What You Need to Know About Medicare Before Turning 65
Your 65thbirthday doesn't just mark the day you officially become a senior citizen. It's also when you’re eligible to sign up for Medicare. Medicare's Initial Enrollment Period starts three months before the month you turn 65 and ends three months after your birthday month.
Of course, don't assume signing up for Medicare simply means checking a box and paying a monthly premium. Medicare offers a lot of coverage options, and the choices you make determine how you pay for important healthcare services. Signing up is an important task, which is why it is best to go into your Enrollment Period feeling informed.
Here are some tips from Free Fundamentals to help you fully understand the process.
How Medicare Part A and Part B Work
Together, Part A and Part B make up Original Medicare, which covers inpatient hospital care (Part A) and outpatient care (Part B).
Part A is premium-free for most seniors, but requires a $1,556 annual deductible before coverage starts. The first 60 days of hospitalization are covered without coinsurance, a cost-sharing practice. From days 61 to 90, you pay $389 per day; and beyond 90 days you pay $778 per day. Inpatient hospital benefits are subject to a lifetime cap. For coverage beyond the lifetime reserve, you need long-term care coverage.
Part B premiums start at $170.10 monthly with higher premiums for incomes over $85,000 for single people and $170,000 for couples. Part B has a low annual deductible of $233, but higher cost-sharing requirements at 20% of covered services (with some exceptions).
Why You Need Medicare Part D
Unless you have prescription drug benefits through a Medicare Advantage plan or prefer to pay for prescription drugs out-of-pocket, you need a Part D plan. Part D covers outpatient prescription drugs, but covered medications vary across Part D plans. Use the Medicare Plan Finder on the Medicare.gov website to compare drug formularies and choose the right plan for your prescription needs.
Even if you don't take prescription drugs now, you may want to sign up for Part D. Unless you have creditable coverage, waiting to enroll in Part D results in a penalty that could outweigh any savings from enrolling late.
What About Medicare Advantage?
If you already have Original Medicare, then you don't need Medicare Advantage, also known as Part C. However,you might still want to get it. Medicare Advantage replaces Original Medicare, providing all the same benefits as Parts A and B and adding supplemental benefits. Take the Humana Medicare Advantage plan, for example. In addition to the standard benefits, it includes prescription drug, dental, and vision coverage, as well as access to a nurse line and the Silver Sneakers program (a health and fitnessprogram).
A lot of seniors choose Medicare Advantage; but before you do, there are a few things to know:
● When you sign up for Medicare Advantage, you still have to pay Part B premiums. Your Medicare Advantage plan may also charge additional premiums.
● Medicare Advantage plans use networks like traditional health insurance. This may limit the doctors you can visit.
● Unlike Original Medicare, Medicare Advantage plans have an out-of-pocket maximum. If you hit it, you pay nothingfor the rest of the year.
● Medicare Advantage plans lower out-of-pocket costs, but may not lower them as much as Medigap (explained below).
Closing the Gap with Medicare Supplement Insurance
Another way to supplement your coverage is with Medicare Supplement Insurance, or Medigap. You must chooseeither Medigap or Medicare Advantage. You can't have both.
Medigap plans cover out-of-pocket costs required by Original Medicare, like deductibles and coinsurances. The amount of costs that are covered depends on which of the 8 current Medigap plans that you choose. Forbes offers a helpful guideto these plans.
Paying for Nursing Home Care
Medicare is so complex that it can be more than a little confusing, which leaves many seniors worrying whether their long-term care is covered. Luckily, from private insurance to government benefits, there are ways you can make sure you’re covered—including how to pay for nursing facilitiesthat are not specifically covered by Medicare.
Now that you understand the basics, it's time to dig in and find the best coverage for you. Gather your budget, your list of providers and prescription drugs, and compare the coverage and prices of various Medicare options. There's no one right choice for everyone, but you can find the right plan for you.
Article by Annabelle Harris of elders.center
Annabelle Harris is a writer, wife, mother, and grandmother. She started blogging nearly a decade ago when she was still facing the prospect of retirement and old age. She was terrified and needed an outlet for her thoughts, fears, and uncertainties. It was through her first blog that she found the support of a community that truly helped her through the process of aging.
Free Fundamentalswas created to provide you with free, simple, and practical information and resources for ways to build a fundamentally sound and balanced lifestyle. For questions or information, please email free.fundamentals@yahoo.com.
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