7 Basic Questions Related to Medicare

7 Basic Questions Related to Medicare

Medicare isn’t that difficult to understand once you learn the basics. What makes it so confusing is all of the additional information that is included with each section. Knowing who is eligible, what each part covers, and what options you have when it comes to supplemental coverage is winning half the battle. Talking to an insurance agent who specializes in all things Medicare-related will help you sort things out.

Table of Contents:

  1. Who Is Eligible for Medicare?
  2. How Much Does Medicare Cost?
  3. What Is Covered by Medicare?
  4. What Are Your Options for Supplemental Coverage?
  5. How do I enroll in Medicare?
  6. Can I travel with Medicare?
  7. How do I find a doctor who accepts Medicare?

Who Is Eligible for Medicare?

Medicare is available to anyone in the United States who is 65 years of age or older. If you are 65 years old and are a permanent resident who has lived in this country for at least 5 years, you are also eligible. Eligibility is also extended to anyone who has qualified for at least 2 years of disability through Social Security. Aging into Medicare at the age of 65 makes you eligible even if you do not receive Social Security benefits. At this point, everyone will receive Medicare Part A and Part B once they have visited the Social Security office to enroll. Medicare Part A will cover any hospital visits, while Part B covers outpatient services. Part D is for your prescription medication.

How Much Does Medicare Cost?

If you or your spouse have worked for at least 10 years in the U.S., your Medicare Part A coverage will be free. For most individuals, Part B will cost, on average, approximately $148.50 each month. If you are in a higher income bracket, you will pay more for your Part B coverage. Part B is an essential part of your insurance plan if you are over 65 and have no other health insurance. When it comes to Part D, most states offer as many as 20 different versions for varying prices. The national average in terms of cost is approximately $41 a month.

What Is Covered by Medicare?

Just like any other type of insurance policy, Medicare will cover the majority of your healthcare costs. However, it is still up to you to pay a percentage of the total cost. You will be responsible for any co-pays, deductibles, and coinsurance premiums. Part A will cover your first 60 days in the hospital. After that period is over, your share of the cost will increase from day to day. Your Part B coverage will pay for up to 80% of any medical equipment, surgeries, therapy treatments, and doctors’ visits. You will also pay a small deductible of around $200 each year. Part D is meant to cover many of your retail prescription medications.

What Are Your Options for Supplemental Coverage?

There are two types of supplemental coverage, Medigap and Medicare Advantage. Medigap lives up to its name by covering many of your gaps in coverage. Medicare Advantage benefits are purchased from a private insurance company and may sometimes be referred to as replacement plans.

Medigap coverage picks up where your Medicare leaves off, covering any balance amount that you are responsible for. This gives you more say when it comes to choosing a physician. They cost more than the other plans because they cover more. Medicare Advantage plans basically replace your traditional Medicare coverage. This is part of the reason they are referred to as Medicare Part C.

How do I enroll in Medicare?

You can enroll in Medicare during your initial enrollment period (IEP), which is a seven-month period that begins three months before you turn 65 and ends three months after you turn 65. You can also enroll during the general enrollment period (GEP), which runs from January 1 to March 31 each year, but you may face late enrollment penalties. If you have a qualifying life event, such as losing your employer coverage, you may be eligible for a special enrollment period (SEP) to enroll in Medicare without penalties.

Can I travel with Medicare?

It depends on where you travel and what type of Medicare plan you have. Original Medicare generally does not cover health care services outside the United States, except in some limited situations. Some Medigap plans may cover up to 80% of emergency care costs when you travel abroad, but you may have to pay a deductible and a lifetime limit. Medicare Advantage plans may or may not cover health care services outside the United States, depending on the plan. You should check with your plan before you travel to find out what is covered.

How do I find a doctor who accepts Medicare?

You can use the Medicare Physician Compare tool to find doctors who accept Medicare assignment, which means they agree to accept the Medicare-approved amount as full payment for their services. You can also use the tool to compare doctors based on their location, specialty, quality of care, and patient feedback. If you have a Medicare Advantage plan, you may have to use doctors who are in your plan’s network, unless you have an emergency or need urgent care.

Knowing the basics of Medicare is important when you are faced with deciding on the best type of coverage for you and your loved ones. The agents at Medicare Advisors are available to help you work your way through the confusion so you can get the right type of coverage that meets your needs. To get started, contact us today!