Really? What is Medicare? It is so many things to so many different people, it is no wonder that so many people start off having no idea what it will be to them.
We are here to help you understand what Medicare will be to you in under 2 minutes.
What Is Medicare?
Simply put, it is a Federal Government healthcare program that provides for a large portion of the medical costs primarily for people over the age of 65.
Once you become eligible you can decide to enroll in original Medicare which includes Part A and Part B.
Or you may choose to enroll in an Advantage plan, sometimes referred to as Part C to provide you with your medical and prescription drug coverage.
If you choose original Medicare, then you will be eligible to also purchase Medicare Supplement Plans to cover the gap in costs that Medicare does not cover.
Part A is your inpatient hospital coverage.
Part B is your outpatient doctor coverage.
Part C is also known as Medicare Advantage and if you choose this coverage you will not be eligible for any of the other Medicare Parts or supplement plans.
Part D is your prescription drug coverage.
How Much Does Medicare Cost (2019)?
Most people qualify for ‘Premium Free’ Part A by you or your spouse working and paying taxes for 40 quarters.
Even if you qualify for premium free Part A, if you use your Part A insurance, you will be responsible for a $1,364 inpatient hospital deductible and coinsurance in 2019.
Part A only covers the first 60 days of hospitalization before you will be responsible for a large daily portion of your stay.
Many people will also choose a Medicare Supplement Plan to pay the Part A impatient deductible and provide for longer hospitalization coverage.
The Part B monthly premiums for outpatient and doctors’ visits start at 135.50 in 2019.
The premiums are determined by your income so if you make a larger amount of income your premiums could be higher.
The annual deductible and coinsurance is $185 in 2019.
After you pay your deductible, you usually are responsible for about 20% of remaining bill unless there are doctors’ excess charges.
Medigap insurance is also available to cover the charges that Part B does not.
Part D costs are dependent upon multiple factors:
- Plan Chosen
- Generic or Brand Name Prescription
- Most Effective
- Most Preferred
All prescription drugs are put into four categories based on effectiveness and prefer-redness.
The coverage amount each plan covers is determined by the drug category.
What Is Medicare Part C?
Most people know Medicare Part C as Medicare Advantage.
If you choose Part C, you will still have the benefits of Part A, Part B and possibly Part D but all the benefits will come from a private insurance company.
There may also be an additional premium by choosing Part C.
People will usually select an Advantage plan because they will receive some extra benefits.
The alternative is to select original Medicare and then choose a Medigap plan aka Med Supp.
There are multiple types of Advantage Plans:
- HMO (Health Maintenance Organization Plan)
- PPO (Preferred Provider Organization plan)
- PFFS (Private Fee-for-Service plan)
- SNP (Special Needs Plans)
- HMO-POS (Health Maintenance Organization – Point of Service plan)
- MSA (Medical Savings Account plan)
When Does Medicare Start?
Medicare starts on your 65th birthday but it is not automatic, you will have to sign up.
The enrollment period is seven months long with the initial starting period three months before your 65th birthday and ending three months after your 65th birthday.
Sign up earlier in the enrollment period to avoid a delay in your benefits.
Taking Action!
Now that you have a much better understanding of What Is Medicare and what it covers, it’s time to discuss your situation with a Senior Benefit Services expert.
There is a limited time you are eligible to enroll during your one-time open enrollment period or the costs of Medicare Advantage or Medicare Supplement coverage can increase dramatically.
Contact Senior Benefit Services today to find out what the best combination of coverage’s are for you.
