Medicare Basics

Key Takeaways:

• Medicare is a federal health insurance program designed for American adults aged 65 and older, as well as certain individuals under the age of 65 with disabilities and specific health conditions.
• Medicare offers coverage for a broad spectrum of medically necessary services, including preventative care, hospital stays, doctor visits, and more.
• To enroll in Medicare, individuals typically go through the Social Security Administration, which administers the program and manages the enrollment process.

You've been approaching retirement, envisioning a life where you're in control of your schedule, perhaps filled with travel, volunteering, cooking classes, and Medicare.

It's eye-opening when you realize that preparing for retirement means you'll need substantial finances to cover healthcare expenses. This is where understanding the fundamentals of Medicare becomes crucial, something many people overlook until it's time to enroll.

It's time to face the reality and understand how to finance your healthcare through Medicare.

Parts of Medicare

Medicare is like a health insurance plan for older Americans and some people with disabilities. It started in 1965 and now helps about 63.1 million Americans. The U.S. Centers for Medicare and Medicaid Services agency manages Medicare, but it's different from Medicaid, which helps low-income people of all ages.

Medicare: Your Government Health Insurance Plan

Medicare is the kind of insurance you might have from your job. You might have to pay some costs, like deductibles, coinsurance, and sometimes copays. Most people also pay a monthly fee, except for hospital coverage (Part A), which is often free.

Medicare has four main parts, and each part covers different aspects of healthcare:

• Medicare Part A: This is hospital insurance. It also covers skilled nursing facility care, hospice care, and in-home care.
• Medicare Part B: Covers doctor visits, outpatient care, home health care, durable medical equipment, and preventive screenings.
• Medicare Part C: Also known as Medicare Advantage, this describes Medicare-approved plans offered by private companies. They provide coverage for Medicare Part A, Part B, and usually Part D benefits.
• Medicare Part D: Covers prescription drugs, helping you pay for the medications you need.
• Medigap: Optional insurance to assist in covering certain out-of-pocket expenses.

When Can You Get Medicare?

Most people can start signing up for original Medicare three months before their 65th birthday. However, some exceptions allow you to be eligible for Medicare coverage at any age, including:

• Certain Disabilities: Eligible after 24 months of receiving Social Security disability benefits.
• Amyotrophic Lateral Sclerosis (ALS): Eligible immediately upon receiving Social Security benefits.
• End Stage Renal Disease (ESRD): Automatically eligible to enroll.

How Do You Enroll in Medicare?

If you qualify for Social Security benefits at age 65, Medicare Part A and Part B will automatically enroll you. For other parts, such as Part D or Medigap, you must enroll yourself through the SSA website.

Missing the initial enrollment or wanting to change plans later can be done during annual Medicare open enrollment periods.

Expert Guidance

Are you seeking help to get clarity on your healthcare coverage choices? Allow our team of experts to guide you in understanding your basic benefits, and then we can assist you in selecting the right supplemental plan. Reach out to us today!