Medicare is the health insurance plan for people over 65 years old or who have been disabled since birth. The first thing to remember is that these are government-funded plans, not private ones, which means you can only sign up if you or your immediate family members qualify. You also need to make sure you’re eligible to enroll in Medicare because it’s a complicated process.
Here we’ll help you understand what Medicare is, what it covers, and how you sign up.
What Is Medicare?
Medicare is a federal health insurance plan that helps pay for health care costs of eligible people aged 65 and older or younger people with specific disabilities. According to the Centers for Medicare and Medicaid Services, “Medicare covers many medical services, such as doctor visits, hospital stays, hip replacement and preventive services.”
There are four parts to Medicare: Part A, Part B, Part C, and Part D. People generally start with Part A and then move on to the other parts as they become eligible.
Part A is a hospital premium-based health insurance plan covering inpatient care at hospitals and hospice care. It also covers several skilled nursing facilities for short periods. Generally, people are eligible for this part once they’ve paid into the Medicare program for 40 quarters, ten years. The employee’s contributions and the federal government pay this part of Medicare.
Part B, sometimes called “medical insurance,” pays for medical services performed in a doctor’s office and other outpatient care. It includes doctors, dentists, labs, and outpatient hospital care services. People who don’t sign up for Part A automatically get Part B when they turn 65. The only way to opt out of this plan is if you have other health insurance coverage that covers you. If you don’t have coverage but later find out you have cancer or a severe medical condition, you may enroll in Part B. For example, someone who has been receiving cancer treatment at a local hospital can enroll in Part B after the fact if they didn’t sign up beforehand. In other words, it’s never too late to get Part B.
Part C is also known as Medicare Advantage, also known as Part C. The Medicare Advantage program offers private insurance plans that generally cover more than Part B and give people more benefits than traditional Medicare but also cost more. For example, if you’re 65 years old and sign up for an HMO, Health Maintenance Organization, you’ll pay less out of pocket because your plan is cheaper, and you do not have to pay a deductible.
Finally, Part D is also known as Medicare Prescription Drug Plan. This part of Medicare helps pay for the medicine. The idea is to help people with prescription drug costs that may be high because they don’t have any other insurance coverage. Part D covers outpatient prescription drugs that treat various conditions and chronic diseases. The majority of prescriptions are covered through the plan.
Part D can be confusing because separate prescription drug plans have different drug coverage and costs. You’ll want to find the plan with the most-needed drugs covered and the lowest monthly premiums. You can do this by comparing all Part D plans at Medicare.gov.
How Do You Sign Up?
If you qualify for any part of Medicare, you must enroll to use these benefits.
You must choose a Part A plan before getting the Part B, C, or D benefits. You can choose Part A and then choose the other parts later. Or you can get an initial Part A and use it while you’re waiting to sign up for the other parts of Medicare.
Once you sign up for Medicare, it’s essential to make sure that you remain eligible throughout the life of your benefits. You may want to enroll in these plans annually or biennially.
Are There Any Special Enrollment Periods?
Yes. A particular enrollment period is when you can add or drop Medicare coverage. There are different rules for each part of Medicare, so it’s essential to follow what’s right for you. And if you didn’t sign up on time, it may be too late. You’ll want to ensure eligibility before you enroll in Medicare or change plans. Read each section below to find out when you can enroll in Medicare and what to do if you don’t.
For other special enrollment periods, it’s essential to know that if you didn’t receive your Social Security card before the 30th day of a given month or you weren’t eligible for Medicare based on your work record or Social Security data when you were first eligible, then you can enroll in Parts A and B anytime during the following 12 months. The same rule applies if there is an error in your Social Security earnings record. For example, when you were first eligible for Part A, you worked and earned too much money. You didn’t know this then and trusted that they’d correct the error. You had no way to know that they wouldn’t correct it, so now you want to enroll in Part A before 12 months expire.
What if I Don’t Sign Up on Time?
If you miss the enrollment deadline, it’s essential to know that you may have to wait up to three months before coverage begins. For example, if you wait one month beyond your initial enrollment date to sign up for Part B, your coverage will start on the first day of the third month. This time frame is referred to as a “late enrollment penalty period.” But if this happens, you’ll only have to pay for Part B for those three months.
In conclusion, when it comes to Medicare, you don’t have to be eligible for the same coverage the entire time you’re in Medicare. You can change between plans and even switch from a Part D drug plan to traditional Medicare if you like. However, there are many reasons why it’s essential to know your eligibility requirements ahead of time to ensure your coverage is what you need when you need it.