Medicare Demystified – Making Sense of Your Coverage Options

Making Sense of Your Medicare Coverage Options
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Whenever it comes time for you to get one of several Medicare options, you need to make sure that you know what your options are, and more importantly, what options are the best for you and your needs. But with so many options, as well as a massive amount of pressure for you to get on the correct Medicare plan and stick to it, 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, and once you read through it you will have a much better understanding of how Medicare can help you stay in good health as you age.

Medicare Coverage Has Five Parts

Starting with the basics of our Medicare breakdown comes the five parts of 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. Part A coverage is what covers the costs of visiting a healthcare facility, such as going to a hospital or going to a psychiatric facility. Once you hit age 65 you will be eligible for Part A as long as you apply during the Initial Enrollment Period. 

Additionally, if 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

Again provided by the Federal Government and available from the Social Security Administration, Part B Medicare coverage covers the costs of outpatient procedures. These can include seeing a doctor or having a laboratory or radiology treatment. Just like with Part A coverage, you become 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. The various premiums for Part B can change based on when you enroll and whether or not you have enrolled in Part A coverage. Make sure to do your research before you enroll, and you will be fine.

Part C Medicare Coverage

You can find this plan offered by commercial insurance companies. While you need to enroll in Medicare Parts A and B to gain access to the Part C program, once you get access to the benefits of a 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. 

You can get Part C plans available as HMO plans that have you work with a contracted network of providers. You can also get them as POS plans that allow you to access specific services outside of the network, and PPO plans let you work with any service you want, though you will be paying higher costs. 

Part D Medicare Coverage

A Part D Medicare plan is also known as a PDP (prescription drug plan) and is often offered by commercial insurance companies to help them pay for their prescription medications. If you have a Part A plan, you can enroll in a Part D plan as well.

Whenever you enroll during your Initial Enrollment period, you must enroll with a Part D medical plan, or you need to enroll within 63 days of leaving another form of prescription drug coverage. If you wait 63 days and then attempt to enroll in part D Medicare coverage, you will be given a late enrollment penalty based on how long you didn’t have the coverage.

Medicare Supplements

Finally, you can get Medicare Supplements, which are designed to reduce the out-of-pocket expenses from Medicare parts A and B. Once you get into the Part B program, you have six months to enroll in the Medicare Supplements program and there are different plans labeled A to N. 

Take some time to look through each supplement plan and see which one is the best for you and your needs, because you want to get the best one.

Make Sure To Know Your Options

With the five parts of Medicare explained you need to make sure that you know how to combine them into the coverage that you need. Many people, simply use Medicare Parts A & B along with a Part D prescription drug plan, and that meets all their needs. It’s simple and comes with easy-to-understand costs.

Another plan that many people get behind is the use of Medicare Parts A & B, a Part D prescription drug plan, and a Medicare Supplement. This plan reduces your out-of-pocket costs and also provides a limit to your Medicare that is paid out of pocket. You will just need to pay the Medicare premiums. 

Additionally, you can just take a Part C medicare advantage plan as well, which gives you some benefits while only having you pay your Part B premium. Again, make sure to look at both plans and figure out which one is going to work the best for you and your medical needs, and once you pick a plan, don’t be afraid to stick with it.

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