Medicare Facts

Margaret Adams

Medicare is the health insurance offered by the Federal Government to all Americans once they reach the age of 65.

As with most programs offered by the government, there are a lot of complicated things you have to understand in order to sign up for coverage.

One of the first things one must know is when you should sign up for Medicare. You should sign up for Medicare 3 months before you turn 65 or 3 months after you turn 65.

The Social Security Administration will send out a Medicare card and sign-up information 3 months before you turn 65. If you are working when you turn 65 and are covered by your employer, or if you are covered by your spouse’s insurance you should still sign up for Medicare Part A and Part B. If you miss this enrollment period, you can end up paying a penalty for as long as you did not have Medicare coverage. There is a Special Enrollment period if you miss the initial enrollment period. If you have questions contact Social Security at 1-800-772-1213 or Ohio Senior Health Insurance Information Program (OSGIIP) at 1-800-686-1578.

Below is a quick summary of the types of Medicare coverage:

*Part A covers basic hospital visits and services, some home health care, hospice, and skilled nursing services.

*Part B is standard health insurance coverage and covers doctor and specialist visits.  It carries a premium base rate of $144.60 per month for 2020, estimated to be $153 in 2021.

*Part C is known as Medicare Advantage and is an alternative to B.  It is provided by private insurance companies and people must sign up on their own if they choose this coverage. There are premiums that have to be paid and the cost can vary by company, and where you live. Most of these plans include a prescription drug option. Choosing this option requires you to know your health status, what medications you take, and who your providers are. Part C Medicare Advantage coverage is why seniors are receiving calls and mailers from insurance providers asking people to choose them. It is the coverage people should take their time with and ask for help before making a decision. Keep in mind the people calling you are salespeople.

*Part D is the Medicare prescription drug coverage. Seniors need to know what medications they are taking, the cost of the medication, whether or not they are required to use generic or the brand name, what their deductible amount is (the amount they must pay before coverage kicks in), what their co-pay dollar amount is, and the price of ordering medication through the mail versus going to a local pharmacy.

Medicare doesn’t cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Some cover dental  during inpatient care.

The above is just a quick overview to help you have a better understanding of Medicare. Please note, if you are satisfied with your current coverage you usually do not have to do anything to continue with your coverage unless instructed by your provider.

If you need assistance with the cost of coverage contact Medicare at 1-800-633-4227.  More information can also be obtained online at the websites for the Social Security Administration, Medicare, and AARP.



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