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The Benefits of Medicare

The Benefits of Medicare

The older you get, the more important it is to have access to affordable healthcare. Medicare helps pay for some of those expenses for people who are eligible. There are over 55 million Americans who rely on Medicare for their health care coverage.  And each year, there are 10,000 people turning 65 years old, becoming eligible for Medicare.

What is Medicare?

Medicare is a federal health insurance program. Those who are 65 years or older, are under 65 with certain long-term disabilities, or are any age with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant) may be able to enroll in Medicare.  For those turning 65 your enrollment period lasts for seven months.  It begins three months before your birthday month, includes the month you turn 65 and ends 3 months after your birthday month.   Medicare is similar to Social Security because they are both entitlement programs. In order to be eligible to receive Medicare Part B, you must have worked and paid taxes for at least 10 years. If you delay electing Part B, you may have to pay a higher premium for Part B at a later time.

People who are covered by Medicare are referred to as beneficiaries. Medicare won’t pay for all of the health care costs, but it will help pay for most of it (about 80%). Medicare is made up of four parts: A, B, C, and D.

Medicare Part A

Medicare Part A is hospital insurance. It covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. This also includes everything that is included in the hospital service, including meals, drugs, and other services.

Part A doesn’t usually require a monthly premium if you paid Medicare taxes for a certain amount of time, but there is a yearly deductible.

Medicare Part B

Medicare Part B is medical insurance. Certain doctors’ services, outpatient care, medical supplies, and preventive services are covered under this plan.

The average monthly premium costs around $134. However, if you pay your premiums directly through Social Security, you might pay a little less due to cost-of-living adjustments. Medicare Part A and Part B are often referred to as “original” Medicare because this is what most Americans over 65 will be covered by.

Medicare Part C

Part C,  also known as Medicare Advantage, is offered by private companies that work with Medicare to provide you with both Part A and Part B benefits and typically Part D as well.

Medicare Part D

Part D includes prescription drug coverage. This is an add-on to original Medicare, Parts A and B. This plan is also offered by insurance companies and other private companies.

Medicare Savings Program

If you fall below a certain income level, you can join a Medicare Savings Program. There are 4 different kinds of Medicare Savings Programs, Qualified Medicare Beneficiary (QMB) Program, Specified Low-Income Medicare Beneficiary (SLMB) Program, Qualifying Individual (QI) Program, and Qualified Disabled and Working Individuals (QDWI) Program.

In order to be eligible, you must receive Medicare, have a very small income, and must not own or pay for any items over a certain value. If you qualify for any of the programs, the state will help you pay your Medicare premiums. This could help you save around 100 dollars a month and even more. Your Medicare Part A and Medicare Part B deductibles, coinsurance, and copayments may also be covered if you meet certain conditions.

How can I sign up?

If you are already collecting Social Security benefits, you will be enrolled in Medicare automatically on the first day of the month you turn 65 years old. However, you will need to apply if you are not receiving Social Security benefits. The enrollment period only lasts for 7 months. Medicare is mandatory for those who are 65 and collecting Social Security.

Signing up for Medicare is simple and takes under 10 minutes to apply. Your application will be processed by Social Security.  You can enroll in Medicare Part A or Part B in the following ways:

  1. Online at SocialSecurity.gov
  2. By calling Social Security at 1-800-772-1213
  3. In-person at your local Social Security office.

Once you’ve been approved, you will receive your Medicare card in the mail. While Social Security helps with enrollment, the Centers for Medicare and Medicaid Services (CMS) manage Medicare.

If you don’t want to enroll in Medicare, you will need to repay your Social Security benefits. If you aren’t collecting Social Security, you are able to delay enrolling in Medicare penalty-free under certain conditions.

Gonzaba Medical Group

For more information about Open Enrollment, call Gonzaba Medical Group. We have English and Spanish-speaking staffs to help answer your questions. Our staff can direct you to resources that can answer questions you may have regarding Medicare plans.  Call 210-921-6680 to speak to a representative today!