Medicare is a public health program funded by the federal government that is designed to provide health coverage to individuals who are 65 years of age or older.
Medicare also provides coverage to those under 65 years of age who are receiving Social Security Disability or Railroad Retirement benefits as a result of becoming disabled.
Qualifying health conditions fast track a person’s ability to receive coverage under the Medicare program, which are end-stage kidney failure or ALS, and people with either of these health conditions can qualify for Medicare at any age.
If you find that you or a loved one in your family qualify for Medicare, there are five things you must know to ensure that you or your loved one can make the most of your coverage and have a positive experience.
1. You Do Not Contact Medicare to Apply for the Program
Most insurance companies require that you contact them directly to obtain insurance coverage. This is not the case for Medicare, however.
To sign up for Medicare, you do so through the Social Security Administration or the Railroad Retirement Board.
You need to sign up through the Social Security Administration or Railroad Retirement Board because these agencies will determine your eligibility for Medicare.
The agency you sign up for Medicare through will depend on your situation. If you have spent most of your career working on the United States railroads, then you will sign up through the Railroad Retirement Board.
All other individuals will sign up through the Social Security Administration.
2. Medicare Will Not Cover Everything
Some people believe that Medicare provides coverage for everything. The surprise comes when Medicare enrollees and their families learn that coverage gaps exist.
Medicare coverage gaps are mostly relevant to the aging population, and these gaps include nursing home care, hearing aids, podiatry, vision, and dentures.
To fill in these coverage gaps, many enrollees purchase Medicare Advantage plans, also referred to as Medicare Part C coverage.
Medicare Advantage plans are designed to fill in coverage gaps by increasing coverage to meet a variety of healthcare needs.
When enrolling in Medicare, individuals must choose whether they desire to have coverage under the traditional Medicare plan or a Medicare Advantage plan. Medicare Advantage plans must cover all the traditional Medicare covers and fill in coverage gaps.
Many Medicare Advantage plan options are available, but the availability of plans will depend on an individual’s location.
For instance, if you or your loved ones reside in a rural community, you will have fewer plan options compared to if you are in a larger city.
It’s important to know that you are not limited to one type of insurance plan. It’s always important to have multiple levels of insurance coverage for many facets of life.
It’s important to look into how being a primary insured customer has many benefits that you may not have known about as well.
3. You Still Have to Pay Premiums When on Medicare
What comes as a surprise to many is that Medicare enrollees must pay monthly premiums. Premiums are usually automatically deducted from Social Security or Railroad Retirement benefits. Individuals who are low-income can receive help paying their premiums.
4. Some Medicare Recipients Purchase Secondary Insurance Policies
Many Medicare recipients choose to purchase secondary insurance policies, also known as Medigap policies, to cover out-of-pocket expenses when they develop a serious health problem or encounter a serious medical emergency.
Medicare coverage is limited, and there is no cap on what a user pays out of pocket to cover medical expenses.
Medigap plans are increasing in popularity because Medicare enrollees want to make sure they are prepared for any serious catastrophe that may come their way, so they do not suffer financial ruin.
5. Medicare and Medicaid Are Not the Same Things
Many people ask, “Are Medicare and Medicaid the same thing?” The fact of the matter is that Medicare and Medicaid are two different programs with different qualifications.
Medicare provides coverage to people no matter their income if they meet the qualifications for being covered under the program. Medicaid provides health coverage to those who are low-income. Some disabled individuals can get on Medicaid if they are receiving Supplemental Security Income and do not have enough work credits.
The more you know about Medicare, the more you can make informed choices about your coverage to ensure that your healthcare needs are met and that you are prepared for the future.
You can also help your loved ones make informed decisions that will help them to be prepared to cope with any potential health crisis.