When you are turning 65, there is a lot of information to learn about and absorb. Sometimes finding accurate information for Medicare is one of the most challenging parts. That’s why Verus Health Partners designed the ABCs of Medicare!
Most adults have a pretty good grasp of their healthcare and what it offers. They know the ins and outs of their policy, and what to expect from doctor’s visits. But, when you turn 65 and retire, leaving your company plan behind, it’s a whole new process to learn. To top it off, it’s often times difficult to find information for medicare, and truly understand what applies to your particular scenario.
Medicare is the Federal health insurance program operated by the Centers for Medicare & Medicaid Services (CMS). Medicare is designed for individuals who are 65 or older, under 65 with disabilities, or individuals with End-Stage Renal Disease (ESRD) . You choose the Medicare option that will work for you and your individual needs.
Refer to our last article that explains the different parts of Medicare.
You are eligible to purchase a Medicare plan if you are 65 or older. You may also qualify if you’re younger than 65 and receive certain social security benefits for a disability. Additionally, if you have end-stage renal disease (ESRD), a type of permanent kidney failure that requires dialysis or a kidney transplant you may also be able to purchase Medicare.
Normally, if you are eligible for/and collecting your social security benefits, you’ll automatically be enrolled in Medicare.
If you still work/or are not collecting your social security benefit, you will need to apply for your Medicare card. Eligible individuals need to apply for their Medicare at least three months before their 65th birthday. If you have other creditable coverage, however, you may opt out of Part B coverage, and enroll in Part B at a later date. It’s important to note that if you do opt of our Part B, you can enroll later, but usually at a higher cost.
It is importan to note, if you do not select your Part B when eligible, you may also incur a penality upon enrollment in your Part B. (Please contact us for more information on what is considered creditable coverage.)
Sometimes spouses and other family members may be eligible for Medicare even if you are not. In rare circumstances, this may actually include ex-spouses as well.
Patients on Original Medicare (Parts A and B) often think because they have low monthly premiums, that Medicare is less expensive than a traditional health care plan. This may not always be the case, however. There are a few parts of the plan that can create high bills that may be financially devastating for someone on a fixed income.
Generally speaking, patients who are on medicare will pay a 20% coinsurance for medical services. To put things into perspective, a $100 doctor’s visit will cost you $20 out of pocket. However, this 20% also applies to additional diagnostics like chemotherapy, x-rays, MRIs, and ER visits. These types of services can cost several thousand dollars each. So, let’s assume you have a final bill of $10,000 for an overnight hospital stay and X-rays. Under Medicare you are now responsible for $2,000 out of pocket costs. Unlike your traditional healthcare policy, there is no maximum out of pocket cost with Medicare. For those who face serious disease or chronic issues, medical bills can reach six figures very quickly. To help fill some of the gaps and reduce your risks, there are other options available to help cover your costs. You can limit out of pocket expenses by selecting a coverage to fill in the gaps of original Medicare.
At Verus Health Partners, we educate our clients. Our goal is to ensure you have the proper coverage for your situation. Contact us today to learn more about the Medicare plan parts and what you qualify for. We will help you determine the right combination for you based on your specific needs. You can follow us on Facebook for other helpful information.