Are you or your parents approaching the age of Medicare eligibility? As excited as you may feel to finally have your medical bills covered by the health insurance program you have financially contributed to for a long time, you likely have many questions about how Medicare works, its various coverage options, and how to go about enrolling in it.
Getting started with Medicare may seem daunting. But, fret not because we’ve got you covered. Here, we’re going to answer some of the most common questions about Medicare to help you understand the federal health insurance program and get the most out of it:
1. Who is Medicare for?
Medicare is a federal healthcare insurance program designed for US nationals aged 65 or above. However, younger people can also qualify for insurance if they have certain health conditions. These include end-stage renal disease, amyotrophic lateral sclerosis, and any disability.
2. How many types of Medicare health plans are there?
There are four different types of health plans available under the Medicare program – A, B, C, and D.
Medicare Part A and B together form the Original Medicare, which is the coverage option offered by the federal government.
Medicare Part C is called Medicare Advantage. It is offered by private insurance companies and is more comprehensive than the Original Medicare.
Medicare Part D is also known as Medicare Drug Coverage. As the name suggests, it includes prescription drugs coverage as well as several recommended vaccines.
3. What does Original Medicare Cover?
Original Medicare is the most common Medicare coverage option. It includes Medicare Part A and B, which are Hospital and Medical Insurances, respectively.
Medicare Part A pays for hospitalization, skilled nursing facility bills for short-term stay, some home health care services, and hospice care. With Medicare Part B covers outpatient care, certain preventive health care services, such as yearly checkups, vaccines, and screenings, medical services or procedures required to detect and/or treat a disease, necessary durable medical equipment, home health care, and ambulance service. Also, Medicare Part B also includes mental health coverage.
4. Does Medicare provide dental coverage?
You can get dental coverage with a Medicare Advantage plan; it doesn’t come with Original Medicare. Offered by private health insurance companies, Medicare Advantage plans also come with vision and hearing coverage.
5. Do you get enrolled in Medicare automatically? Or do you have to do it yourself?
If you’re getting Social Security or Railroad Retirement benefits, you’ll automatically enroll in Medicare upon becoming eligible for it. Otherwise, you’ll have to enroll for it yourself.
6. When can I enroll for Medicare?
Your Initial Enrollment Period (IEP) for Medicare spans over seven months around your 65th birthday, starting about three months before it. It’s best to enroll in Medicare during the initial period because if you miss it, you’ll have to wait for the General Enrollment Period (GEP) or a Special Enrollment Period (SESP) to do it.
7. How to sign up for Medicare?
Those who’re already receiving Social Security benefits get enrolled in Medicare automatically upon turning 65. If this applies to you (or your parent), you don’t have to do anything; you will get the Medicare card in the mail about three months prior to your 65th birthday.
Those who are not receiving Social Security benefits can enroll in Medicare in the following three ways:
- Online, via the Social Security website
- By calling the Social Security office at 1-800-772-1213 between 7 am to 7 pm, Monday to Friday
- Visiting your local Social Security office in person
8. What happens if I don’t sign up for Medicare during the Initial Enrollment Period?
If you’re eligible for Medicare and not covered for health insurance by your employer or your spouse’s employer, missing the Initial Enrollment Period for Medicare will put you at a disadvantage. You will have to pay a10% per year penalty for Medicare Part B and a 1% per month penalty for Medicare Part D.
Don’t delay Medicare enrollment; do it as soon as you become eligible for it to avoid penalty.
9. How much does Medicare cost?
Medicare Part A comes free to most people. However, if you’re not eligible to receive premium-free Medicare, you’ll have to pay a certain amount every month [Refer to the eBook What is Medicare? to learn about the eligibility criteria for premium-free Medicare].
The premium amount tends to change over time. According to the Medicare website, the monthly premium for Medicare Part A for 2022 is $499 for those who paid Medicare taxes for less than 30 quarters and $274 for those who paid the taxes for 30 to 39 quarters.
Medicare Part B doesn’t come free to anyone. The standard monthly premium for Medicare Part B is $170.10 in 2022. However, it can be higher for some people. Talk to our Medicare advisor to find out how much Medicare Part B will cost you.
10. How do I find the right Medicare coverage option for myself or my parents?
With so many options and plenty of things to consider, choosing the right (best) Medicare coverage plan for yourself or your parents can be a little daunting. But, don’t let your confusion or lack of understanding of Medicare be the reason for making the wrong choice. Read up on it or contact a licensed Medicare agent to help you understand the health insurance program and choose the right coverage option according to your needs and budget. We at United Insurance have been helping Americans choose the best Medicare health coverage options for themselves and their loved ones for a long time. Contact us to clear your confusion and find the right Medicare plan for yourself.