If you’ll be turning 65 soon, chances are you’ve got a lot on your mind. If you’re not already retired, you may be planning for a major transition or you may be deciding how much longer you’ll be working. Along with that, you may have important decisions to make when it comes to healthcare.
You are eligible for Medicare at age 65 if you are a U.S. citizen or legal resident, if you resided in the U. S. for at least five years and if you worked for at least 10 years in employment covered by Medicare.
Medicare is a health insurance program, administered by the federal government, for people age 65 or older, younger people with certain disabilities and people with end-stage renal disease (ESRD).
Medicare is made up of four parts, which are described as Parts A, B, C and D. Each parts covers specific services within the program. Federal and state laws determine Medicare coverage. Medicare pays about 80 percent of health care costs, including lab tests, surgeries, doctor visits and other services. It also covers supplies, such as wheelchairs and walkers that are considered medically necessary to an individual’s treatment.
Other rules may apply for Medicare Advantage Plans or other Medicare plans. However, those plans are required to provide at least the same coverage as Original Medicare. Some limitations may apply. When determining if Medicare covers what you need, talk to your doctor or other healthcare provider and ask if Medicare covers the services and supplies you need.
Sometimes called Medicare Part C or MA Plans, Medicare Advantage Plans are offered by private companies and approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. Your Medicare Part A and Part B coverage will come from the Medicare Advantage Plan and not Original Medicare.
These plans cover all Medicare services and may also offer extra coverage. However, fees and rules for each plan vary. Prescription drug coverage (Part D) is usually provided through the plan. However, you can join a Medicare Prescription Drug Plan if the plan does not offer drug coverage.
Medicare Supplement Insurance or Medigap policies help to pay the remaining 20 percent of what Medicare doesn’t cover. These plans cover such expenses as copayments, coinsurance and deductibles. Sold by private companies, some plans cover services such as travel outside of the United States.
If you have a Medigap policy, Medicare will pay its share of the approved costs, then your Medigap policy will pay its share. A Medigap policy is NOT a Medicare Advantage Plan. Medigap only supplements Original Medicare benefits. Medigap policies generally DO NOT cover long-term care, vision or dental care, hearing aids, eyeglasses or private-duty nursing.
We offer Medicare Supplement Insurance or Medigap policies from a number of quality providers including Mutual of Omaha, Aetna, Equitable, Old Surety, Blue Cross Blue Shield, United Healthcare and others. Your six-month Medigap open enrollment period is the most optimal time to purchase a policy. During this period, you have the option to buy Medigap policies sold in your state, even if you have health problems. After this period, you may not be able to purchase a Medigap policy, but if you are, it may cost you more.
Have questions? Contact our experienced staff for more information. Call us (336) 226-8595 today!