5 Things You Need to Know About Medicare

Updated on November 4, 2019

Medicare is a point of contention for many who are getting closer to retirement age and trying to understand the ins and outs of the program. What does it cost? What’s covered and what isn’t? When can you enroll in the program?

To completely comprehend Medicare, it’s worth discussing the program with an expert. Fortunately, you can get a better overall understanding of the answers to some frequently asked questions about this program. Here are five things you need to know about Medicare.

The Different Parts of Medicare

There are different coverage parts in Medicare that you may wish to pursue when looking at coverage options. Part A covers hospital services. Part A coverage is free to those who have paid Medicare taxes for a decade or can be acquired for a monthly fee if not. Part B covers physician services and has a monthly fee attached. Part D covers prescription medication for a moderate monthly fee as well.

Part C of Medicare is offered through private insurance in partnership with the Medicare program. This part of Medicare is also known as Medicare Advantage and provides Part A, B, and D.

Open Enrollment Period

The Medicare open enrollment period is a span of time ranging from October 15th to December 7th, during which you can make changes to your coverage without paying a penalty or experiencing delays.

This approach to managing the program simplifies the process for all. Rather than having workers field changes throughout the year, there is a specified period where administrative duties are focused on this practice. This reduces clerical errors and keeps costs low. A similar approach is taken with workplace insurance programs. There are other enrollment periods with specific limitations and situational considerations throughout the year, but fees are often attached.

More Preventative Services

One of the main perks of Medicare is the addition of more preventative medicinal service coverage options than other coverage programs. This includes advance screening and checkups, in addition to a personalized preventative plan. As health issues and risk factors escalate as people age, regular screening for things like prostate cancer, breast cancer, and cardiovascular diseases are essential.

Medicare also covers proactive treatment measures that benefit the immunocompromised aging generation, including the annual flu shot. Rather than focusing on treating issues after they’re discovered, Medicare prioritizes early detection.

No Custodial Care Coverage

While Medicare does cover a lot of different screening programs and treatment plans, it does not provide custodial care coverage to assist with the limitations brought on by aging, nor does it cover “specialty” healthcare. To clarify, Medicare will not cover in-home healthcare or assisted living fees, whether that includes a facility or someone to assist with daily activities. There are a few exceptions to the rule if an emergency situation arises.

In terms of specialty healthcare, Medicare doesn’t cover dental visits or dentures, optometry visits or glasses, nor hearing tests and hearing aids. To receive coverage for these visits and items, you must have additional coverage through Medicaid or private insurance.

Income Threshold

Medicare costs are scaled to reflect the income of the person covered. That means, if you make more money you will pay more for Medicare Parts B and D. If someone is past the threshold – whether it be the single person threshold or family amount – they will be charged a surcharge on their premiums.

As of 2018, single people making more than $85,000 annually or couples with an income of more than $170,000 when filing together will receive this surcharge. The range of the surcharge is usually a couple hundred dollars monthly depending on the adjusted gross income.

Medicare can be confusing to figure out when looking at the whole program. By learning about the various moving parts and how everything works, then focusing on the information pertinent to your needs, you can simplify Medicare and ensure you have the coverage you need.

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