If you are getting close to your 65th birthday you have a lot of stuff to think about. One major decision you need to make is signing up for your Medicare benefits. Understanding the costs and benefits of signing up for supplemental coverage will give you a huge advantage when you go shopping. It is no secret the cost of healthcare is on a strong upward trajectory of becoming very expensive. The majority of our senior population is living on a fixed income, and or has a part time job to keep up with inflation. It is very important to understand what your paying for when it comes to Medicare Coverage. In the following you will find the top 5 medicare questions people have when they sign up for their benefits.
1: When Can I Sign Up for Coverage?
Medicare is for people age 65 and older and those who have special condition(s) or disability. If you are a U.S. Citizen and meet the residency requirements, the Initial Enrollment Period is your first chance to sign up for Medicare. It starts 3 months before your 65th birthday, includes the month you turn 65, and ends 3 months after the month you turn 65.
You qualify for Medicare Part A and Medicare Part B if one of the following apply to you:
- You are age 65+
- You are already getting benefits from Social Security or the Railroad Retirement Board (RRB)
- You are under 65 and have a disability
2: How do I sign up for Part A & Part B?
- Apply online at Social Security (Include Link)
- Visit your local Social Security Office
- Call Social Security at 1-800-772-1213
3: What does Medicare Part A Cover?
Medicare Part A is the basic platform of coverage. This is your Hospital Coverage, and will cover certain things if you are admitted to a facility. The following is covered while you are admitted in the hospital, and some services may only be covered in certain settings or for patients with certain conditions:
- Hospital Care
- Skilled nursing facility care
- Nursing home care (as long as custodial care isn’t the only care you need)
- Hospice
- Home health services
To find out if the services or supplies you need is covered you should call your doctor for a consultation.
4: What does Medicare Part B Cover?
Medicare Part B is your Medical Insurance. It is designed to cover two types of services, medically necessary services, and preventative services.
Medically Necessary Services: are services or supplies that are needed to diagnose or treat your medical condition and usually prescribed by a primary physician.
Preventive Services: This is healthcare used to prevent illness, and would include items like a flu shot.
The following are examples of Part B coverage:
- Clinical Research
- Ambulance services
- Durable medical equipment
- Mental Health
- Inpatient
- Outpatient
- Partial Hospitalization
- Getting a second opinion before surgery
- Limited Outpatient prescription drugs
The best way to find out if a treatment is covered under Medicare Part B is to consult your primary doctor.
5: Do I need a Medicare Advantage Plan?
Like health insurance you received from your employer, you get what you pay for when it comes to Medicare. There are limitations to coverage when it comes to Medicare Part A and Part B. By choosing to purchase a Medicare Advantage Plan you will be covered for the items not covered by Part A and Part B. This excludes coverage for Hospice, because it is covered in your Part A coverage.
There are many versions of the Medicare Advantage Plans. Some plans offer extra coverage like, vision, hearing, dental, and health and wellness programs. Most of these plans also include Part D coverage which is prescription drug coverage.
The cost of healthcare increases as we get older, and we will see the doctor more frequently as we age. You will have the choice to pay for increased coverage in the form of Medicare Insurance, or you will choose to pay these increased costs out of pocket. I am a proponent of paying a little more in health premiums instead of risking your retirement savings for a catastrophic health condition.
To find the best prices on Medicare Advantage Plans use a service like Medicare Finder, and you can compare coverages from multiple carriers to find the right coverage for you.
