Are you aged 65 or about to turn 65 and trying to understand what you need to know about Medicare? 10,000 people daily turn 65 and are ready to sign up or explore the benefits that come with Medicare. Some 55 million or more Americans take advantage of Medicare.

So, what is Medicare and how does it work? Medicare is a government based insurance plan available for Americans aged 65 or older. Parts of the coverage are free, while others are not. 

It can be an overwhelming system to understand and navigate. Get the medicare facts you need to understand the system. Read on for 5 Medicare facts that will help you understand what you need to know. 

1. Know the Forms of Medicare

Medicare, which is considered an entitlement program, is government insurance that you become eligible for at age 65. As you work and pay taxes, you pay into the system that allows you when you turn 65 to get medical coverage. 

Understanding Medicare can be daunting because of the many parts of it. Often referred to as the alphabet soup of Medicare, there are several parts or forms of Medicare to understand to get a handle on the coverage you will get. Let’s take a look at the basics parts of Medicare. 

Medicare Part A

Medicare Part A is the hospital care part of the coverage. It covers you when you need inpatient hospital services. If you need to be in a skilled nursing facility, it will cover that for a short period of time.  It also covers some skilled nursing care for at home and hospice care. 

Medicare Part A is the free part of the coverage, as in you don’t pay to get it. Yet, you will share in the costs if you need to use it. It will only cover a portion of a hospital stay. You must first meet a deductible up to a certain point. 

Medicare Part B

Medicare Part B covers your medical care. It covers:

  • Doctor visits
  • Blood tests
  • X-rays
  • Diabetic screenings
  • Diabetic supplies
  • Outpatient hospital care

This part of Medicare is not free. You must pay a premium for the coverage. Then you share in the costs when you use it. So, you pay a deductible when you go to the doctor for a visit, for example. 

Medicare Part C

Medicare Part C or Medicare Advantage gets you all the parts of Medicare in one package. It’s considered private insurance that offers you Medicare Part A and Medicare Part B plus additional benefits like prescription drug coverage. 

Plans vary on the coverage so it’s smart to research these plans in depth.

Medicare Part D

Medicare Part D is another version of private insurance you can seek through Medicare for prescription drug coverage. Again, plans vary depending on the insurer and the cost. 

2. Medicare Is Not All Free

Understanding the costs of Medicare coverage can be quite confusing. Medicare Part A and Part B are mostly free coverage. Medicare Part A you pay a deductible by benefit period. Medicare Part B you will pay a monthly premium for coverage. 

The cost of Medicare Part C and D plans can vary depending on the private insurer. 

There are also some gaps in coverage on Medicare and things not covered (more on that later). Many will opt for supplemental coverage in addition to what they get from Medicare. 

The cost of supplemental insurance for Medicare is often well worth the additional coverages for the gaps and deductibles that are a part of Medicare Part A and Part B. 

3. Know When to Enroll

Many people confuse the eligibility of Social Security and Medicare. Social Security actually has a rolling eligibility period. Your benefits vary depending on when you decide to start getting the benefits. 

Medicare, on the other hand, is available for you on the day you turn 65. You can start enrollment three months prior to your 65th birthday. 

Enrollment periods are quite strict with Medicare so you must pay attention to the rules. You can get quite a financial penalty if you miss deadlines too.

The three months before you turn 65 and the three months after are your original window to sign up for Medicare. If you miss that window, you can be eligible to enroll in the next window starting on the next January 1st. 

Read More: Is Medicare Supplement Plan F Really Going Away?

4. What Is Covered With Medicare Coverage

If you sign up with optimal coverage Medicare can cover many of your medical needs. It provides you with inpatient hospital care. It covers a large percentage of the doctors’ visits you have. You pay a deductible from those visits. 

If you need to stay in a skilled nursing center, it covers those up to a certain percentage. It also covers therapies, lab tests, home healthcare, durable medical equipment, and some preventive services such as screenings and vaccines.

You need to research the plan carefully. But there it also covers artificial limbs, ambulance services, hospice care, mental health care, and transplants in most scenarios.

5. Know About What’s Not Covered Under Medicare

While Medicare does provide good coverage for many things. There are things not covered under Medicare. It’s important to know about those things not covered. Some of those things include:

  • Long-term care
  • Most dental care
  • Eye examinations for glasses
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams 
  • Routine foot care

Many will opt for supplemental insurance to cover those things not covered. Supplemental insurance will also help with gaps in coverage for Medicare too.

Understanding the Medicare Facts You Need to Know

Knowing these Medicare facts can help you navigate the system. Health care coverage is so important for everyone, you want to make sure you have the coverage you deserve and need. 

For more health-related articles like this one, be sure to visit our page often.


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