Medicare, the health insurance program administered by the Social Security Administration, is an important benefit for American seniors. Medicare is available to seniors age 65 or older, as well as to those with disabilities. For more information about Medicare benefits and how to enroll in a Medicare plan, speak with a professional from Medicare Peace of Mind.

Why Do Seniors Need Medicare?

Marketplace health insurance coverage is extremely expensive for people who are advancing in years. The insurance companies raise their premiums for people who are older because they have a reduced life expectancy relative to younger policyholders. Seniors also have a higher chance of being injured from an everyday fall or accident because their bones are not as strong. Many degenerative diseases will also take hold later in life, making older people more expensive to insure.

Medicare offers American seniors affordable healthcare coverage. For Medicare, seniors can anticipate paying premiums for Part B as well as coinsurance, copayments, and deductibles for Part A and Part B. These expenses and out-of-pocket costs leave beneficiaries with more in their bank accounts and an easier time handling the rest of their budget with the lower costs associated with Medicare. As an added benefit, seniors can choose to have their premiums deducted from their Social Security checks, because the same administration handles both affairs.

Most seniors receive premium-free Part A. As a result of working and paying taxes to Medicare, American seniors can receive Part A coverage without having to pay monthly premiums. To receive premium-free Part A, a Medicare beneficiary or their spouse would have had to have worked for at least 40 calendar quarters (10 years) while paying taxes to Medicare. The majority of Medicare beneficiaries receive this benefit.

Medicare offers seniors care around the nation. Seniors with Original Medicare (Part A and Part B) are able to find coverage around the country without being restricted to a network of healthcare providers in a certain region. Medicare Advantage plans often come with networks of providers and it is much more expensive to see healthcare professionals outside of the plan’s network. This benefit allows seniors to travel comfortably around the United States without having to worry about finding coverage if an accident or emergency were to take place. All they need is to find a provider that accepts Medicare, and major healthcare institutions do.

What Are the Benefits of Medicare?

Medicare is made up of five parts. Medicare Part A and B are generally one unit called Original Medicare. You can purchase Part A alone or purchase Part A and Part B together. There are late enrollment penalties associated with signing up past your initial eligibility without holding creditable coverage, so be wary about delaying your medical insurance.

Next is Part C, which is called Medicare Advantage. These plans are offered by private health insurance companies who Medicare approves to handle your Part A and Part B coverage. Medicare Part D is prescription drug coverage, which is purchased separately from Original Medicare. Medicare Supplement plans, also known as Medigap, are separate policies that help cover the out-of-pocket costs from Part A and Part B. You cannot have both a Medicare Advantage plan and a Medicare Supplement policy, so this is a decision you should make when you enroll in Medicare.

Medicare Part A Coverage

Medicare Part A is your hospital coverage. It covers inpatient care in a hospital or skilled nursing facility, which includes semi-private care. It also covers reasonable and necessary home health services and hospice care.

Medicare Part B Coverage

Medicare Part B is your medical coverage. This covers medically necessary and preventive care services, items, and tests. This can include clinical research, ambulance services, durable medical equipment, mental health care, and limited outpatient prescription medications.

Medicare Advantage Coverage

Medicare Advantage plans all have the same coverage as Medicare Part A and Part B. In addition, many plans have additional packages which you can purchase to add supplemental coverage to your health insurance, including dental care, vision care, or hearing care.

Medicare Advantage Prescription Drug (MA-PD) plans have a combination of Part A, Part B, and Part D coverage. These are a popular option among people who choose Medicare Advantage plans.

Medicare Part D Coverage

Medicare Prescription Drug Plans cover your prescription drugs. Each plan can choose which drugs it would like to cover, which are listed in the plan’s formulary. Plans will cover essentially all anticancer, anticonvulsant, antidepressant, antipsychotic, antiretroviral, and immunosuppressant drugs. If you are prescribed a medication that is not covered under your plan’s formulary and cannot be substituted by a drug that is covered on the list, you and your prescriber can request an exception. You can also do this if your quantity needed exceeds the limit.

Medicare Supplements Coverage

Medicare Supplements cover some or all of the following expenses from Part A and Part B:

• Part A coinsurance and hospital costs
• Part B copays and coinsurance
• Your first 3 pints of blood
• Part A hospice
• Care in a skilled nursing facility
• Part A deductible
• Part B deductible
• Part B excess charges
• 80% foreign travel emergency care

Signing Up for Medicare As a Senior

You should enroll in Medicare when you are first eligible. Your Initial Enrollment Period begins three months before the month you turn 65. This signup period lasts for seven months and ends three months after your 65th birthday month. During this enrollment period, you will need to apply for Medicare through Social Security. You can do this by applying online, visiting your local Social Security office, or calling Social Security.

Signing up during the three months before your birthday means your Medicare coverage will begin on the first day of the month of your birthday, or the first day of the month before if your birthday is on the first. You can still sign up in the second half of the enrollment period, but your coverage will begin later.

For help signing up for Medicare or to understand your benefits, contact a representative from Medicare Peace of Mind.