Ten thousand seniors age into Medicare every day, according to AARP. Medicare is federal health coverage for seniors ages 65 and older and others with specific disabilities. If you are not receiving Social Security benefits, you must enroll yourself in Medicare during the correct enrollment period. According to the Congressional Research Service (CRS), about 750,000 Medicare beneficiaries failed to enroll in Medicare in 2014.
The government puts complete trust in beneficiaries to understand every in and out of Medicare, but many find there isn’t much guidance. You can request a Medicare and You book from the government. However, many seniors find Medicare to be so complex that the book still often leaves them confused. If you are finding yourself overwhelmed during this transition, keep reading on how to keep Medicare uncomplicated.
Research Medicare in advance
Research is the uttermost important part before the transition to Medicare. Although premiums and deductibles typically change annually, the benefits of Medicare primarily stay the same.
There are many online resources you could consider when researching about Medicare. For example, there are a handful of Medicare webinars, seminars, courses, and even YouTube videos that teach the basics of Medicare.
If you are a hands-on learner, you can even consider purchasing a Medicare book. There are best-seller Medicare books available, such as “10 Costly Medicare Mistakes You Can’t Afford to Make” and “Medicare for Dummies.” These books go in-depth about everything there is to know about Medicare.
You should not enroll in a Medicare plan without knowing your Medicare options first and what your Medicare coverage consists of. Once you start understanding your Medicare options, all the different Medicare parts, plans, enrollment, and election periods will begin to make sense.
Know when to enroll in Medicare
Many beneficiaries are not aware that there is a penalty if they do not enroll in Medicare on time. If you are not actively working for a large employer past Medicare age and have their insurance, you must enroll in Medicare during your Initial Enrollment Period.
The Initial Enrollment Period is different for every Medicare beneficiary. It is different because it’s based on the beneficiary’s birthday. Your Initial Enrollment Period begins three months before your 65th birthday and ends three months after your birth month. For example, if your birthday is on September 20, your Initial Enrollment Period would begin on June 1 and end on December 31.
If you fail to enroll in Medicare during your Initial Enrollment Period without creditable coverage, you will pay a lifelong late enrollment penalty on top of your Medicare premiums.
Understand the Medicare parts
A beneficiary receives inpatient and outpatient coverage from the federal government in the form of Medicare parts. Medicare Part A is for inpatient care, and Medicare Part B is outpatient coverage.
Medicare Part A covers your room and board as an inpatient inside a hospital. For example, Part A covers three meals, a semi-private room, any administered drugs, and necessary lab services. Part A also covers post-hospital care, such as skilled nursing, hospice, palliative care, and counseling. However, Medicare Part A will not cover long-term care, such as nursing homes.
Part B covers any medically necessary service in an outpatient facility, such as a doctor’s office or an emergency room visit. Part B coverage also provides access to ambulance rides, durable medical equipment, lab testing, multiple vaccinations, and much more.
There are two Medicare alternative options
Medicare Part A and Part B will leave you with out-of-pocket costs, such as copayments, coinsurance, and deductibles. Many Medicare beneficiaries will purchase either a Medigap plan (Medicare Supplement) or a Medicare Advantage plan (Part C) to help with these costs. These types of plans are sold by private insurance carriers, not the government. Therefore, these plans are 100% optional.
Medigap plans work alongside Original Medicare. So, you can visit any doctor in the United States that takes Medicare and use your Medigap plan, as Medigap plans do not have network restrictions. You do not need a referral to see a specialist with a Medigap plan, and all Medigap plans are standardized.
Medicare Advantage plans work differently than Medigap plans. For instance, Medicare Advantage plans do not work alongside Medicare. Instead, you will receive your Part A, Part B, and Part D benefits from the private insurance carrier you purchase your plan through.
Medicare Advantage plans also have a network of doctors and pharmacies where you can receive your health care, which is similar to employer group coverage. Each Medicare Advantage plan contains a different set of benefits and cost-sharing. So, if you want to purchase a Medicare Advantage plan, you will want to shop within multiple carriers to ensure your plan has the most beneficial healthcare benefits.
Work with a Medicare broker
Lastly, working with an experienced Medicare broker is an excellent way to uncomplicate Medicare. A Medicare broker is a group of independent agents that represent multiple carriers. Since Medicare brokers represent numerous companies, they can help find a cost-effective plan in an area while giving unbiased opinions.
Medicare brokers get paid by the private insurance companies they represent, so there is no cost to the beneficiary for using their services. If you begin working with a Medicare broker who does charge for their services, you should run away fast and look elsewhere. You will pay the same premium with a Medicare broker as if you were to enroll in a Medicare plan directly through the carrier.
Therefore, working with a Medicare broker can help benefit your healthcare and budget needs.
Knowing the different Medicare parts, plans, and enrollment periods can be confusing at first. But, whenever you do your research and work with an experienced Medicare broker, it can help ease the Medicare confusion.