Medicare is health insurance for people 65 years old and older, those under 65 suffering from certain disabilities and those of any age with End-Stage Renal Disease (ESRD).
Most of the time, Medicare gives enough coverage for your health care needs-if you read your Medicare handbook thoroughly, you’ll know this. Hospital insurance, medical insurance and prescription drug coverage are the benefits that you can expect with Medicare. Most of the time, problems with Medicare crop up when beneficiaries don’t have a complete understanding of how the system works.
To prevent that and so you can get the most of your Medicare, follow these guidelines:
1. Get Medicare coverage above everything else. You are eligible for coverage under Medicare Part A and B if you have paid Medicare taxes while you were still working and are receiving benefits from Social Security upon your retirement. If you don’t have Social Security, you can still purchase coverage although you will be subject to monthly premiums for Part A. The cost of buying Part A coverage for 2011 is $450. Part B premium per month for those whose annual incomes are $85,000 or less is $115.40, getting higher the higher your annual income becomes.
2. Be certain to get the coverage that’s right for you. You can select to be covered by Original Medicare or get Medicare Advantage Plans provided by HMOs or PPOs. Part A and B comprise the Original Medicare Plan and you can stick with this if you feel it’s enough for your health care needs. For a more comprehensive coverage, you can opt for a Medicare Advantage Plan. However, be informed that these HMO plans have their own prices, premiums and rules so you have to thoroughly understand these provisions. HMOs will only cover services and treatment you get from their own network of providers. Like any insurance policy, read the fine print of any HMO policy before purchasing one.
3. Part B enrollment is not automatic so you will have to sign up for it. You can delay enrollment in certain cases, such as when you are covered by employer insurance if you or your spouse is still working. But as soon as you or your spouse stops working, you should make it a point to enroll. If you don’t enroll in Part B, you will experience gaps in your Medicare coverage. You may also be subject to late enrollment penalties.
4. Sign up for Part D or a Prescription Drug Plan, especially if you are on prescription medication. Prescription Drug Plans are usually bundled with Medicare Advantage plans so there’s no need for it when you have HMO or PPO policies tied with Medicare. In selecting a drug plan, understand the quantity limits, the premiums and deductibles and if it covers the drugs you are currently taking.
5. Appeal if you are denied coverage. There are cases when Medicare or an HMO will deny you coverage you think you should be entitled to. In such cases, you can appeal the decision.
Last but not least, don’t forget to check out this awesome site about senior insurance and this article about life insurance for seniors.