Signing up for Medicare can be daunting, but it shouldn’t be. Whether you are new to this process or an old pro, you should be aware of some options available to you before the Medicare annual enrollment period. To be eligible for Medicare, you must have been a US citizen or resident for at least five continuous years, be at least 65 years old, have a disability. You can get Medicare one of two ways: the original government-run program or a Medicare contracted private insurance company. Whichever route you take, the options for coverage are similar.
The Basics
Medicare Part A coverage is your inpatient hospital coverage, hospice, and skilled nursing. This includes any inpatient hospital stays and required medical equipment and services to treat your condition.
Medicare Part B coverage is outpatient medical coverage. Outpatient coverage can include preventative services, lab tests, ambulance services, doctor’s office visits, mental health care, and even medical equipment. These services are all provided while you are not admitted to a hospital as an inpatient. This is also the part of Medicare that will include a premium payment and can vary each year as your situation changes. There may also be some out-of-pocket costs with Medicare Part B that can include co-payments and/or deductibles.
Once you’ve selected options under these plans, other options available to cover additional areas.
Medicare Part C (also known as Medicare Advantage) plans are offered by private insurance companies. By opting for Medicare Part C, all your Part A and Part B options are covered under Part C except hospice care. In addition, many Part C plans also offer dental and vision care in addition to wellness programs. The benefit of a Part C plan is that it often has lower co-pays and premiums than the original Medicare plan. Many Part C plans also have a prescription benefit (comparable to Medicare Part D) and are all housed under one single plan.
Medicare Part D is the prescription drug plan section of Medicare and is not a requirement to have. These plans are offered by private insurance companies and have a monthly premium and annual deductible that must be met before the plan covers prescriptions. This means there are some out of pocket costs on the front end before the plan will cover your prescriptions.
Medicare Supplement Insurance (Medigap) is an optional plan that helps to handle costs that are not covered by Medicare Parts A and B. These plans are sold by private companies and have a monthly premium for their services. There are multiple standardized Medigap plans to choose from based on what coverages you want.
Investigate Your Options
Knowing the basics before investigating individual plans can ease the burden of making the right choice. Many of the plans depend on your individual health and what benefits you may need to maintain your health. This can include what kind of chronic conditions you have, what kind of prescriptions you take and whether you expect to have the same health issues in the coming year as you did in the past year. Knowing the answers to these questions can help to better select which plan(s) to pick.
You can also search and see what tests or services you need before signing up for an individual plan and see what costs might be associated with it. If you know that you will need a colonoscopy or mammogram, see what plans cover these procedures combined with your prescriptions and medical conditions the best.
If technology is not your strength, you can always call to speak with a trained professional to help you navigate the system.
Signing up for Medicare should not be confusing or difficult. These should be some of the best years of your life, so you want to make sure your health is a top priority.
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