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Medicare Insurance Made Easy
Wise County Medicare Plans
Medicare is the United States health insurance plan for citizens over the age of 65 and some others with certain health conditions. It covers many, but not all, of the costs of health care for these populations.
- Medicare is health insurance for most U.S. residents 65 and over or with certain health conditions.
- There are several different types of coverage, and the costs vary depending on the plan you choose and the number of years you paid Medicare taxes.
- Most seniors will want to purchase Medicare Advantage or Medigap coverage to supplement the limited coverage that Original Medicare offers.
- Medicare should not be confused with Medicaid, which is a health care assistance program for certain U.S. residents.
Health care costs become increasingly significant with age or with certain health problems. These situations often coincide with an inability to work and earn income, so Medicare is an important part of long-term care plans for many Americans. Learn more about the basics of Medicare and how you qualify.
Medicare is the U.S. federal health insurance program for people aged 65 and older, and taxpayers fund it. Every working American pays a portion of their income in Medicare taxes. In 2021, the withholding rate for Medicare is 1.45% (2.9% if you’re self-employed). If you pay these taxes for at least 40 quarters (10 years), you’ll receive basic Medicare coverage for free when you reach age 65.
If you are within three months of turning 65, you can apply for Medicare. Your basic Medicare options come in four types: Parts A, B, C, and D. Part C is also known as Medicare Advantage. Each part covers different items and comes with different costs. Original Medicare (Parts A and B) does not cover all your health care expenses, so most retirees will want additional coverage in the form of a Medicare Supplement policy or Medicare Advantage plan, as well as some form of long-term care insurance.
Medicare does not cover the costs of every single service or prescription. It’s important to understand what’s automatically covered and what services require additional paid coverage.
Basic Medicare coverage starts with Parts A and B.
- Part A is referred to as hospital insurance. This is free for most people because they spent their working years paying into Medicare. If you paid Medicare taxes for 39 quarters or less, you’ll have to pay a premium for Part A.
- Part B is referred to as medical insurance. It covers additional services and supplies needed to treat medical conditions as well as some preventative services. You must pay a monthly premium for Part B.
Medicare Parts A and B comprise what is referred to as Original Medicare. Expect Original Medicare to cover a moderate portion of your total health care expenses—primarily medically necessary services and preventative services. To find out if a service is covered, you can use the coverage check feature on the Medicare website.
With Original Medicare, as with most other insurance plans, you still have deductibles, copays, coinsurance expenses, and prescription costs. That’s where Medicare Parts C and D come in to offer additional coverage you can purchase.
- Part C is called a Medicare Advantage Plan or Medicare Health Plan. It is private insurance that provides coverage in a single plan that includes Medicare Parts A and B, and may also include prescription drug coverage (Part D). Medicare Advantage plans may also include extra covered services such as vision, dental, and hearing. Some of these plans may cost less than other options if you do not have frequent medical needs.
- Part D refers to prescription drug coverage that you can add to your basic Medicare Part A and B benefits.
When enrolling in Medicare you will have to decide if you want Original Medicare or a Medicare Advantage Plan. You’ll need to consider your location, budget, lifestyle, and care providers when making this decision.
Are You Eligible for Medicare?
Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States.
If you are not 65, you might also qualify for coverage if you have a disability or with End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).
Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:
- You already get retirement benefits from Social Security or the Railroad Retirement Board.
- You are eligible to get Social Security or Railroad benefits but have not yet filed for them.
- You or your spouse had Medicare-covered government employment.
If you are under 65, you can get Part A without having to pay premiums if:
- You have received Social Security or Railroad Retirement
- Board disability benefit for 24 months. You are a kidney dialysis or kidney transplant patient.
While you don’t have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you don’t get any of the above payments, Medicare sends you a bill for your Part B premium every 3 months.
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Ashford Insurance is an independent health insurance agency specializing in Texas Medicare insurance and has been helping seniors since 2005. Ashford Insurance is here to help you understand Medicare and health insurance in simple, plain terms that anyone can grasp. We specialize in assisting folks who are Medicare eligible to learn about the coverage options available through the Medicare Health Insurance Program.
Ashford Insurance Agents
Here is a partial list of the products offered by Ashford Insurance
M-T 9:00 – 4:00
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Weekends & Evenings by Appointment
1245 Southridge Court Suite 101, Hurst, TX, 76053
* A licensed sales agent may call or e-mail as a result of completing the information to discuss Medicare Advantage, Prescription Drug Plans or Medicare Supplement Insurance.
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Medicare, a vital federal health insurance program for seniors, plays a crucial role in providing healthcare coverage to millions of Americans aged 65 and older. While Original Medicare (Medicare Part A and Part B) offers comprehensive coverage, many beneficiaries wonder why the program can be associated with substantial costs. In this blog post, we will delve into the factors that contribute to the expenses associated with straight Medicare and shed light on the complexities of healthcare pricing within the system.