Insurance Health & Medical Insurance

10 Important Facts About Your Medicare Plan

Medicare can be bewildering but if you understand how it works your experience will be considerably smoother and more rewarding. Here are ten key facts you need to know about. When you discover what pertains to you go deeper to find out more for the answers you want.

  1. You can get Medicare by two main routes, the choice is yours. Here are the two options available to you:

    • Original Medicare (Part A and Part B) - the federal government provides this option.

    • Medicare Advantage Plan (Part C) -it's the private insurance companies which offer these plans.

  2. If you choose Original Medicare you'll have to share the cost because you paid taxes when working you have contributed to Medicare. That's what makes you eligible for Medicare benefits when you reach the age of 65. But not everything is paid for by Medicare. You will still have to share the cost by paying a small monthly premium and copays.

  3. Out-of-pocket costs can be controlled through Medicare supplement insurance. If you need considerable medical services it's very possible that you'll run up big bills. Some of these expenses like copays and deductibles can be taken care of through Medicare supplement insurance plans.

  4. Drug costs can be controlled through Prescription Drug Coverage. As a Medicare member you have the option of enrolling in Part D to avail of prescription drug coverage. You also have the option of enrolling in one of the Medicare Advantage plans which include this feature.

  5. Your state has choices, learn about your choices. There is no difference across the U.S. with Parts A and B of Original Medicare. Private insurance companies offer Medicare Advantage and Prescription Drug Coverage plans (Parts C and D), and these might be restricted only to certain regions, counties and states. Supplemental policies for Medicare offer coverage nationwide. These are available by
    the state.

  6. Choose the right time to enroll. Your first chance to enroll in Medicare is during the Initial Enrollment Period (IEP) which is during the three months before your 65th birthday and the three months succeeding your birthday month.

    • If you enroll before the month of your 65th birthday your coverage will start on the first of the month of your birthday.

    • If you enroll on or after your birthday month your coverage will start on the first of the month after the month in which you enrolled.

  7. Review your options every year. After you have decided on your Medicare coverage you can still make changes, but this has to be done between October 15 and December 7 known as the Medicare Open Enrollment Period (OEP). Assess your coverage every year to see if it matches your current needs.

  8. Sometimes a situation could arise where you might have to enroll or make changes at a time other than the IEP or OEP. Circumstances which create such a situation could be moving out of the service area of your current health plan or retiring and having to leave a health care plan in which you were enrolled. You might be able to do so if your reason is justified.

  9. Review your present coverage. If you are already covered under group coverage in your job or you are benefiting from retiree coverage from your earlier job you need to see how this fits in with Medicare.

  10. Even though Medicare is complex, help is forthcoming. If you really cannot afford it, you might be eligible for financial aid.

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