What You Should Know About Medicare

What You Should Know About Medicare | HealthSoul

You can choose to avail of Medicare coverage in various ways. The original Medicare essentially consisted of two parts, which are as follows. Part A or hospital insurance and Part B in the form of medical insurance. Additionally, you can purchase supplemental insurance or Medigap. It will let you cover other expenses that you would have to otherwise incur out of your pocket.

Medicare Benefits

There is yet another component to the full Medicare benefit, commonly referred to as Part C or rather Medicare Advantage. This Part C assumes the form of a comprehensive insurance solution comprised of the coverage provided by Part A and B and Medigap. In other words, Medicare advantage offers a comprehensive health-related expense coverage that includes in its scope:

  • Out of pocket expenditure due to health issues
  • Dental
  • Vision
  • Chiropractors
  • Wellness programs and much, much more

To add to the goodness and good cheer, many Medicare Advantage plans also have specific plans covering the cost of prescription drugs.

Different Medicare Components

However, you should note that Medicare in its initial form didn’t entirely be as bold as providing insurance coverage to prescription drugs too. To make up for this, the federal government has entered into legal contracts with several private insurance firms, which ultimately resulted in Medicare Part D.

People who are eligible for receiving the assistance provided by Medicare Part A and/or if they are enrolled in Medicare Part B have the option of purchasing Medicare Part D. It happens to be the standalone insurance program offered to cover the costs of prescription drugs. The large majority of Medicare Advantage Part C health insurance plans offer a prescription drug add-on. You can choose to enhance your health insurance coverage with the help of Medicare agent.

The Meaning Of Critical Medicare Related Acronyms

Medicare has several essential components or program aspects. With them come a host of acronyms that professionals use while talking about Medicare. Don’t worry; this guide will help you through. The key Medicare acronyms demystified are as follows:

  • Initial Enrollment Period (IEP)- This term refers to the period of the initial enrollment.
  • Annual Enrollment Period (AEP)- It refers to the annual opportunity that the Medicare program provides during the year’s fall to modify health coverage and the provider of the same without attracting penalties.
  • Late Enrollment Period (LEP)- For Medicare-eligible citizens, delay in enrolling for Part B or D components of the Medicare program may potentially attract penalties. Often the penalties are heavy and come with no expiry dates.

Medicare Dates You Must Be Aware Of

The whole Medicare program comes with several important dates that are very important for you to keep in mind. They are as follows:

  • People older than 64 years and nine months can enroll in the Medicare program.
  • The Part B and Part D components of Medicare are open for a seven-month window, i.e., three months preceding and following the month you turn 65. It is critically essential for you to be aware of this time frame. Otherwise, you stand to incur heavy penalties.
  • During the AEP period, typically from the fifteenth of October to the seventh of December, you can choose to switch between plans.

Essential Facts You Need To Be Aware Of

Changing Medicare Plans

Changing your plan is not so hard as it seems. Irrespective of your Medicare plan selection, you are free to choose another more suitable plan for yourself during the Annual Enrollment Period. However, keep in mind that this will be your Medicare plan till the time of the following AEP. Indeed, there are special provisions for exceptional circumstances that do let you switch plans at other periods. However, to do so, you are going to need a Special Election Period permission or grant.

You, Will, Need To Pay The Insurance Premiums

There is often this misconception that Medicare is free for retirees-it isn’t. Contrarily, you will need to pay a premium in the form of a deduction from your Social Security financial benefits. Not only that, but Part B will also require you to pay a deductible annually besides furnishing a percentage of the total medical bill. This percentage figure typically stands at twenty percent. One should also mention that Medicare is devoid of caps. You can cover costs like co-payments, deductibles, and prescription drugs by purchasing supplemental insurance plans or Medicare Flex Card for seniors. As mentioned previously, Part C plans cover such costs that were overlooked by Initial Part A and B.

You Can Choose Medicare As An Effective Insurance Option If You Are Older Than 65

Medicare brings good news to people old enough to be eligible for the facilities provided by the program. While you are at it, you still should compare and contrast your existing health insurance policy with the health plans on offer at Medicare. You may have health insurance that your employer pays for.


You can choose Medicare if you are older than 65

Still, you can potentially get lower rates and better coverage with Medicare plans. Remember Medicare remains the same for you even if your working career isn’t over or if you are yet to receive social security financial assistance check.

In all likelihood, both insurance firms and the federal government have already furnished you with several detailed documents regarding Medicare. Examine your current health insurance and decide on Medicare accordingly. When in doubt, never hesitate to seek the help of your benefits administrator.