Terrell Medicare Plans

Understanding Medicare and its Various Parts

Healthcare costs have been a growing issue in the United States for years. Many people might worry that they can’t afford all their medical bills or insurance. This could leave some people with tough decisions about their health and finances.

The Medicare program was developed by the government to protect the health and well-being of millions of Americans. Over time, Medicare has provided an increasing number of Americans with access to the quality and affordable health care they need. If you’re a Medicare beneficiary or helping someone who is, you may want to read this article to get an understanding of the Medicare program and the parts of Medicare. Understanding the basics of Medicare may be useful when you’re deciding on Medicare coverage to fit your individual needs.

What is Medicare, and who can get it?

Medicare is our country’s health insurance program for people age 65 or older and younger people receiving Social Security disability benefits. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care.

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get Medicare:

Original Medicare

Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you want drug coverage, you can join a separate Part D plan. To help pay your out-of-pocket costs in Original Medicare (like your deductible and 20% coinsurance), you can also shop for and buy supplemental coverage. Examples include coverage from a Medicare Supplement Insurance (Medigap) policy, or from a former employer or union.

Medicare Advantage (also known as Part C)

Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually, Part D. Part C plans may have lower out-of-pocket costs than Original Medicare.  They also may offer extra benefits that Original Medicare doesn’t cover — like vision, hearing, dental, and more.

If you can’t afford to pay your Medicare premiums and other medical costs, you may be able to get help from your state. States offer programs for people eligible for or entitled to Medicare who have low incomes. Some programs may pay for Medicare premiums, and some pay Medicare deductibles and coinsurance. To qualify, you must have limited income and resources.

Medicare Part D

The Medicare Part D program provides prescription drug coverage. You can sign up for a stand-alone Medicare Part D Prescription Drug Plan to work alongside your Original Medicare coverage, or you can get all your Medicare coverage through a Medicare Advantage Prescription Drug plan.

If you enroll in a stand-alone Medicare Prescription Drug Plan (or a Medicare Advantage Prescription Drug plan), make sure you choose a plan that covers your medications. Every Medicare Prescription Drug Plan has a formulary that lists the drugs it covers, and many plans make their formularies available online. A plan’s formulary may change at any time. You will receive notice of your plan when necessary.

Most beneficiaries must pay a premium for Medicare Part D, along with other costs such as copayments and coinsurance; these costs vary among plans. Although this insurance is optional, if you don’t enroll when you’re first eligible for Medicare, you could face a late enrollment penalty if you decide you want this coverage later.

Additional health insurance options

Original Medicare doesn’t cover everything. If you decide to stay with Original Medicare (instead of switching to Medicare Part C), you can purchase a Medicare Supplement (also called Medigap) plan to help cover Original Medicare’s out-of-pocket costs, such as coinsurance, copayments, and deductibles. Original Medicare doesn’t include prescription drug coverage, so you also might want to add a stand-alone Medicare Prescription Drug Plan.

Medicaid is another viable option to help cover healthcare costs for those eligible for the program.

Timing is important

Knowing when to enroll in the various types of Medicare coverage might save you late-enrollment penalties and may help you get the coverage you want in a timely manner.

Making an informed decision

If you’re new to Medicare, you may want to determine which type of Medicare insurance plan will fit your healthcare and financial needs. If you’re still employed or have coverage such as veteran’s benefits, check with your plan administrator to see how this insurance works with Medicare. It’s also important to decide if you need prescription drug coverage. Once your Medicare benefits kick in, don’t forget to schedule your complimentary “Welcome to Medicare” physical exam with a doctor, and be sure to ask about any preventive services he or she might recommend.

As you can see, there are various Medicare insurance options available. To get help finding a plan or comparing plans in your area, you can feel free to contact one of Ashford Insurance’s licensed insurance agents at the phone number shown below.