Overwhelming—this is how the healthcare landscape in the US is commonly described. If you’re 65 or older, you have to take the time to check out what options are available to you under Medicare, the federal health insurance for seniors.
Familiarizing yourself with your Medicare options early on is one of the things you can do to prepare. Otherwise, you may want to reach out to agents or agencies like We speak Medicare – Boomer Benefits and others to help clarify any questions you may have or to guide you choose the plan that fits your needs.
To get you started, here’s a senior’s help guide to Medicare health insurance:
1. Enrollment
Not everyone is qualified to get Medicare coverage. Here’s a list to check your eligibility:
- US citizen, US resident, or a lawfully admitted alien who lived in the United States for five continuous years
- Age 65 or older
- Disabled for over 24 months
- Diagnosed with end-stage renal disease or Lou Gehrig’s disease (ALS)
Medicare enrollment is held only at certain times throughout the year. You can opt to enroll during the annual enrollment, which runs from October 25 to December 7, or during the General enrollment period, which starts on July 1. Note that missing the initial registration, which is the window before and after your 65th birthday, means higher premium payments for Part A and Part B of Medicare.
For seniors or their spouses still covered by an employer’s group insurance, you have the option to enroll anytime while still covered by group insurance or within eight months after your coverage ends.
2. Coverage
Since you can’t switch plans abruptly or add supplemental insurances at the drop of a hat, studying what coverage these plans have and if they’re appropriate for your medical needs is crucial.
Original Medicare
This is commonly called the traditional Medicare program, the fee-for-service program. With this, you can choose any doctor located anywhere in the country, and the government will pay directly for the costs you accumulated for health care. Original Medicare comprises Part A and Part B.
Medicare Advantage
This is a plan from a private company that’s Medicare-approved. Medicare Advantage is usually a bundle comprised of Part A, Part B, and sometimes Part D. This may have lower out-of-pocket costs than Original Medicare. Often, Medicare Advantage may include other benefits like hearing, dental, and vision services.
To get a picture of what you are getting, here are Medicare Parts A, B, and D for your review:
Medicare Part A
This is also known as the hospital insurance. Part A covers patient costs, including home health services, hospice care, skilled nursing facilities, and hospital inpatient expenses. The federal government would give Medicare Part A for free to you or your spouse if you could complete your Medicare contributions when you still worked. For those who have minimal or no work history, you pay a premium of USD$499 every month.
Medicare Part B
This is popularly referred to as the medical insurance. Medicare Part B covers most outpatient prescription drugs or services for your medical condition treatment as long as they meet the accepted standards of medical practice. Preventative services are also included in Part B.
Medicare Part D
This is the prescription drug benefit for outpatient drug coverage and is an optional component in your health insurance. This insurance is provided only by a private insurance company approved by the federal government.
3. Considerations
Before signing up for any Medicare plan, it’s essential to list down every medical requirement you need that may impact your living arrangements and financial health. These considerations are as follows:
Cost
Make sure your yearly budget can accommodate your insurance premiums, inquire about your deductibles, and do your due diligence in examining what other fees you should expect. Make it a point to know the limit of out-of-pocket costs if you plan on signing up with Medicare Advantage.
Coverage
Make a checklist of your medical needs and your living arrangements. If you travel a lot, make sure the coverage you get includes the places you frequent.
Network Of Hospitals And Doctors
Ask your health providers or doctors which coverage they accept and if the hospitals of your choice belong to the network of providers that cater to your health insurance option.
Wrapping Up
Going into your golden years can be a roller coaster ride. With many physical and mental changes, you have to start preparing for the worst. Studying your options as early as possible means having an easier time determining which health care plan would be the most beneficial for you.
It’s essential to ask for help if things become chaotic and confusing. You’re not the only one who gets frazzled navigating the healthcare industry. So, buckle up and keep this guide with you so you can use it when you’re ready to pick a Medicare health plan.