Medicare 101

What Is Medicare?

Medicare is health insurance for people who are age 65 or older, under 65 with certain disabilities, or any age with End-stage Renal Disease (permanent kidney failure).

Types of Medicare

There are four types of Medicare. Medicare Part A helps cover inpatient care in hospitals, skilled nursing facilities, and hospice and home health care. Generally, there is no monthly premium if you qualify and pay Medicare taxes while working.

Medicare Part B helps cover medical services like doctors’ services, outpatient care, and other medically necessary services that Part A doesn’t cover. You need to enroll in Medicare Part B and pay a monthly premium determined by your income, along with a deductible.

Many people also purchase a supplemental insurance policy, such as a Medigap plan, to handle any Part A and B coverage gaps.

Medicare Advantage Plans, also known as Medicare Part C, are combination plans managed by private insurance companies approved by Medicare. They typically are a combination of Part A, Part B, and sometimes Part D coverage, but must cover medically necessary services. These plans have the discretion to assign their own copays, deductibles, and coinsurance.

Medicare Part D is prescription drug coverage and is available to everyone with Medicare. It is a separate plan provided by private Medicare-approved companies, and you must pay a monthly premium.

Getting Started

Applying for Medicare is a complicated and lengthy process. You should start your research when you turn 64. Medicare sends you an informational brochure about three months before you’re entitled to Medicare coverage. Your enrollment period is three months before your 65th birthday and ends four months after your 65th birthday.

Coordination of Coverage

If you have Medicare and another type of insurance, the question of who should pay or who should pay first can be tricky. For example, generally, a group health plan would pay before Medicare, but there are several exceptions.

Contact RCB & Associates for specific answers to your situation. We represent several carriers and can guide you to your best coverage and give you an accurate sign-up, for no extra charge!