David L. Brown & Associates

Medicare: Understanding All Your Options

 

In 1965 Medicare first became available as a federally funded health insurance program for people over 65 and people who had become permanently disabled.  Since then the program has grown to provide healthcare for nearly 50 Million Americans, and been modified through additional legislation, most recently with the changes from the Affordable Care Act commonly known as “Obamacare.”

 

The original program was designed as a “stand alone” insurance program that included significant cost sharing requirements that would be paid by the beneficiaries.  Many people chose to insure their liability for their portion of cost sharing through private insurance companies.

 

You are eligible to join Medicare if you are 65 years old, or you are under 65 and qualify on the basis of disability or other special situation. You are a U.S. citizen or a legal resident who has lived in the United States for at least 5 consecutive years.

 

You must initiate the Medicare enrollment process with Social Security.  If you are drawing Social Security benefits when you turn 65, Social Security should automatically enroll you in Medicare Part A and Part B. If you are not drawing Social Security, go online, call, or visit your Local Social Security office.

 

Medicare Part A insurance is provided automatically when you first turn 65, and helps pay for “Medically necessary” care that involves an inpatient stay in the hospital.  Part A also helps pay for a stay in a skilled nursing facility.

 

Medicare Part B insurance helps pay for services like doctor’s office visits, laboratory tests and some diagnostic screenings and some skilled nursing care at home.  Part B is voluntary, but most people sign up when they first become eligible.

 

Medicare Part C:  Medicare Advantage plans must cover the same services as Medicare Parts

A & B.  They combine coverage for hospital stays with coverage for doctor visits and prescription drug coverage.  Medicare Advantage plans also offer additional benefits that Medicare Parts A & B do not.  These benefits can include vision, dental, hearing aids, gym membership and 24 hour nurse hot line.

 

Medicare Part D helps pay for the prescription drugs you use.  Medicare Part D coverage is not

automatic.  You decide whether to enroll in a Medicare Part D plan offered by private Insurance companies.  If you delay signing up after you are eligible, though, you may pay a penalty on your premium, unless you qualify for an exception.

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