Most people become eligible for Medicare health insurance coverage once turning 65 years old, but until that time looms close, many people don’t know much about it. Whether you are inching toward retirement, your parents will soon turn 65, or you want to understand it for far future reference, it is never too early to start learning about this benefit.
While it isn’t difficult to understand, some find it difficult to determine where and how to dig into the subject.
Here are three pro tips to understanding Medicare coverage.
1. Learn Who Is Eligible
Turning 65 is a core requirement for Medicare eligibility, but there are some other considerations for qualification:
- You are a U.S. citizen or a permanent legal resident who has lived in the United States for at least five years
- You are receiving Social Security or Railroad Retirement benefits or have worked long enough to be eligible for those benefits but are not yet collecting them
- You or your spouse is a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes while working
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You must fit one or more of these eligibility requirements to obtain Medicare Part A, Part B, Part C or Part D. Younger people with certain disabilities or anyone with permanent kidney failure also qualify for Medicare coverage.
2. Get to Know More About Original Medicare
Original Medicare includes the core parts of Medicare, which are Part A for hospital insurance and Part B for medical insurance. If you need or want to add drug coverage, you can join a separate plan known as Part D for prescription drug coverage. If you do not want to pay out-of-pocket costs, such as your 20% coinsurance payment per physician visit, you can seek and buy supplemental insurance coverage. As many as 9 out of 10 physicians across the U.S. accept Medicare, according to the Kaiser Family Foundation, and you are welcome to choose your doctor from that massive list.
3. Explore Bundling Options
Medicare Part C, also known as a Medicare Advantage plan, offers policyholders an “all-in-one” bundling option, which includes Part A, Part B and Part D. Private insurance companies provide Part C plans for the Medicare system and policyholders.
The benefits in this part of the Medicare Advantage plan include:
- Often offer lower out-of-pocket costs than Original Medicare
- Includes routine vision care including contacts and eyeglasses
- Provides coverage for health and wellness pursuits that include fitness classes and gym memberships
- Allows for hearing checkups and hearing aids
- Offers prescription drug coverage without having to go out-of-pocket since Part D comes with the all-in-one package
Dental benefits are included in Medicare Advantage plans — including coverage for cleanings, x-rays and dentures — but standard dental care can also be added as a supplemental dental package to another Medicare plan if you decide a Medicare Advantage plan isn’t right for you. One of the few minor downsides to choosing Medicare Advantage is that you need to choose providers in the Medicare-approved network to make sure the package works seamlessly.
Learn more about the advantages and disadvantages of Medicare Advantage plans on Health.com.
Personalizing Your Medicare Coverage
With these tips, you can make a better decision for your retirement health insurance plan. Learning the eligibility requirements is just the beginning. Once you start exploring the various parts of Original Medicare and Medicare Advantage, you will have some big decisions to make.
