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Medicare Tips and FAQs

Financial Advisor Medicare August 18, 2017 Author: Woody Derricks

Medicare is a health insurance system provided by the federal government. It is generally utilized by individuals 65 and older, but it can also be used by younger people who suffer from certain disabilities or diseases – like Lou Gehrig’s or end-stage renal disease. If you believe that Medicare eligibility is in your future, it’s important to know some essential facts about coverage and enrollment. As with everything regarding your retirement, you will need to make some smart decisions about what options are right for you.

 

Types of Medicare Coverage

When considering coverage, keep in mind that it can be impacted by state and federal laws, decisions made by Medicare itself, and determinations made by companies who process Medicare claims in your state. These bodies may rule whether or not something is deemed medically necessary – and therefore, covered – in your area.

  • Part A: This coverage is part of “Original Medicare” and covers many types of services. It typically includes things like inpatient hospital stays, hospice, skilled nursing facility care, and physical therapy.
  • Part B: Another part of Original Medicare, Part B covers preventative services – like checkups and flu shots – and certain types of durable medical equipment, such as blood sugar monitors and crutches. This part may also cover ambulance rides, mental health therapy, and some outpatient prescription drugs.
  • Part C: Also called a Medicare Advantage Plan or “MA-PD,” Part C is a Medicare health plan that is similar to an HMO or PPO. It offers prescription drug benefits through Part D as well as Original Medicare coverage.
  • Part D: Known as the Prescription Drug Plan, or PDP, Part D offers Medicare subscribers drug coverage in addition to their benefits under Parts A and B.

Search for prescription coverage plans here.

 

Medicare Enrollment

You may get enrolled in Medicare Parts A and B automatically – especially if you are receiving benefits from the Social Security Administration (SSA) or the Railroad Retirement Board (RRB). If you do receive automatic enrollment, coverage generally begins on the first day of your birthday month, when you turn 65.

medicare tipsIf you are not drawing any benefits, you may need to sign up for Medicare coverage manually. The Initial Enrollment Period (IEP) extends for seven months around your 65th birthday. If you do not sign up during that time, you may enroll during a Special Enrollment Period (SEP) or General Enrollment Period (GEP). The SEP is available for two full months after you lose healthcare coverage from your employer or a spouse’s plan, while the GEP runs from January 1st to March 31st every year.

 

 

 

Late fees may apply depending on your situation, so it’s imperative to consult a qualified Medicare representative before missing an enrollment period or delaying coverage. A knowledgeable professional can also give you guidance regarding premiums, which can vary from person to person.

 

Understanding Your Medicare

If Medicare doesn’t offer the benefits you need, you can purchase a supplemental policy (i.e., Medigap) for an additional fee. You can consult a licensed health insurance professional for further guidance on these policies.

When it comes to your health, it’s best to know exactly what is covered and what isn’t. Do a little research before your Medicare eligibility window arrives; you will thank yourself for it.

 

To learn more about Medicare, visit the official site here.

 

The opinions voiced in this material are for informational purposes only and are not intended to provide specific advice to any individual. We suggest that you discuss your particular situation with a qualified Medicare professional.


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