What do I Need to Know About Medicare?

What do I Need to Know About Medicare?
What do I Need to Know About Medicare?

Medicare is a confusing thing for many seniors as they try to take a look at all of the options and see what will work the best for them. This is a type of government-funded health insurance available to seniors in America who are 65 and older as well as those who have chronic disabilities and other health conditions. But there are a few different options to consider when choosing Medicare and there isn’t a one size fits all idea that goes with it either.

If you are getting close to the age of 65 and you want to pick out the right health insurance for your needs, then you need to learn more about the different types of Medicare and what they all mean. Let’s dive in and learn a bit more about Medicare to clear up some of the confusion.

What is Medicare?

First, we need to take a look at what Medicare is. Medicare is basically a government-funded insurance program for those who are at least 65 years old. Some individuals with chronic conditions can get it younger, but it is usually reserved for those who are nearing or already in retirement. There are a few different types of Medicare to choose from including:

  1. Medicare Part A: This is often known as hospital insurance and it is going to cover some of the services that you get when you are put into a hospital or another healthcare facility. You will need to meet a deductible on this one and there are some co-insurance fees. Depending on your income level, you may need to pay some kind of premium on Part A coverage.
  2. Medicare Part B: This is going to be more of the medical insurance and can cover the outpatient services that you would get for your health condition. You will need to cover the annual deductible and a monthly premium. Parts A and B are usually combined to form the original Medicare.
  3. Medicare Part C: This is going to be known more as Medicare Advantage and is a private insurance that will cover both Part A and Part B. Most of these plans will also cover additional services like dental, hearing, and medications. You will need to pay for these, but you can often find some affordable choices.
  4. Medicare Part D: This is the part that will help cover the medications that you need. Many of the Medicare Advantage plans will have coverage for medication as well, but you can do this one if you think you will need quite a few medications in retirement.

Medigap: This is sometimes known as Medicare supplemental insurance. It can be added to the original Medicare that we talked about above to cover some of the other costs that you have for insurance and your health. You will need to cover an additional premium for this plan.

What is Covered in Part A and Part B?

Most individuals will choose to get Part A and Part B as a minimum. This can protect them for a lot of different situations that may come up with their health and the premiums are often low. For some individuals with lower income, their premiums and deductibles can be nothing. The coverage that you will get depends on the insurance you pick, but with Part A, some of the services that are covered include:

  • Inpatient hospital care
  • Hospice care
  • Limited amounts of home healthcare to help you around the home
  • Limited skilled nursing facility care when needed
  • Inpatient psychiatric care
  • Inpatient rehab care

This part of the Medicare bundle is not going to cover some of the outpatient services that you need, including emergency room visits, unless you end up having to stay as a patient for longer. You will need to have Medicare Part B to get some of the coverage for this. Some of the coverages you can expect from Medicare Part B includes:

  • Preventive services
  • Any of the outpatient mental health services you may need
  • Clinical research services
  • Durable medical equipment that is used to treat some of your health conditions
  • Any of the medications and treatments that are given to you by a healthcare professional
  • Any diagnostic services like X-rays and blood tests
  • Emergency ambulance transportation

If you need coverage for medications, then you will need to take a look at some of the other plans that are offered through Medicare.

Who is Eligible for Medicare?

Most people will be able to start the process of enrolling in Medicare about three months before they turn 65. However, there are a few other situations where you could get this coverage, regardless of your age. These include:

  • Certain disabilities: The SSA and the Railroad Retirement Board can provide monthly disability benefits if you are eligible based on certain disabilities.
  • Amyotrophic lateral sclerosis or ALS: If you have ALS, you could be eligible to get Medicare from the first month.
  • End stage renal disease: This will automatically qualify you to enroll in the Medicare program that you would like.

Most people who are eligible for Medicare will need to enroll during the enrollment periods. These can be the three months before, the month of, and the three months after you turn 65. There is also a general enrollment of January 1 to March 31 if you did miss the initial enrollment period. Just be aware that there are some additional fees that you need to handle for this one.

When you are looking into some of your benefits of Medicare and you want to get the best experience possible and the best coverage, then take a look at what Ensurem can provide. We are here to work with you to make it through the different components of Medicare, ensuring that you will be able to get a good amount of coverage for an affordable price. From providing more information on Medicare to making sure you have the right phone numbers to call to get signed up, our team is here to help you out!

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