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Medicare and You: Part II

Is everyone feeling a little nauseous from the turbulence in the financial markets last week?  Wow, times are unsteady!  Now, onto Medicare.

As previously mentioned, most people 65 or older are eligible for Medicare.  However, not everyone will sign on at 65.  Some individuals may continue working and have a health care plan with their employment.  Others might possess coverage under their spouse.  When you do choose to utilize the program, it is wise to explore Medicare’s enrollment guidelines a few months before so you do not miss important deadlines.

People who receive Social Security before age 65 will usually receive notification about Medicare.  However, not everyone falls into that category.  There could be negative ramifications for people who fail to apply when they should.  For instance, the premium for Medicare Part B, the part you pay for, might have a 10% (or higher) cost if you do not adhere to certain rules.  Below are three enrollment periods to keep in mind.

  • The first period is three months before age 65 extending until three months after age 65.
  • The second period is up to eight months after you cease employment or up to eight months after your employment health care coverage has ended.
  • The third is a universal enrollment period that extends from January 1 through March 31.  (People who do not sign on by March 31 may have to wait until the following year to get coverage).

Now that we briefly examined enrollment periods, let’s quickly look at the four parts of Medicare.

  • Part A-Hospital Insurance. This part covers medically necessary inpatient care in hospitals, rehab centers, and hospice; it might also address some home health care.  However, it will not, as a general rule, pay the entire bill (so it is always important to investigate coverage).  Part A is usually without cost for individuals who have the appropriate credits needed.
  • Part B-Outpatient. This part covers preventative services, doctors’ visits, outpatient hospital care, tests, home health care, physical therapy, etc.  Still, there could be limits on coverage.  There is a cost for Part B.
  • Part C-Medicare Advantage.  This part combines Part A and B and is managed under private insurance companies.  Part C may also include prescription drugs.  Individuals must join this plan and costs vary (usually according to coverage).
  • Part D-Prescription Drugs.  This part is a cost option, and the program is usually provided by private insurance companies.  There are different plans and different degrees of coverage (thus, different costs).

Medicare guidelines can seem complex.  Still, if there is adequate preparation in advance, the process can be relatively uncomplicated.  Knowledge is vital when confronting health care, so it is crucial to stay informed.  Remember, you are truly your best advocate.

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