Medicare is a term that most of us have heard and typically associate with senior health care.  It is also something that can be difficult to discern without considerable research and explanations.  One way to make the most out of your Medicare benefits is to learn more about the program and how it works. While it is not possible to explain every aspect of this complicated program, here are some basic facts which may help shed light on Medicare coverage and how it may apply to you:

Who Qualifies for Medicare?

Medicare is typically available to anyone who is 65 years old in the United States.  The program can also be used for social security disability recipients who have qualified for 24 months of social security disability benefits. 

When Will My Coverage Start?

When you first become eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B of Medicare. Typically, Medicare coverage starts on the first day of the month of your birthday (unless your birthday is on the first of the month) if you sign up for Parts A and B and during the first three months of your enrollment period.  However, different factors can affect your eligibility and enrollment period.

Medicare Parts A and B

Medicare Part A is for your hospital coverage and generally pays for your care there and in skilled nursing environments.  Medicare Part B is for routine medical care such as doctor office visits, labs, routine diagnostic tests, and necessary medical equipment.  

Medicare Part C

Medicare Part C or Medicare Advantage Plans are health insurance plans which are offered which through private insurance companies and have been approved by Medicare.  These plans are available for purchase by individuals who are enrolled in Medicare Parts A and B.  Part C plans are designed to cover expenses which Parts A and B do not include such as co-payments, deductibles, and co-insurance.  Having and paying for Part C coverage does not negate your responsibility to continue paying your Part B premium. 

Medicare Part D

Medicare Part D refers to optional prescription drug coverage This is insurance you can purchase which typically allows you to buy your medications at lower prices.   Part D premiums must be paid in addition to your Part B premium.

Medicare Costs

Ordinarily, recipients do not have to pay a monthly premium for Medicare Part A  provided the individual or their spouse paid Medicare taxes for a certain amount of time while working. You will make a premium payment each month for Medicare Part B which, as of this writing, is $135 per month and will be $135.50 in 2019.  The costs for Medicare Parts C and D vary according to what the chosen insurance company charges. 

Medicare is a complex system with numerous rules and requirements which can be challenging to negotiate.  Talking with an experienced Medicare attorney can help you assess your eligibility and determine the steps you need to benefit from the program.  We understand the Medicare program and can provide you with the advice you need to start and remain eligible. Please contact us online or by phone if we may be of assistance.

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