What is Medicare?
Medicare is a medical insurance program for people aged 65 and older. Started in 1965 to help older adults pay for health care, Medicare is a federally run program and can be used as your sole coverage for health insurance or as a companion or back up coverage to other policies you may purchase.
Medicare is designed primarily for people over age 65, but over the years it has been expanded to cover some younger people with disabilities. Most likely, Medicare will not cover all of your health care expenses. There may be premiums, deductibles and co-pays and some services may not be covered. But read on!
How do I know what I need?
Understanding the Medicare maze can be frustrating! It may seem overwhelming, but we like to simplify it to one choice – will you go with the original Medicare Plan – Part A and B – and supplement it with Part D or will you choose a Medicare Advantage Plan (Part C). In order to make this decision, it’s helpful to understand that Medicare has several plans or parts. They include:
Part A and B
Part A and B are sometimes called traditional or original Medicare. Part A helps pay for hospital bills, and most of the time you have paid for your Part A premium through payroll taxes while you were working. Part B helps pay for visits to the doctor and other health care services, including screenings for some types of cancer, diabetes and heart disease.
Think of Part A as your hospital insurance plan. It covers stays in the hospital, nursing care and some home health services or skilled nursing care after a hospital stay and hospice care. This part of your coverage pays about 80% of your Medicare-approved hospital costs for the first 60 days you are in a hospital. If you need to stay longer, you will be responsible for part of the costs.
Part B pays for part of your doctor visits, some medical equipment, home health care, outpatient procedures, rehab, X-rays, tests, ambulance services, mental health care and blood services. Part B is optional and requires a premium and a small deductible.
Find out more about Part A and B Plans here.
Part C
Part C plans are also called Medicare Advantage plans. These are plans that are approved by Medicare and offered by private insurance companies. They are an alternate to Part A and B plans, or original Medicare as described above. Sometimes they cover prescription drugs. For more information on Medicare Part C plans, go to this part of our website. We do not typically recommend Part C plans, and we will tell you why!
Part D
Part D plans are also private plans, approved by Medicare that help people with Part A and B pay for prescription drugs. Part D is optional and offered by private insurance companies. Each plan varies in premiums, deductibles and co-pays. Find out more about Part D here.
You must be enrolled in Part A or B to enroll in the optional Part D plan.
How do I know if I am eligible for Medicare?
Most of the time, to qualify for the full benefits of Medicare, you must be 65 and have earned the coverage. This means that you or your spouse (or possibly your former spouse) worked and paid Medicare and Social Security taxes for at least ten years.
But you may also qualify if you are disabled or meet other requirements. You must be a U.S. citizen or permanent resident. For full information about eligibility requirements, it’s always best to go to the source – at Social Security or Medicare.gov
What about my family?
Medicare is not family coverage. If you qualify you are insured as an individual. You cannot add your children or younger spouse to your plan. Your spouse must qualify individually, and young adults can now stay insured under a parent’s employer plan or a private insurance plan up to age 26.
So, understanding Medicare does not have to be overwhelming. And we specialize in Medicare coverage! We are here to help you find the best plan to meet your needs and fit your budget. Call us today or click here for us to contact you.
Call us today Toll Free at (855) 825-1400. We will help you find the best Medicare Plan for you!
