Once you have retired, one of the things you need to consider is what you are going to do about medical coverage. Very few people have money to spare for regular medical care, let alone emergencies or hospitalizations. That is where Medicare comes into play. This health insurance is available to anyone over the age of 65. However, it is necessary to sign up between three months before your 65th birthday and three months after that birthday. If you don’t, you may have to pay a fee when you decide to sign up for this program. Should you still be working and have employee-provided medical insurance, you may choose to wait. However, you will need to sign up for Medicare benefits within eight months of leaving your employment. Medicare benefits can seem confusing at first. Here are the top four things you need to know.
What Parts Cover What
Medicare benefits are split into three parts: A, B, and D. Part A will cover hospital stays. This part of the coverage does not have a monthly premium attached to it. Part B is the part you will use most. This is what covers doctor visits and outpatient services. The monthly premium for Part B is based on your income. Today’s average monthly premium is approximately $145, but that can vary from no payment to as much as $400 a month for a couple. Part D is the part of Medicare that covers your prescription drugs and medical equipment.
Each year you will be allowed to choose a related prescription plan between October 15 and December 7. Each plan varies in the amount of monthly premium and amount of required copayments, so you will want to go over this part of your Medicare benefits every year and change if necessary. You will also need to see if the prescriptions you need are covered.
Preventive Services and Co-Payments
Medicare benefits include certain preventive procedures. These procedures include such things as a yearly wellness checkup, mammograms, and some cancer screenings. While these preventive appointments are free, your doctor may require additional tests that won’t be covered. Each service other than the included preventive services will require a co-payment. This will vary depending on your plan and the type of service. For example, you will pay one amount for a general practitioner visit but may be required to pay a different amount to a specialist. Prescription co-payments will depend upon what plan you have chosen for the year. There is a deductible you must meet each year before these co-payments stop.
What Isn’t Covered
Medicare benefits do not include things like hearing aids or dental care. There are some plans that will cover the cost of one pair of glasses every two years and routine eye exams. Your benefits are also limited to no more than 100 days in a long-care facility or nursing home. This can be troublesome because even Medigap plans do not cover long-term facilities.
Medigap comes into play to attempt to cover the things that aren’t covered by normal Medicare benefits. Like your Part D prescription plans, you will want to go over the available plans and pick the one that best meets your needs. These plans help cover things like the co-payments you owe with Medicare, and they can cover medical expenses that occur when you travel outside the country. With some of these plans, you also get extras like an additional amount of money for over the counter items each month or a membership to a health club. The cost to you varies by plan, so you will need to do your homework.
Learn More With SeniorSmart
Regardless of your background, you can get the benefits you deserve with Medicare. We can guide you through this process. Call 833.303.0983 or visit us online for answers about how to get all of the Medicare benefits you’re entitled to.