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Medicare Basics That You Should Consider
How Do I Know If I’m Eligible for Medicare?
If you are 65 or older and eligible for Medicare plans and benefits, we welcome you to our site. You qualify for Medicare if you are:
- a U.S. citizen or a permanent legal resident, and
- You or your spouse have worked in the Social Security system at least 10 years
If you are under the age of 65 and have certain health conditions, you may also be eligible for Medicare plans. You may qualify for Medicare under Social Security disability rules if you:
- Have been totally and permanently disabled for at least 24 months and entitled to Social Security benefits
- Have a specific disabling condition such as ALS or renal failure.
When is the Best Time to Enroll for Medicare Part A and Part B?
Any person eligible for Medicare can enroll in Medicare Parts A, B, C, D and a Medicare Supplement. The best time to enroll your Medicare plans and Medicare Supplement:
- 3-months prior to your 65th birthday
- If you are age 65 and no longer working, you should at minimum enroll in Medicare Part A and Part B.
- If you are still working, you may delay enrollment in Part B if your employer health plan is primary.
3 Surprising Things Medicare Won’t Tell You
There are 3 things Medicare won’t tell you when you first sign up . . . or never. Don’t let these things catch you off guard OR cost you money! You can prepare and plan ahead, but only if you know what to expect.
#1 Medicare Doesn’t Pay for Everything
You may or may not be shock by this but the truth is, Medicare is not an “all you can eat” health care buffet. Medicare pays for some things, but you have to pay the rest.
Most seniors (if they worked in the Social Security system long enough) will get Medicare Part A at no charge.
You have to pay for Part B to cover doctor visits, lab work, scans, physical therapy, chemotherapy, radiation therapy, dialysis and other outpatient services.
Now this is where your out of pocket costs come in. Not only will you pay a monthly or quarterly premium for Medicare Part B, but you will also have to pay deductibles and coinsurance. Medicare actually pays about 80% of your medical bills, and you pay the rest.
Medicare also doesn’t cover:
- routine eye exams
- routine dental work
- hearing aids or hearing exams
- custodial care
- outpatient prescription drugs
#2 The Free Plans Aren’t Really Free
There are low to $0 premium plans available, but what you may not realize is those plans can cost you dearly. Often at the time you need good coverage the most.
These “low cost” or “free” plans can be heavily restricted and you could be slapped with pretty severe financial penalties if you end up at the wrong out of network doctor or hospital.
In the end, cheaper doesn’t always save you money.
#3 Some Doctors Don’t Like Medicare
Let’s face it, though most doctors love what they do – they want to get paid. And they don’t want to get paid less to see some patients. And getting paid less for the same service is exactly what happens with some Medicare Advantage plans.
In fact, the number of doctors that actually see patients with Medicare Advantage plans are down by at least half.
So how do you still get the best care by the best doctors?
Instead of relying on the Advantage plans, you have the right to enroll in a Medicare Supplement policy, also known as Medigap. These plans allow you to see any doctor and go to any hospital.
So What Can I Do to Protect My Health?
The first thing you can do to protect your health is to get informed. Unfortunately, Medicare can leave you feeling like you need a Ph.D. to understand all of it.
Even if you’re familiar with insurance in the past, most of the process and regulations don’t apply with Medicare. They truly have their own terminology and way of doing things. Therefore, navigating the Medicare system is not a DIY project.
Original Medicare is challenging enough. Add in the different parts (including Part D), supplement plans (usually called Medigap), Advantage plans and all the rest and you have a web of confusion.
Click here to find out what plans you qualify for and how to get the simple tools you need to get started with Medicare.
Our number one goal is to make sure you get the best possible care at the best possible price!
by Wilson Group Financial
121 South Orange Avenue, Ste. 1500
Orlando, FL 32801
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