UNDERSTANDING MEDICARE

If you are eligible for medicare, you have many options on how you can take advantage of the coverage available to you.  We live in a great country that provides incredible healthcare benefits at a very reasonable price for those of us over 65 or under 65 and disabled.

If you are just becoming eligible for medicare, there are a few things you need to know.  There are basically 2 parts to medicare.  Part A and Part B.  Most people who are turning 65 and have applied for social security benefits will automatically be enrolled in Part A coverage.

Part A coverage basically covers hospital care.

Part B covers medical expenses.  This is for doctors visits, surgery, preventative care, etc.

Part A coverage typically has no premium as long as you or your spouse paid medicare taxes while you were working.

Part B coverage does have a cost involved.  Most people will pay $134 per month premium for part B coverage.  If you earn more than $85000/year as an individual or $170000 as a couple filing jointly, your cost for medicare part B will be more.  You can enroll online at www.medicare.gov

You are eligible to sign up for Part A and Part B starting 3 months before your 65th birthday but must sign up no later than 3 months after your 65th birthday or you could be penalized when you do sign up.  For example, if you turn 65 on April 15th, you can sign up starting January 1 and must sign up no later than July 31.

Part A and Part B are referred to as original medicare.  This provides great coverage and you can access treatment at any medicare approved doctor or hospital.  However, original medicare does not cover everything and also has deductibles and coinsurance that you must pay.

Here is what Original Medicare does not cover:

• Long term care
• Most dental care
• Eye Exams
• Dentures
• Hearing aids and exams
• Cosmetic surgery
• Acupuncture
• Routine Foot Care

Once you have enrolled in part A and part B you must also enroll in a prescription drug plan.  Original Medicare does not cover prescription drugs.

Prescription drug coverage is known as Part D.   You must enroll in a prescription drug plan within 63 days of your initial eligibility period.  That means that if you turn 65 in April and your eligibility period ends July 31, you have until Oct. 3rd to enroll in a prescription drug plan.

If you do not enroll in a prescription drug plan within 63 days your initial eligibility period, you will be penalized 1% for each month you do not have prescription drug coverage.  So for instance, if you waited 10 months to enroll in a prescription drug plan, you would pay a 10% higher premium for your coverage.  This is a permanent penalty and will remain with you forever.

There are many other options when choosing your medicare coverage and I will go into detail on those choices in my other posts.  If you ever have questions please leave a comment and I will be sure to respond.

You now have the very minimum information needed about medicare.  Please read all pertinent posts to assist in making your decisions.