Medicare covers various health services, including outpatient and inpatient hospital care, prescription drugs, and physician services. The elderly with permanent medical conditions and disabilities are eligible for this type of coverage irrespective of their medical history.
Understanding the various parts of Medicare Supplement plans can help you choose the right plan for your needs. Here is some more information about Medicare to help you make informed decisions on prescription drug coverage, enrollment, and supplement plan choices:
Eligibility for Medicare
If you are 65 years old or more, you are eligible for Medicare if:
- You are a U.S. citizen or a permanent resident in the U.S. and have lived there for five years.
- You qualify to collect railway retirement or social security benefits.
If you’re below the age of 65, you are eligible for Medicare if:
- You have received Railroad Disability Annuity or Social Security Disability Insurance (SSDI) checks for the past 24 months.
- You have an end-stage renal disease (ESRD). That means your kidneys are not functioning correctly, and you require a kidney transplant or dialysis to live. To qualify, your parent, spouse, or you must have been paying Medicare taxes for a reasonable time.
- You have mild amyotrophic lateral sclerosis (ALS) and get Railroad Disability Annuity or Social Security Disability Insurance checks.
Different Parts of Medicare Supplement Plans
Part A: Hospital Insurance
Part A, also called hospital insurance, pays for hospital care and the cost of staying at skilled nursing facilities. Hospital insurance also covers hospice care for individuals who are terminally ill. Part A doesn’t cover home health care; it’s included in Part B. Part A is funded by Federal Insurance Contributions Act (FICA) and reserved in the Hospital Insurance Trust Fund.
Part B: Medical Insurance
Part B is often known as medical insurance and pays for outpatient hospital care, doctor services, and home health care. The program covers the following:
- Diagnostic and laboratory tests such as blood work and x-rays
- Some preventative services such as prostate cancer screening and mammograms
- Durable medical equipment
- Occupational and speech therapy
- Ambulance services
- Outpatient physical
- Outpatient mental health care
Part C: Medicare Advantage Plan
You can obtain medical coverage through a sponsored plan by a private company known as the Medicare Advantage Plan or through parts A and B. If you register in the Medicare Advantage plan, you can still get Medicare Parts A and B. But you can seek healthcare services using a private program that you will select. Pay the standard Part B premium and any other premium charged in the plan.
Part D: Prescription Drug Coverage
Part D, provided by private drug plans and approved by Medicare, helps pay for prescription drugs. If you are eligible and you don’t have creditable coverage, you might face a Late Enrollment Penalty (LEP) if you are without Part D prescription drug coverage. If you’re interested in prescription drug coverage and already have the original Medicare (A and B), you can choose a stand-alone prescription drug plan.
Tips to Make the Best Medicare Decisions
Medicare eligibility begins at age 65, but you can sign up earlier for your coverage to start as soon as possible. You have an initial enrollment period (IEP) that begins shortly before your 65th birthday. Signing up later could lead to a delay in your coverage. Medicare helps to pay for medical care, but it’s not free. Identify an option that you can afford. Identify what you want to cover and choose a Medicare plan with the necessary benefits.
Part A covers hospital coverage, while Part B covers medical coverage, which means dental and drugs are not included. You may need to add coverage like Plan D, which offers prescription drug coverage. Another option is adding Medicare Advantage Plans, which provide prescription drug coverage, and other extra benefits such as hearing, dental, or vision coverage. Do some research before assessing your options and selecting Medicare supplement plans.
Create a list of your doctors to decide if you’d wish to continue visiting them when on Medicare. Make a list of medications you’re currently taking to confirm that your prescription drug plan can meet your needs. Consider your financial situation and lifestyle as they can influence your decision.
Find the Best Medicare Supplement Plans Brokerage Firm
Look for a brokerage firm that provides a wide range of Medicare supplement plans to give you the peace of mind and security you need. They should have agents readily available to respond to questions that you may have regarding coverage costs and options. The best firm will assess your needs and financial situation and help you choose the best plan.