Medicare is health insurance. It is administered by the government and enrollment can be done through Social Security. In order to qualify for Medicare, you typically must reach a certain age. Those who have paid into Medicare taxes for the required amount of time will be able to enroll and will not be required to pay the Part A premium.
There are two different areas of Medicare that must be understood…
What is Medicare?
- What is Medicare?
- When do I enroll?
- How many parts are there in Medicare?
- What is a Medicare supplement?
- Do I need Part D?
All of these questions are going to get anybody's head spinning.
What is Medicare?
Medicare is a national health insurance program that is set up for most individuals that are 65 and older. I say that because there are some exceptions for those of us under 65, and that would include individuals who are on disability or have terminal illnesses.
When do I enroll in Medicare?
For most individuals, when they turn that magic age at 65 - that's when they go into
Medicare a full time. When you're about 64 and a half-ish you will start to get lots of Medicare information and mail, as well as some probably unwanted calls. But for most, turning 65, that's when you go on Medicare. There are some of you who turn 65 and continue to work past 65 and are on your employer insurance and that's okay once you fully retire that's when you will go on to Medicare full-time.
What are the parts of Medicare and how many parts are there?
There are four main parts to Medicare with an optional fifth part that I will go into later.
The parts up of A,B, C, and you guessed it: Part D.
Part A is your hospital insurance, and this helps cover your hospital care. Most individuals get this automatically when they age into Medicare, and it's usually at no additional cost to you.
Part B is your medical insurance and that includes things such as doctor's visits, outpatient procedures, lab work, and various things like that.
Part C is also known as a “Medicare Advantage Plan.” In order to get Part C you have to have Parts A and B, that is the requirement. These Medicare Advantage plans typically have additional benefits that Parts A and B don't cover, which are things such as dental and vision.
Part D - I like to call it “Part D for Drugs,” because it's an optional prescription drug plan that you can either purchase separately, or a lot of times you can get it built into your Part C Medicare Advantage plan.
So those are the four main parts of Medicare.
That optional fifth part that I was talking about is a Medicare supplement or a Medigap plan, and these plans are basically the “bee's knees.” They basically help work side by side with the original Medicare, and they help cover the costs that Parts A and B do not cover.
I get a lot of questions of “Do I need Part D?”, especially from those individuals who are really healthy and are not taking any prescriptions. And there are two main reasons why I suggest that you do get a prescription drug plan when you go into Medicare.
First reason is you incur a late enrollment penalty when you finally do enroll in a prescription drug plan. So, if you wait a couple years and then you change your mind and say “Yeah, I think it's time for me to go on a drug plan”, so that amount of time that you went with that one you will be paying a penalty, and it's not a one-time penalty. So to spare you from having to do that I recommend getting a prescription drug plan when you finally go into Medicare.
But the second reason - and in some cases the more important reason - is because we don't have a crystal ball and we cannot predict what our health is going to be like in the future years to come. Most people tend to not get healthier as we get older. So if you decided to skip on getting a prescription drug plan, and then at some point during the year something happens and now you are taking prescriptions and you don't have any coverage at all, you can be incurring hundreds and hundreds of dollars in prescription drug costs that you shouldn't have to pay if you had a prescription drug plan.
So I always recommend that you get a Part D drug plan, whether you purchase it separately and get a Medicare supplement or you get it built into your Medicare Advantage plan. Very important to have that!
I hope all this information was helpful! If you have any other questions, feel free to give us a call at 888-959-1028, or check out our website https://myhealthcaredirect.com.
Original Medicare consists of Parts A and B. It is a basic level of health insurance and many prefer it because of lowered bills. However, there is no flexibility offered through Original Medicare. If you are enrolled in Original Medicare, you may purchase a Medigap policy. If you do want to be able to make changes to your coverage, consider Medicare Advantage.
Part C, or Medicare Advantage, allows the beneficiary to establish which areas of coverage will be included in their policy. While all Part C policies include Original Medicare coverage as a baseline, there are many other options that can be added on. If you choose Medicare Advantage, you will not be able to enroll in Medigap.