What is Medicare?
Why Medicare is a good idea
Medicare is a tax-funded health insurance program for seniors ages 65 and older.
Without health insurance, medical costs may be as steep as buying a new home. Medical expenses tend to rack up with age, as health problems become more likely. Treating worsening or newly emerging medical conditions often require repeated doctor’s appointments, as well as expensive exams and procedures.
Or, if you already have a health insurance policy, you can still reap the benefits of Medicare. Whether you’re with or without health insurance, Medicare only serves to benefit you.
The Parts of Medicare
Medicare is often referred to as if it’s a single insurance plan, but in reality, it refers to the multiple insurance plans that fall under it. These policies are known as Parts, which consist of Medicare Part A, B, C, and D.
Medicare Part A is a must-have – not just because of what it covers (inpatient treatments), but because it’s mandatory. If you don’t have Part A, then you can’t have Medicare.
Medicare Part A:
- Covers hospital, skilled nursing facility, and hospice costs
- Can be premium-free if you join during the Initial Enrollment Period (lasts from three months before your 65th birthday to three months after your 65th birthday)
- Missing the Initial Enrollment Period will result in late enrollment fees on top of the standard premium every month (this can also be said for the other Medicare policies)
Medicare Part B focuses on the outpatient facet. While optional, it’s still a policy you should strongly consider. Many will have just Medicare Part A and Part B, a combination commonly known as Original Medicare.
Medicare Part B:
- Covers outpatient costs (i.e., copay for doctor’s appointments, preventative care, and durable medical equipment)
- When combined with Medicare Part A, you can also get supplemental insurance and retain your current health insurance policy
Medicare Part D is the prescription drug plan, which covers six medication categories: antipsychotics, anticancer, HIV/AIDS medications, anticonvulsants, antidepressants, and immunosuppressants.
Medicare Part D:
- Covers prescription drugs based on a formulary (the list of drugs covered)
- Must cover costs for at least two medications in each of the six medication categories
- Doesn’t cover drugs like benzodiazepines, fertility medications, medications for weight loss, or barbiturates
- Requires a $445 deductible payment before benefits begin (as of 2021)
Lastly, there’s Medicare Part C, also known as Medicare Advantage. It’s a combination of Medicare Parts A, B, and D. But, there are key differences between Medicare Advantage and Original Medicare.
Medicare Advantage:
- Is sold via private insurance
- Requires being enrolled in Medicare Part B
- Must cover everything that Original Medicare does
- Also includes dental, vision, and hearing coverage. Some plans include gym memberships
- Has a variety of policies within it. These include Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans, Private Fee for Service (PFFS) Plans, and Special Needs Plans (SNP)
- May require choosing a primary care doctor. You may also have to get referrals from your primary care doctor before seeing a specialist
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We are not connected with or endorsed by the United States government or the federal Medicare program.
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We at World Financial Solutions pride ourselves in being Medicare specialists. Medicare, along with associated policies like Medigap and Medicare Advantage, can be a lot to digest. But with our help, that won’t be an issue at all. There’s a policy out there for you, and we will make sure you get it. Let today be that day. Call us at 281-639-7787, and you can also email us at [email protected].
