Image courtesy of Unsplash
It’s not unusual to find the Medicare enrollment process a bit daunting. All those letters and parts can get pretty confusing, and you want to make the choice that will be best for you. Here’s how to determine what will fit your circumstances when you’re signing up for health care.
Begin with Basics
There are two terms used to describe basic Medicare: Original Medicare and Traditional Medicare. They refer to the package you sign up for on or around your 65th birthday, which is Parts A and B. US News explains if you already receive Social Security benefits you will automatically start receiving Medicare coverage the month you turn 65. Otherwise, most seniors need to enroll within the seven-month window surrounding their birthdays, beginning three months prior to the birth month. For seniors who wait to enroll after their birthday but within the enrollment window, coverage begins in accordance with when they enroll.
If you or your spouse is still working when you turn 65 and you receive healthcare coverage through an employer, you have until eight months after that coverage ends to enroll in Medicare.
Missing your enrollment deadline will mean paying penalties for the rest of your life, so timely enrollment in Medicare is very important.
How Much Is It?
Parts A and B are provided through the government, and if you worked 40 quarters or more, Medicare Part A is free. It covers your hospital stays and related charges. Part B covers outpatient services, and the cost is determined by your income.
Beyond Basic Coverage
There are two more parts of Medicare, Part C and Part D. These are designed to cover things Parts A and B do not. However, Parts C and D are through private insurers who must meet government guidelines in what they offer.
One example of Part C insurance is Medigap, and it includes several plans to help cover costs Medicare does not. One of the nice things about Medigap is it works in conjunction with Parts A and B. Some plans provide coverage for emergencies during foreign travel, and when you’re exploring your options, note Plans F and G offer a broader range of benefits than the other choices. Plan F offers a high-deductible option, but once you meet that deductible, it covers your Part B deductible while G does not.
Another Part C option is Medicare Advantage. This confuses many seniors, but as Investopedia explains, there are differences between Medigap and Medicare Advantage, with pros and cons to each. While Medigap works alongside Parts A and B, Medicare Advantage replaces them.
Sometimes, Medigap costs more per month than Medicare Advantage but also might equate to less out-of-pocket expenses. Medicare Advantage will limit what healthcare providers you see as well, so before going that route you should verify your physicians are covered.
Last, But Not Least
Part D is the last of the four Medicare parts, and it is private insurance covering prescription drugs. If you’re trying to decide whether it would benefit you, one suggestion is to examine the drugs covered by Parts B and D, in comparison with your personal needs.
All Part D providers are required to cover at least two medications in each of the six drug classes. So, for instance, if you’re on an anti-seizure medication, an antidepressant, or in chemotherapy, you might want to see if the medication you’re taking is covered, or if there is a comparable drug your doctor might switch you to.
Time to Change?
If you’re already enrolled in Medicare, you aren’t stuck with your decisions. The open enrollment period runs from January 1st through March 31st every year. If you want to make changes after examining your situation, you can do so during that time.
Medicare can be pretty confusing. Begin by ensuring you enroll on time, and choose supplemental plans in accordance with your circumstances. Thanks to your careful research, you can rest assured you’ll have the healthcare coverage you need.