Medicare is health insurance for people 65 years old and older, those under 65 suffering from certain disabilities and those of any age with End-Stage Renal Disease (ESRD).
If you get to learn about the extensive benefits that Medicare offers, you will find that it gives you sufficient coverage for your health needs. In a nutshell, it provides for hospital insurance, medical insurance and prescription drug coverage. Problems with Medicare often crop up because of a lack of thorough understanding about the system.
Here are ways to avoid that and guidelines to follow so you can optimize your Medicare coverage.
1. Be sure to obtain Medicare coverage in the first place. If you are currently receiving Social Security benefits, that means you have paid Medicare taxes and are eligible for Medicare Part A and B the moment you turn 65. If you don't have Social Security, you can still enroll in Original Medicare so you can get health insurance although you will have to pay the needed premiums. The cost of premiums each month if you should purchase Part A coverage on your own is $450. Part B premiums depend on how much your annual income is-for those earning $85,000 or less annually, the premium is $115.40 per month.
2. Get the right coverage. You can select to enroll under an Original Medicare or Medicare Advantage Plans which you can get from HMOs or PPOs. If you feel that Original Medicare will suffice for your health care needs, then that's fine. A more thorough coverage can be provided by a Medicare Advantage Plan, also known as Plan C, under HMOs or PPOs. However, these types of HMO policies also have their own pricing, premiums and policies, so make sure that you figure these in your monthly budget. They have their own governing rules as well so certain exclusions and limitations on the providers you can go to for care also vary with each HMO. Thus, it's important to know the specifics of a specific policy before locking yourself into one.
3. Part B enrollment is not automatic so you will have to sign up for it. You can delay enrollment in certain cases, such as when you are covered by employer insurance if you or your spouse is still working. But as soon as you or your spouse stops working, you should make it a point to enroll. If you don't enroll in Part B, you will experience gaps in your Medicare coverage. You may also be subject to late enrollment penalties.
4. Sign up for Part D or a Prescription Drug Plan, especially if you are on prescription medication. Prescription Drug Plans are usually bundled with Medicare Advantage plans so there's no need for it when you have HMO or PPO policies tied with Medicare. In selecting a drug plan, understand the quantity limits, the premiums and deductibles and if it covers the drugs you are currently taking.
5. You have the right of appeal. There are times when Medicare or the HMO or PPO will not cover procedures or services you feel you should be entitled to. In that case, you can always appeal the decision.
If you get to learn about the extensive benefits that Medicare offers, you will find that it gives you sufficient coverage for your health needs. In a nutshell, it provides for hospital insurance, medical insurance and prescription drug coverage. Problems with Medicare often crop up because of a lack of thorough understanding about the system.
Here are ways to avoid that and guidelines to follow so you can optimize your Medicare coverage.
1. Be sure to obtain Medicare coverage in the first place. If you are currently receiving Social Security benefits, that means you have paid Medicare taxes and are eligible for Medicare Part A and B the moment you turn 65. If you don't have Social Security, you can still enroll in Original Medicare so you can get health insurance although you will have to pay the needed premiums. The cost of premiums each month if you should purchase Part A coverage on your own is $450. Part B premiums depend on how much your annual income is-for those earning $85,000 or less annually, the premium is $115.40 per month.
2. Get the right coverage. You can select to enroll under an Original Medicare or Medicare Advantage Plans which you can get from HMOs or PPOs. If you feel that Original Medicare will suffice for your health care needs, then that's fine. A more thorough coverage can be provided by a Medicare Advantage Plan, also known as Plan C, under HMOs or PPOs. However, these types of HMO policies also have their own pricing, premiums and policies, so make sure that you figure these in your monthly budget. They have their own governing rules as well so certain exclusions and limitations on the providers you can go to for care also vary with each HMO. Thus, it's important to know the specifics of a specific policy before locking yourself into one.
3. Part B enrollment is not automatic so you will have to sign up for it. You can delay enrollment in certain cases, such as when you are covered by employer insurance if you or your spouse is still working. But as soon as you or your spouse stops working, you should make it a point to enroll. If you don't enroll in Part B, you will experience gaps in your Medicare coverage. You may also be subject to late enrollment penalties.
4. Sign up for Part D or a Prescription Drug Plan, especially if you are on prescription medication. Prescription Drug Plans are usually bundled with Medicare Advantage plans so there's no need for it when you have HMO or PPO policies tied with Medicare. In selecting a drug plan, understand the quantity limits, the premiums and deductibles and if it covers the drugs you are currently taking.
5. You have the right of appeal. There are times when Medicare or the HMO or PPO will not cover procedures or services you feel you should be entitled to. In that case, you can always appeal the decision.
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Last but not least, don't forget to check out this helpful web site about seniors insurance and this article about senior care insurance.
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