Medicare was created to provide affordable health coverage for retirees and their spouses who were no longer eligible for medical insurance through employment. Medicare health plans are normally offered through private companies which contract to provide benefits under Parts A (hospitalization coverage) and B (medical insurance, such as healthcare providers and most non-hospital services.)
Start by visiting Medicare’s website for plan options and benefits, as well as information about how enrollment processes work. There are several choices for Medicare coverage available, depending on affordability and other factors mentioned below.
Understanding Medicare: An Overview
Plans and coverage available through Medicare include the following:
- Part A – Part A covers hospitalization expenses and is included with part B in Original Medicare.
- Part B –As the other half of Original Medicare, this portion covers physician and other non-hospital services.
- Part C – Also known as Medicare Advantage (MA), these plans may offer a more comprehensive form of coverage while keeping costs down. These often take the form of an HMO (“health maintenance organization”) or PPO (“preferred provider organization”) but your choice of providers and facilities in these plans may be limited, so if you are already seeing a particular doctor regularly, check to see whether he or she is a participating provider before signing up in any new plan under consideration.
- Part D – This is a stand-alone policy plan that pays for most prescription drugs, other medications and other pharmaceutical expenses not covered in Original or MA.
- Supplemental Medicare coverage – Also known as “Medigap”, this is a separate policy that helps cover services and other expenses not fully covered by Original Medicare or MA.
Several factors can affect your choice of coverage as well as out of pocket costs with Medicare, including:
- Whether your healthcare provider accepts Medicare assignment
- Whether you have both A and B coverage
- What kind of care you may need and how often, such as monthly visits
- Whether you take prescription drugs
- Whether you have other health insurance, such as from an employer or supplemental health insurance policy
- The importance of being able to choose your providers or hospitals
The variety of plans available can be confusing, leading many people turning 65 and eligible for Medicare to put off thinking about enrolling until the last minute. This sets the stage for making mistakes, like choosing wrong plans or missing enrollment deadlines.
Common Medicare Mistakes Consumers Make
- Consumer advocate site Kiplinger reports that the one of the biggest problems for prospective Medicare enrollees is assuming that you will be automatically enrolled. The fact is that you are automatically enrolled if receiving Social Security at the time you turn 65. If you have opted to wait to claim Social Security benefits, you’ll need to sign up during the Open Enrollment period.
- Another mistake is missing enrollment deadlines if still employed, although this depends on how many full-time workers are in your company. Fewer than 20 and you’ll need to sign up during the Initial Enrollment Period of your 65th birthday, rather than waiting for retirement. If your company employs more than 20 full-timer employees, you would be eligible for a Special Enrollment Period.
- Not selecting the best Medigap or other type of Medicare plan suitable for your needs during the initial enrollment period. Buying a plan within six months of enrollment in Part B usually means that you can get any plan offered in your area, including covering pre-existing conditions. Waiting too long may mean that insurers could charge you more or, depending on your medical history, possibly refuse coverage altogether.
Working with an experienced Medicare Insurance Agent can help avoid these and other Medicare pitfalls.
Why Use A Medicare Insurance Agent?
- To help decide which Medicare or Medigap plan might the best choice for your needs your best option is to consult with a licensed Medicare Insurance Agent before signing up. Your agent will make sure that you enroll in Medicare during the correct enrollment periods.
- Knowledge and experience - Licensed agents are knowledgeable about Medicare, with additional ongoing training to stay current on the latest Medicare and other insurance regulations.
- More choices - There is a wider selection of companies and coverage options available, giving you a better chance of finding a plan that’s right for you.
- Convenience - Using the services of an agency saves you time and frustration you might spend researching and comparing the multitude of available plan options while tailoring a plan just for you.
- Knows your area – your local independent broker can help you choose from Medicare plans and their providers servicing your particular area.
- Ongoing service - After-sale service is provided by your broker, who can review your plans annually to anticipate and accommodate your coverage needs as they change in the future.
Enrolling in Medicare and selecting a plan will have a major impact on your future medical care. It is important to get advice from an agent that understands how medicare works, has years of experience, and cares about you.
They will help you navigate your options and select the plan that is right for you!
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