The Beginner’s Guide to Medicare
If you’re approaching the age of 65, you may soon qualify for Medicare. Medicare coverage is a specific type of health insurance offered by the government, typically reserved for people 65 or older and those younger than 65 with disabilities and certain diseases. In this quick guide, we’ll cover eligibility, what Medicare covers, costs, and how to apply.
Who is Eligible for Medicare?
Seniors 65 years or older are typically eligible for Medicare coverage. If you’re younger than 65, you have to meet certain conditions for Medicare eligibility. Some examples include:
- Disability
- End-Stage Renal Disease
- ALS
What Medicare Covers
Medicare has various parts which provide coverage for different things. Here’s an outline of what Medicare covers:
- Part A: Through Medicare Part A, you get hospital insurance which covers any care you get while in the hospital, as well as hospice care, home care, and nursing facility care.
- Part B: As part of Medicare Part B, you get medical insurance which covers doctor’s appointments, medical equipment, outpatient care, prevention services, as well as home health care.
- Part C: Medicare Part C refers to Medicare Advantage plans. These plans typically bundle Parts A, B, and D and are offeredby private insurance companies that are approved by Medicare.
- Part D: In this case, think of the “D” in Part D as drug coverage. So if you have any prescriptions or need updated vaccines, you’d be covered with Part D.
What’s considered “original Medicare” has Part A and Part B, with the option to add Part D by enrolling in a specific prescription drug plan (PDP).
You can also get Part C which is called Medicare Advantage and bundles the various parts together. Typically under this option, you get Part A, Part B, and typically Part D as well. Through Medicare Advantage, you get coverage through a private company that is approved by Medicare.
INsite:
Once you apply for Social Security benefits, it’ll kickstart your application for Medicare as well. If eligible and approved, you’ll get Part A automatically.
How Much Does Medicare Cost?
A common question people have is “How much does Medicare cost?” The answer isn’t so straightforward, as it depends on a range of factors.
Medicare Part A is typically no cost if you paid Medicare taxes throughout your working career. You will pay a premium for medical insurance through Medicare Part B. Starting in 2024, the premium is $174.70 per month. However, you may pay higher premiums based on your income and tax filing status.
To pay the standard amount, individual taxpayers and those who are married and file separately must have an income of $103,000 or less (your income from 2 years prior is used). If your tax filing status is married filing jointly, your income must be $206,000 or less.
Once your income goes beyond that level, your premiums will increase. The increases are tiered based on earnings. For example, an individual earning above $103,000 up to $129,000 will pay a premium of $244.60 per month in 2024.
The costs of Medicare Part C and Medicare Part D will depend on the plan you choose. If you have a limited income, you may be eligible for help to offset costs.
Help With Your Debt
How to Apply for Medicare
There are some cases where you might get Medicare automatically. Once you apply for Social Security benefits, it’ll kickstart your application for Medicare as well. If eligible and approved, you’ll get Part A automatically.
If you haven’t started the process, here’s how to apply for Medicare:
- Gather materials. You’ll need your Social Security Number (SSN), birth location, and health insurance information. For Medicare Part B, you’ll need an email address and a Medicare Number.
- Apply online. When you apply for Social Security, you’ll be able to sign up for Medicare Part A and Medicare Part B. Your Medicare Part B premiums will automatically be deducted from your Social Security check.
- Get more coverage. If you want Medicare Part C and Part D, you can sign up on Medicare.gov.
If you don’t want to apply online, you can call +1 800-772-1213. After your application is complete, you can check the status through your online account.
Medicare vs. Medicaid
If you’re thinking of government health insurance, you might confuse Medicare with Medicaid. Though the two programs have some similarities, they’re different. When comparing Medicare vs. Medicaid, the main difference is who is eligible.
Both are types of health insurance coverage. Medicare is designed for people 65 and older, while Medicaid is a program that offers health coverage to those with limited income and resources.
If you forget which one is which, consider the fact that “aid” is part of Medicaid. So when you compare Medicare vs. Medicaid, you know that the latter is the one that offers “aid” to those who need it.
Advantage and Supplement Information
When considering Medicare eligibility and your options you may come across Medicare Advantage and supplement information.
As noted above, Medicare Advantage Plans are referred to as Part C. This option bundles the different parts of Medicare and offers extra benefits and may have lower costs than Original Medicare.
There’s also something called Medigap, also known as Medicare Supplement, which is a policy that supplements your Original Medicare Policy. If you’re reviewing Medicare Advantage vs. a supplemental policy with Medigap, you must choose one or the other.
How Medicare Advantage plans work is quite different from Medigap, so it’s important to know the differences. Medicare Advantage replaces Original Medicare, while Medigap is in addition to your Original Medicare policy.
The Bottom Line
If you’re approaching retirement age, you’ll want to look into your health insurance options. At 65 and beyond you can get Medicare. When applying for Medicare, make sure you understand the different parts you’re getting, what your coverage includes, total costs, and consider any supplemental coverage that you may need to stay protected.
