Understanding The Medicare Basics

Because the federal government makes changes every year, many people find it difficult to understand Medicare. Is it something you need? What does it cover? How much does it cost? When and how can you sign up? Although there are thousands of questions associated with the program, most of the answers are simple.

When can I sign up for Medicare?

Believe it or not, you do not have to be just 65 or older to qualify for Medicare. Those who are under the age of 65 can also sign up. However, those who are under the age of 65 must be disabled. People of any age with the end-stage renal disease also qualify for Medicare.

How Do I Sign Up?

If you receive Social Security or Railroad Retirement benefits, you will automatically receive parts A and B of Medicare on the first day of the month you turn 65. Those who are 65 and disabled will be automatically enrolled in the program after receiving Social Security or Railroad Retirement Board disability benefits after 24 months. You will then get your Medicare card 3 months before your 65th birthday, or on the 25th month of being disabled in the mail.

For those who are not already receiving Social Security or Railroad Retirement benefits, you must sign up. You can do this by contacting Social Security or the Railroad Retirement board. Those with end-stage renal disease should also contact social security to sign up for benefits.

What Does Medicare Cover?

Medicare is divided into 4 parts: A, B, C, and D. This allows you to pick and chose which coverages are best for you. Keep in mind, that if you deny any of these coverages without another form of health insurance, you may be subjected to a penalty or have to wait to sign up for that specific type of coverage.

Part A is hospital coverage. It will help cover inpatient hospital services, skilled nursing care, home health care, and hospice care.

Part B is medical or doctor coverage. It will help cover physicians’ costs as well as durable medical supplies, lab tests, preventative care, and rehabilitation therapy. Part B may also help cover diabetes supplies.

Part C consists of Medicare Advantage plans. Private insurance companies provide these plans. Most combine the benefits of Part A, Part B, and sometimes Part D into one package. An alternative to Medicare Advantage plans is Medicare Supplements.

Part D is prescription drug coverage. The type of prescription drug plans vary from state to state, but it will help cover the costs of your prescriptions, insulin supplies, and some vaccinations. Part D plans are offered through private insurance companies, or you can get one through a Medicare Advantage plan that offers it.

How Much Will My Medicare Benefits Cost?

Like other health insurance coverage, you are subjected to pay a variety of copayments, premiums, deductibles, and coinsurance. Each part of Medicare has different costs associated with it.

There are no premiums for Part A as long as you paid enough into Medicare taxes when you were working. The rest of the costs depend on what type of services you receive. For instance, if you are admitted into the hospital, you have to satisfy a $1,184 deductible for each benefit period in 2013. Once that deductible is satisfied, you will not pay anything for the first 60 days in the hospital. If you stay in the hospital for 61 to 90 days, you will have to pay $296 per day per benefit period. From day 91 to 150, you will have to pay $592 a day. After you pass that, you are responsible for all costs associated with your hospital stay. Keep in mind there are also daily charges for skilled nursing care and home health care as well.

Most people will pay $104.90 each month as a premium for Part B coverage. Some people pay higher premiums depending on their income level. This amount is deducted from your social security benefits. There is also a yearly deductible of $147 in 2013. For most of the services under part B, you will pay 20% coinsurance.

What you pay for Part C will vary from plan to plan. Some plans do not cost anything. Others can cost hundreds of dollars. The same applies to your Part D coverage.

Learning about Medicare can be a daunting task. Choosing the right coverage can be just as overwhelming too. You may have more questions or concerns about Medicare that were not covered here. If so, there are plenty of other resources available. Medicare.gov is the official government website for those who are interested in learning about the program online. You can also speak to someone who works at Medicare by phone. The number to reach them is 1-877-486-2048.