What is Medicare?

After attaining the age of 65, you qualify to enroll and benefit from a program that you have been contributing for a long time. However, getting the most out of the Medicare program is not a walk in the park.

According to a recent survey, it is estimated that about 65 percent of seniors enrolled in the program are not aware of the different options such as Parts A, B, C, and D. This clearly shows that lack of information about the program is a big issue.

For example, missing your enrolment date can translate into penalties or increased premiums for your entire membership period. Besides, you need to be careful to ensure that you only pay what you need.

If you are approaching the age of 65 or assisting your parents, it is important to clearly understand how the program works in order to make the most out of it.

How to sign up for the program

In case you are already getting Social Security, it means that you are automatically a member of the Medicare program. You are supposed to receive your card within two or three months prior to your birthday. The coverage basically takes effect on the first day of your birthday month.

Part A of the program covers hospitalization and doesn’t include any premiums – assuming that you paid it while working. Part B of the program requires you to pay premiums and covers for various medical services, although you can opt out any time.

But if you haven’t started receiving Social Security, then you will have to enroll in the program during the stipulated enrolment periods in the course of the year. Your first enrolment period will last for at least seven months before turning 65 years.

You can find your Medicare number on your Medicare card or you can sign in to your MyMedicare.gov account to see your number. Make sure to only give your Medicare number to health care professionals you trust.

To prevent creating a gap in your coverage, you should try to register for the program at least three months before your 65th birthday.

Should you enroll at 65 if you are covered and still working?

If you are facing such a situation, the best thing to do would be to enroll in Part A – because it doesn’t require you to pay any premiums and can also cater to some expenses not available in your employer’s health plan.

Part B premiums could be higher because of your income. As such, it would be wise to delay enrolling in this program until you retire – provided you are working in a company that has 20 or more employees.

If the company that has employed you has less than 20 employees, it would be wise to enroll for part B coverage. This is because Medicare is regarded as your basic insurance. The good news is that you can register at any time without paying any penalty within the 8 months after terminating your employment.

How about Part C and Part D programs?

Part C is also referred to as Advantage. It comprises plans offered by private companies like preferred provider organizations and health maintenance organizations. These two programs offer almost the same services found in Parts A and B such as dental, hearing, and vision coverage.

The costs of plans in part C differ depending on the insurance company. It is always important to get a list of insurance companies and compare their rates before making the final decision. Some insurers tend to be more expensive in terms of premiums compared to others.

Additionally, some plans may require referrals or limit you to doctors or health professionals in a certain network. You must also have Parts A and B plans before enrolling.

Another thing to consider is that some plans may restrict their coverages to particular geographical areas. This means that if you are contemplating to travel wide or relocate, then Part C program will not fit you.

Part D basically provides cover prescription drugs for both generic and brand name. However, you must be enrolled in the original program in order to be accepted into the Part D plan. You can only buy this plan from a private insurance company.

Although deductibles, co-payments, and premiums differ according to the plan, the amount you can be charged for prescription drugs is limited by federal laws. It is important to check whether you are already covered for prescription drugs before enrolling in Part D. If you are already enrolled, then there’s no need to enroll twice.

What services are not covered by the program?

Parts A and B of the original program will not cover coinsurance, deductibles, or co-payments. It also won’t cover medical care when a person travels outside the United States.

Additionally, other services such as acupuncture, long-term care, and cosmetic surgery are also not covered. But some of these services can be covered form those enrolled in a Part C plan.

You can also supplement the original program with a supplement insurance program – also referred to as Medigap. All plans offering Medigap adhere to strict state and federal standards and the costs differ from one insurer to another.

For you to be allowed to purchase Medigap, you must be enrolled in both Parts A and B. You should enroll at least six months after enrolling with Part B in order to guarantee availability.

Additional information

After getting enrolled in any of the above programs, you can keep reviewing them and make adjustments on a yearly basis. In general, you should always check the plans every year to see which one best suits your situation and make necessary changes.

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