MEDICARE ABCs Medicare open enrollment begins on October 15th this year. Whether you are already enrolled in Medicare or are preparing for when you become eligible, this is a good reminder to complete your annual review of benefits and determine which options are the most cost-efficient for you. The choices can get overwhelming, so here are some tips to help break down your decisionmaking:
HOW TO QUALIFY & WHEN BENEFITS BEGIN Most Americans qualify for Medicare coverage. However, some will pay different premiums based on the number of quarters they paid into the Medicare system (i.e. through Medicare taxes). Most individuals qualify for Medicare at age 65. However, it is important to do your homework early because you want to be covered when any other insurance ends. Experts recommend starting your research at least by age 64 and a half - six months before your 65th birthday.
MEDICARE BENEFITS – THE BASICS Medicare itself is comprised of two parts: •
Part A – Hospitalization: This includes inpatient care at a hospital, hospice care, home health care, and nursing home care (but does not include any custodial or long-term care expenses). Part A is typically free of charge, unless you did not pay into the Medicare system for a sufficient period of time during your working years.
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Part B – Medicare Insurance: This includes services or supplies that are needed to diagnose or treat a medical condition and preventative services. Examples include physician visits, ambulance services, inpatient and outpatient mental health, and durable medical equipment. Part B can cost as little as $144.60 per month and up to $491.60 per month, depending on income and tax filing status.
If you choose, you can rely on Plan A and Plan B only for your health insurance needs. However, most individuals purchase a Medicare Supplement policy and a Prescription Drug policy, or they choose the route of a Medicare Advantage plan. 12 | 50+ Living | October 2020
MEDICARE SUPPLEMENT POLICIES Medicare Supplement policies are offered by private health insurance companies to supplement expenses that are not covered by Medicare Part A or Part B. These policies are often referred to as “Medigap” policies: they fill in the gaps that A and B don’t cover for the patient, including co-payments, co-insurance, and deductibles. A few things to know about a Medicare Supplement policy:
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You are only eligible for a policy if you have Medicare Part A and Part B. You must show proof of this coverage when you apply for a supplement policy.
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Supplement plans are required to be standardized – they must offer the same basic benefits, but different insurance companies may charge different premiums.
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You pay a monthly premium for the policy in addition to the premium for Medicare Part B.
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Medicare Supplement policies only cover individuals, there is no option for family coverage.
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Policies range from option “A” to option “N,” depending on the amount of coverage preferred. Option G is the plan most individuals choose.
