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The Basics of Medicare Coverage

9 Questions about Medicare Coverage

When it comes to Medicare coverage, there are a lot of misconceptions. Who is eligible to use it? What health events does it actually covers? We want to make sure that you get the best information so that you can get connected to the health care products you need quickly and easily. Medicare can reduce or even eliminate some of your monthly health care costs.

#1 Who is Medicare for?

Medicare is primarily health insurance for people aged 65 and older. People under the age of 65 may also be eligible for Medicare based on a disability or qualifying medical condition. Medicare does have a list of disabilities and medical conditions they cover that is available on their website or via their customer service department. Have a question about your eligibility? Use Medicare’s eligibility calculator.

#2 Where and when should I enroll in Medicare?

Your initial enrollment window begins 3 months before your birth month and lasts for 3 months after your birth month. During this window, you can enroll in Medicare online at www.ssa.gov/medicare or you can visit your local Social Security office to apply in person. If you miss your initial enrollment period and you do not have other creditable health coverage such as employer coverage, you will have to wait until the next General Enrollment Period to apply and you will be subject to late penalties.

#3 Is Medicare widely accepted?

Medicare Parts A and B are the most widely accepted insurance plans in the United States. That means that you can visit just about any doctor or hospital and be confident that your insurance will be accepted. Recent changes in Medicare law concerning parts A and B have made it possible to participate in preventive health care services without a copayment or coinsurance. This includes services like immunizations, mammograms, and a colonoscopy. You can also use Medicare to cover items like CPAP, catheters, adult diapers, power scooters and wheelchairs, and other durable medical equipment.

#4 How much does Original Medicare Cost?

Most people pay nothing for Part A as long as they or a spouse have worked at least 40 quarters here in the U.S.  Part B has a monthly premium based on your household gross income. It may go up a little each year. Visit the Medicare website to estimate your Part B premiums.

#5 Should I wait until the end of COBRA coverage to enroll in Medicare?

It is advisable to enroll in Medicare no later than your 8th month of COBRA coverage. Doing so will help you to avoid substantial penalties and gaps in coverage.

#6 Am I obligated to only use Medicare for medical coverage?

Many people who are still working at age 65 delay their enrollment into Medicare Parts A and/or B.  Medicare can coordinate with your employer coverage to reduce your out of pocket spending. However, the size of your employer determines whether Medicare is primary or secondary. it is best to speak with your plan advisor before determining which parts of Medicare you should enroll in now or delay until later.

#7 Does Medicare cover long-term care?

In short, Medicare does not cover long-term care. What patients receive is limited access to a skilled nursing facility and access to certain home care benefits. This benefit is for people who will be recovering. If qualified, you can use the nursing facility benefit for up to 100 days. Medicare pays for the first 20 days. On days 21 – 100, you will pay a daily co-pay.

#8 What is Medicare Part D?

Medicare Part D is a voluntary prescription drug program. It helps to purchase retail prescription drugs at reduced prices. Although it is not mandatory, there are late penalties if you enroll later on and did not have any other creditable drug coverage.

#9 What are my options to cover the gaps in Medicare?

You can enroll in either a Medigap policy or a Medicare Advantage plan to help you pay for the things that Medicare does not cover. This includes things like your hospital and outpatient deductibles, copays and coinsurance. Seek out a reputable Medicare insurance broker or you can contact Medicare itself for guidance at 1-800-MEDICARE.Medicare coverage facts

Medicare is a great benefit to those who find that they are eligible to use it. Medicare coverage can help reduce or eliminate certain medical expenses that can occur all at once or on a monthly basis. Some examples of a one-time cost can include an item like a power wheelchair or scooter. An example of a monthly recurring expense can be items like adult diapers. Aeroflow is happy to work with you to connect your benefits to the items you need to live your life.

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