Are you turning 65 soon? If so, there are a few things that you really need to know about the healthcare system, like what it provides and what it doesn’t.
With that in mind, we’ve prepared these ten quick and simple general facts to make sure you know when considering your Medicare options:
- Original Medicare includes Parts A and B which are offered through the Federal government.
- Part D prescription drug coverage, is a standalone add-on plan to Original Medicare. You can browse Part D Plans by state in our online catalog here.
- Original Medicare doesn’t cover all of your hospital and medical expenses, there are significant coverage gaps that you should know about.
- Medigap insurance plans, sometimes called Medicare Supplemental Plans, can help fill in the gaps that come with Medicare Parts A and B.
- Medicare Advantage Plans, also known as Part C, are offered by private insurance companies and provide your Part A, Part B and often Part D coverage.
- Cost and coverage for Parts A and B are the same all over the US, but Medigap, Medicare Advantage and Part D Plans vary by state and sometimes even by county.
- Those who are currently employed or those who have retiree insurance from a former employer, might not need to enroll in a privately insured Medicare plan. Check with your HR department on how your current plan fits with Medicare. You still might want to enroll in Original Medicare.
- Don’t put off enrolling in Medicare, because if you wait you could end up paying more for your coverage and have fewer choices. There are penalties for late enrollment.
- Medicare allows for freedom and flexibility in plan selection. It’s important to make sure your plan meets your needs. You have the ability to change plans at least once a year.
- Medicare is your right, you earned it! Ask for help and take full advantage of your benefits.
What Medicare Does Not Cover
The most significant point to come to grips with is what Medicare covers and what it doesn’t. In general, Medicare covers services deemed medically necessary. There is one caveat to this, and that’s your outpatient prescription medications. Even though your prescription might be medically necessary to handle a chronic health condition, Medicare does not cover this expense, you do by purchasing a Medicare Part D prescription drug plan.
Here’s the short list of what Medicare doesn’t cover:
- Long-term care (also called custodial care)
- Most dental care and oral health procedures
- Eye examinations related to prescribing glasses
- Cosmetic surgery
- Hearing aids and exams for fitting them
- Routine foot care
In addition to what Medicare does not cover, they only pay for about 80 percent of what is covered. You’re on the hook for the rest. We’ll be blogging more on this topic in the coming weeks.
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- How to Approach Medicare for the First Time
- Late Enrollment Penalties in Medicare