Medicare is a health insurance program for people 65 and older and under 65 with certain disabilities. You’re first eligible to sign up for Medicare 3 months before your 65th birthday, and you have a 7-month window to enroll beginning the month you turn 65. If you don’t sign up for Medicare during this initial enrollment period, you may have to pay a late-enrollment penalty. If you’re new to Medicare, you may be wondering how to get started. Here are the basics of what you need to know.
There are Four Parts to Medicare
Medicare comprises four parts: Part A, Part B, Part C, and Part D. These parts work together to provide you with complete coverage, but each part covers different services.
- Part A: Part A of Medicare covers inpatient hospital care, skilled nursing facility care, hospice care, and home health care. This part of Medicare is free for most people.
- Part B: Medicare covers outpatient services, such as doctor visits, lab tests, and X-rays. You pay a monthly premium for Part B coverage.
- Part C: Part C of Medicare is also known as Medicare Advantage. This part allows you to receive all your Medicare coverage through one plan. These plans can include hospital and doctor coverage and prescription drug coverage. You usually pay a monthly premium for Part C coverage, and sometimes you must also pay a deductible or copayment.
- Part D: Part D of Medicare is prescription drug coverage. You can receive this coverage through a stand-alone plan or a Part C plan that includes drug coverage. You pay a monthly premium for Part D coverage, and you may also have to pay a deductible or copayment.
You Can Get Parts A and B Without Paying a Premium
Part A is free for most people. You usually don’t pay a monthly premium for Part B unless you or your spouse ever worked and paid Medicare taxes while working. If you’re not sure whether you’re eligible for premium-free Part A, check with your personnel office if you’re still working or with the Social Security Administration if you’re already retired.
Medicare is secondary to employer coverage if you’re still working when you turn 65. ( This means that if you have health insurance through your job, you don’t need to do anything until you retire or your job-based coverage ends. You should sign up for Parts A and B 3 months before your 65th birthday or within eight weeks after you stop working (whichever comes first). You may pay a late enrollment penalty when you sign up for Part B unless you have other creditable coverage.
You Can Get Extra Coverage with Medicare Supplement Insurance
In addition to the four parts of Medicare, you can also purchase supplemental insurance, also known as Medigap. Medigap policies help cover some of the costs not covered by Medicare, such as deductibles and copayments. There are ten different types of Medigap policies available, and each type covers different costs. You can purchase a Medigap policy from any private insurance company that sells them. Medigap also offers two high-deductible plans, K and L. These plans have lower monthly premiums but higher out-of-pocket costs than other plans.
You Can Also Get Coverage Through Medicare Advantage Plans
If you don’t want to purchase a Medigap policy, you can get coverage through a Medicare Advantage plan. These plans are offered by private insurance companies that contract with Medicare. Medicare Advantage plans must cover all the same services as Original Medicare (Part A and Part B). Still, they can also offer additional coverage, such as prescription drugs, vision, and dental.
Most Medicare Advantage plans also include Part D prescription drug coverage. This can be helpful if you take a lot of medication, as it can be expensive to pay for prescription drugs out-of-pocket. Most Medicare Advantage plans include extra benefits, such as vision and dental coverage.
You Can Get Free Preventive Care Under Medicare
Medicare covers a wide range of preventive care services to help keep you healthy and catch health problems early when they’re easier to treat. These services are free when delivered by a doctor or other provider who accepts Medicare. Preventive care services covered by Medicare include:
- Annual wellness visits
- Mammograms
- Colorectal cancer screenings
- Flu shots
- Pneumonia vaccines
- Bone density tests
- Depression screenings
If you’re new to Medicare, there’s a lot to learn. But the basics are simple: Medicare is a health insurance program for people 65 and over or for people with specific disabilities. You can get coverage through four different parts of Medicare, and you can also purchase supplemental insurance to help cover costs not covered by Medicare. There are plenty of resources available to help you understand all your options and make the best choices for your needs.
Written by Allen Brown May 16, 2022 | Photo by Pixabay on pexels