Do you want to know the Medicare Demystified? Then keep reading this article for more information.
When the time comes for you to get one of several Medicare options, you will need to make sure that you know what your options are and more importantly, some options are the best for you and your needs.
But with diverse options, as well as a massive amount of pressure for you to get on the correct Medicare plan and stick to it. Moreover, what do you need to know about the various options that you have access to?
This article is going to demystify Medicare and break down the various options that you will be able to work with. However, when you read through it you will have a much better understanding of how Medicare can help you stay in good health as you age.
READ MORE: Medicare Demystified – Making Sense of Your Coverage Options
Medicare Coverage Has Five Parts
Table of Contents
To start with the basics of our Medicare breakdown come in five parts Medicare coverage.
Original Medicare Part A
This is one of the two parts of Medicare coverage that the Federal government provides and it is available from the Social Security Administration.
Moreover, Part A coverage is what covers the costs of visiting the healthcare facility, like going to the hospital or going to a psychiatric facility.
However, when you hit age 65 you will be eligible for Part A as long as you can apply during the Initial Enrollment Period.
Additionally, when you or your spouse have been at a job where you have worked at least 40 calendar quarters and have paid Social Security taxes, then you will not pay premiums on your Part A coverage.
Original Medicare Part B
Moreover, it is provided by the Federal Government and available from the Social Security Administration.
Also, the Part B Medicare coverage covers the costs of outpatient procedures. These are seeing a doctor having a laboratory or radiology treatment.
However, just like with Part A coverage, you can be eligible when you turn 65 during the initial enrollment period and will need to pay premiums.
These monthly premiums are based on your adjusted gross income from the Federal Income Tax that you filed 2 years before you chose to enroll.
Furthermore, various premiums for Part B can change based on when you enroll and whether or not you have enrolled in Part A coverage. Also, make sure to do your research before you enroll and you will be fine.
Part C Medicare Coverage
You can easily find the plan offered by commercial insurance companies. You need to enroll in Medicare.
Moreover, for Parts A and B to gain access to the Part C program when you get access to the benefits of the Part C Program, your Part A and Part B benefits are suspended because you can’t have all three parts active at the same time.
However, you can get Part C plans available as HMO plans that have you work with the contracted network of providers.
You can get them as POS plans that allow you to access specific services outside of the network. Additionally, PPO plans let you work with those services you want, though the costs are high.
READ MORE: Medicare Parts A, B, C, and D Explained
Part D Medicare Coverage
A Part D Medicare plan is known as a PDP (prescription drug plan) and is mostly offered by commercial insurance companies to help them pay for their prescription medications.
Moreover, when you have a Part A plan, you can enroll in the Part D plan as well.
Whomever you enroll during the Initial Enrollment period, you have to enroll with the Part D medical plan or you need to enroll within 63 days of leaving another form of prescription drug coverage.
Furthermore, if you wait 63 days and then attempt to enroll in part D Medicare coverage, you will be given the late enrollment penalty based on how long you didn’t have the coverage.
Medicare Supplements
Finally, you can have Medicare Supplements that are designed to reduce the out-of-pocket expenses from Medicare parts A and B.
When you get into the Part B program, you have six months to enroll in the Medicare Supplements program and there are diverse plans labeled A to N.
Also, take some time to look through each supplement plan to see the one that is best for you and your needs, because you want to get the best one.
What Are Medicare Advantage Plans?
Medicare Advantage has two popular types of plans. Medicare Advantage is called Part C of Medicare. Moreover, these are private health plans that are tightly regulated and funded by Medicare. You’re still in Medicare.
The only difference is that the plan will be administering Medicare benefits. All the claims are filed with the insurance company, not through Medicare.
However, this is similar to a group plan you may have when you are working. This is a bundled type of plan where you will still need to have Parts A and B.
Furthermore, you will still need to keep paying for your Part B of Medicare even when you choose Medicare Advantage rather than the Medicare Supplement.
Additionally, Medicare Advantage is not a Medicare Supplement. Then you can have more but not both at the same time.
READ MORE: Demystifying Medicare Supplement (Medigap) Plans
Conclusion
The five parts of Medicare have been explained above, you need to make sure that you know how to combine them into the coverage that you need. Moreover, diverse people use Medicare Parts A & and B along with the Part D prescription drug plan, which meets all their needs.
