7 Tips to Get the Most Out of Medicare
Few things in life are as important as maintaining good health, especially in the later years of life. For seniors, Medicare is the best solution to the challenge of rising healthcare expenses and the economics of retirement. However, to get the most from a healthcare plan, you must first navigate through the Medicare maze. By following these simple tips, you’ll ensure your health and welll-being.
Know How Medicare Works
Medicare Part B pays for part or all outpatient fees associated with preventive and medically necessary healthcare. Healthcare providers bill Medicare directly for costs incurred during the course of treatment, though individuals are still responsible for making co-payments. Whether you need a psychiatrist, cardiologist or other outpatient provider, Medicare covers the majority of costs in most cases. Choosing Medicare providers may reduce the costs associated with co-payments.
Educate Yourself about Medicare
Medicare is a national health insurance program administered by the federal government. Medicare was originally created for citizens or permanent residents of the United States age 65 or older. Medicare consists of Parts A, B, C, and D.
Be Aware of Your Enrollment Period
You can sign up for Medicare during the enrollment period. The enrollment period consists of the three months before, the month of, and the three months after your 65th birthday.
Know the Eligibility Requirements
You are eligible for Medicare Part A if you:
- Worked for a minimum of 10 years
- Paid Social Security taxes
- Receive Social Security benefits
- Receive railroad retirement benefits
- Paid FICA taxes
- Are disabled
You will automatically be enrolled in Medicare if you receive Social Security. If you do not, you can enroll on your own online through Medicare.gov or at a Social Security branch office. Check to see if you have one in your area.
Know the Definition of the Parts That Make up the Whole
When you become eligible for Medicare, you should enroll in Medicare Part A as soon as possible because it has no premium. You should sign up for Part B either when you turn 65 or when you or your spouse stops working, whichever comes later.
To enroll in Part C, which is referred to as the Medicare Advantage plan, you must:
- Live in the plan service area
- Be entitled to Medicare Part A
- Be enrolled in Medicare Part B
- Not have end-stage renal disease
Unless you’re covered under a retirement drug plan, signing up for Medicare Part D may be a wise decision. Before making any changes to existing prescription drug coverage, check with your provider to ensure selection of the best plan.
If you’re not prescribed medication for a chronic condition and are relatively healthy, don’t make the mistake of thinking prescription drug coverage is unnecessary. With the unpredictability of illness and accidents, it’s best to ensure you’re covered when needed. Otherwise, expect a 1% penalty for each month not enrolled in Part D.
What Does Medicare Cover?
Medicare provides basic coverage for the cost of healthcare, but it does not cover all medical expenses or the cost of most long-term care. In addition to monthly premiums for Medicare, you are responsible for other “out-of-pocket” costs for services. Out-of-pocket expenses are the amounts you must pay when you receive care; this includes deductibles and co-insurance.
Consult Your Physician or Healthcare Provider
Consult your physician or healthcare provider to find out if they accept Medicare patients, because some do not. Physicians who opt out of Medicare will not be able to bill Medicare for your treatment leaving you responsible for payment. Fortunately, the solution is easy. Browse Medicare.gov’s physician database to find a Medicare provider in your area.
Sources:
http://www.consumerreports.org/cro/2012/09/managing-medicare/index.htm
http://www.mibcn.com/pdf/bcna2013/making-the-most-of-medicare.pdf
http://www.patientadvocate.org/requests/publications/Clear-View-Medicare.pdf
http://www.medicare.gov/Pubs/pdf/11386.pdf
http://blog.aarp.org/2011/12/19/how-to-get-the-most-out-of-your-medicare/
http://www.dailyfinance.com/2011/08/03/how-to-make-the-most-of-medicare/
http://www.maforagents.com/carriers/united_snp/Marketing_Enrollment/Getting_the_most_out_of_Medicare-Evercare.pdf
http://www.sbhis.net/blog/how-to-get-the-most-out-of-your-medicare-advantage-plan/
http://www.medicare.gov/
Category: Medicare Facts, Tips, and Tricks
