.
To help decide what’s right for you, look at what your needs are, how often you see a doctor, and how much you’re willing to spend on your medical costs. While some premiums may be higher, the out-of-pocket costs end up being less after the service is received. After age 65, your medical costs can be more affordable and comprehensive, but it might take a little homework and careful research to get there. Get signed up today so your future medical expenses can be worry-free. We hope this helped you with the ABCs of Medicare.