Everybody probably knows that the federal government provides a health insurance program named Medicare. The Medicare Program is only offered to individuals 65 and older and those with certain disabilities. Choosing Medicare coverage can be confusing. Once an individual is eligible, the knowing the facts about Medicare coverage is helpful in making the right decision. Medicare has several parts designed to help meet the needs of anyone who qualifies. Since Medicare coverage can be complex, it is essential to learn how Medicare works, what the different parts are, and how they fit into your current situation. One should always review his or her health care needs and finances before making a selection.
The Social Security Administration is the agency that handles the
paperwork when applying for benefits. When an individual becomes
eligible for Medicare, the first thing they need to know is that the
Original Medicare coverage is Part A and Part B. Part A pays for
inpatient care and Part B pays for outpatient care and physician visits.
Some benefits not covered by Original Medicare are most dental care,
routine eye care, cosmetic surgery, chiropractor service, custodial
care, routine foot care, acupuncture and most care while traveling out
of the United States.
There are several key points worth knowing about Medicare. One point is
there are two ways in which to get Original Medicare. A recipient can
select Original Medicare on its own, and as an option add prescription
drug coverage and include Medigap for coverage for more complete
coverage. The other way is to select a Medicare Advantage plan that
bundles extra benefits, normally obtained through an insurance company.
Another key point is although Original Medicare does not include
prescription drug coverage it is available. However, a Part D is
available that does cover prescriptions. Everyone contributes to
Medicare through paying taxes while working.
However, when an individual starts using Medicare they are responsible
for paying a share of covered benefits thorough terms such as monthly
premiums, coinsurance, deductibles and co-payments. It is necessary to
understand what the terms mean. The term premium means the cost paid to
participate. The term deductible means the amount one has to pay before
the plan pays. The term co-payment means the share paid for a medical
expense. The term coinsurance means the percentage of health care costs
that are split with the plan. Understanding Medicare costs is essential
in order to receive the right benefits for each individual situation.
An additional key point is that the share of the Medicare costs may be
larger than anticipated. Medicare simply does not cover some expenses.
Many individuals prefer to add extra coverage through a supplement plan
to help fill in the gaps of coverage. Since, Original Medicare does not
cover everything individuals, can enroll in Part C a Medicare Advantage
Plan, Part D a Medicare Prescription Plan, and/or Medigap a Medicare
Supplement Plan to help defer some of the costs not covered by Original
Medicare. Medicare Advantage plans may also include coverage for vision,
dental, prescription, preventive and hearing along with all the
services associated with Original Medicare coverage. Part D plans help
pay for the cost of prescriptions. Supplement plans help with some of
the medical costs not covered by Original Medicare. There are also
programs available to help individuals with limited incomes with the
cost of Medicare.
Many people do not realize that where they reside makes a difference.
Although Original Medicare is the same across the U.S., other parts
offered are by private insurance companies and may be available only in
certain states. Timing is a key point to remember. Enrollment to join
begins three months prior to your 65th birthday or the date of
eligibility due to a disability. If an individual, who qualifies for
coverage waits until after the eligibility period ends, the choices may
be more limited and the premium may be higher. Since plan choices do not
have to be permanent, it is certainly a great idea to review health
care needs at least once per year. Need may change over time. A good tip
to remember is that the coverage selected can be change each year, and a
new plan selected, but only during the annual enrollment period.
Therefore, it is an excellent idea to review health care coverage each
year to check that it still meets the required health needs and provides
Last of all; do not be afraid to ask for help. Understanding the basics,
about Medicare and what the plan includes so the selection will be the
right plan and coverage needed.