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Medicare is a federal health insurance option for people ages 65 years old and above, as well as for people who have disabilities and those who may be suffering from End-Stage Renal Disease. Medicare has different pathways. There are various parts that make up Medicare and each cover distinct aspects of health services. It is important to become familiar with the options available to make sure your needs are covered.
For example, Medicare is broken down into Hospital Insurance, Medical Insurance and Prescription Drug Coverage. There are two types of Medicare: Original Medicare (Part A and B) and Medicare Advantage (Part D). Part A covers inpatient needs, such as hospital stays and care in a nursing facility or hospice care. It also will cover some other health care services. Part B covers specific doctors’ services, any outpatient care, preventative services and medical supplies. The Medicare Drug Plan, also known as Part D and/or Medicare Supplement Insurance (Medigap) Policy, serves to cover costs of prescription drugs or any recommended vaccines.
Upon your Medicare enrollment, a few decisions will need to be made. You will be provided with choices for how you wish to receive health coverage. This is when you will need to decide between “Original Medicare or “Medicare Advantage”. Original Medicare (Part A and B) provides good, basic coverage and pays for approximately 80% of all approved costs from doctors who accept Medicare. It is important to note that usually prescription drug costs and dental care are not covered with this option. Part A is free if you are 65 and meet specific requirements.
Medicare Advantage Plans are offered by Medicare approved private companies and often include drug coverage (Part D). When choosing this type of plan, you may want to consider that there is a limit on out-of-pocket expenses. The most well-known Advantage Plans are the HMO, PPO, Private fee for Service or Special Needs Plan.
There are specific times to apply for Medicare. If you choose Plan A you are eligible to apply 3 months before you turn 65 and/or up to 3 months after. Not applying on time could result in penalties. Becoming familiar with the options available to you and talking about your medical needs will help you to choose the best plan for you.
UrHealth Benefits is here for all Ur (your) healthcare needs. Not sure if you qualify for special enrollment and don’t know where to start? Whether you are looking for Life, Individual & Family Health, Supplemental, Travel and Medicare Insurances, UrHealth is here as a resource for you and your loved ones. Contact UrHealth Benefits to find the best personalized plan that fits your lifestyle and to simplify the insurance process.