When it’s time to enroll in a Medicare plan, it’s a good idea to know certain facts about it. Medicare has been the federal government’s medical plan for seniors since 1965.
Here are important points to know about Medicare as you begin to investigate its benefits.
- You Have Multiple Choices
These days you can choose between Original Medicare, which includes parts A and B, or Medicare Advantage, also known as part C. Original Medicare provides access to any doctor or medical facility in the United States that accepts Medicare. At the same time, you can purchase Medicare Advantage through a private insurance agency. However, if you choose this option, you will not be able to use a supplemental Medigap plan to fill in coverage gaps.
- Medicare Has Several Parts
One of the reasons many people think Medicare is complex is because it’s divided into parts that not everyone can keep straight. It is possible that after you choose between an Original Medicare or Medicare Advantage plan, you may still need to enroll in parts B and D or pay a penalty. Part B involves outpatient medical care, while part D relates to prescription drugs.
- You May Have to Pay More
It’s imperative to estimate the costs before signing up for Medicare which may be higher than expected. Co-insurance is the part of your medical insurance that you must pay for with your own cash. An advantage to Medicare Part D is its catastrophic threshold in which, after spending a certain amount of your money, the catastrophic coverage takes over and pays the rest.
- Delays Will Cost You
Once you turn 65, you have four months to enroll in Medicare. While some people are automatically enrolled in parts A and B, others must fill out an application. The best way to find out your status is to check with the Social Security office. If you don’t have coverage through your employer and fail to sign up for parts A, B, or D during the enrollment period, you will have to pay a late fee.
- You May Not Qualify for a Medigap Plan
Enrolling in an Original Medicare plan allows you to enroll in a supplemental Medigap plan, which is available to all Medicare beneficiaries. Medigap pays for copayments and deductibles, as well as other things that Medicare doesn’t cover.
Seniors who choose Medicare Advantage but aren’t satisfied with it during the first 12 months can switch to Original Medicare. Under certain conditions, you can use Medigap, such as if you signed up for Medicare Advantage when you turned 65. You can also qualify for Medigap if you already purchased it before testing Medicare Advantage.
- Dental and Vision Coverage Is Limited
Medicare does not provide much coverage for dental, vision, or hearing care. While it will pay for emergency dental services during your hospital stay, it is often restricted to eye exams for conditions like glaucoma and does not cover hearing aids. If you need dental, vision, or hearing coverage, you can purchase it separately.
- No Long-Term Care Coverage
Some people are stunned when they learn Medicare doesn’t offer long-term care except for rehabilitative health conditions related to extended hospital visits. It covers therapy but not daily nursing home care.
- Marketplace Plans Can Be Complicated
It’s possible to face tax penalties if you hang on to a Marketplace plan and then enroll in Medicare. Many seniors cancel their Marketplace plans and simply go with Medicare.
- Help Is Available
Another place to check for reducing your medical costs is your State Health Assistance Program (SHIP) at ShipHelpCenter.org. You can also call the program at 800-333-4114.